Better education and monitoring should reduce harm from opiods

| March 15, 2018

Painaustralia is calling for better education and awareness around opioid use for pain management, in light of evidence of significant harms and increasing use of opioids for chronic non-cancer pain.

The health pressure group’s submission to the Therapeutic Goods Administration consultation paper on options for a regulatory response to opioid use and misuse in Australia calls for better understanding of quality use of medicines and best-practice pain management for both prescribers and consumers, as part of a national pain strategy.

Prescribers need to be equipped with tools to deliver best-practice pain medicine, which should be part of core training and Continuing Professional Development, and consumers need the knowledge to seek out the best pain management options for their individual situation.

“Issues of opioid reliance and misuse in relation to pain are complex and can only be resolved when the wider problem of inadequate access to best-practice pain management is addressed,” says Painaustralia CEO Carol Bennett.

“There is a particular need to provide rural communities with improved pain services and this should be a priority area. Our 2018-19 Pre-Budget Submission outlines options to facilitate this.”

Despite opioids being generally ineffective for treating chronic non-cancer pain, with potential for over-reliance and addiction, they are prescribed by GPs in more than 7 in 10 cases of multisite pain management in Australia.

The latest general practice data on opioid prescribing found rates have increased significantly in recent years, jumping from 3.8 per 100 encounters in 2000-01 to 5.6 per 100 in 2010-11.

The ATLAS of Healthcare Variation 2015 found that opioid dispensing rates where higher in regional areas than in major cities.

People who do use opioids for their long-term pain condition can experience judgement from the community and medical practitioners, and we believe any opioid response should include actions that would help remove this stigma.

“When it comes to opioids for chronic pain, we need to strike a balance between safety and quality of life considerations,” said Ms Bennett in a post launching the submission.

The consultation invites suggestions from stakeholders on ways to control the prescribing of opioids in Australia and reduce the toll of  overdoses, hospitalisations and deaths which have caused an epidemic of harm in the USA.

Painaustralia uses the opportunity to call for a national and holistic strategy to prevent, treat and manage pain as a ‘national health emergency’. It claims the issue extends beyond the remit of the Therapeutic Goods Administration and requires a cross-portfolio and multi-level government response.

As well as better understanding of medicine use and best practice pain management, treatment and support for both prescribers and consumers, it argues that resources and programs are required to address stigma and educate society.

While encouraged by the strong emphasis on education and the harmonisation of regulatory approaches with clinical guidelines in the consultation paper. Painaustralia warns of possible unintended consequences for consumers and those working in pain medicine.

There is little evidence supporting the long-term effectiveness of opioid analgesics in people experiencing chronic non- cancer pain, and the pressure group backs the implementation of a real time prescription monitoring system to reduce harm.