Prescription opioids are used to manage chronic pain but more people are misusing the drugs.
?Misuse of powerful opioid prescription painkillers has surged in the past three years, prompting one of the country’s leading medical groups to call for a reduction in the number of scripts handed out.
According to the latest National Drug Strategy Household Survey report, the misuse of opioid painkillers increased from 4.8 per cent of the Australian population in 2010, to 7.7 per cent in 2013.
The Royal Australasian College of Physicians wants more education for doctors about how chronic pain is treated and a re-evaluation of other treatments to reduce “inappropriate” prescriptions.
RACP president Nick Talley? said a multi-discipline approach was often the best way to treat chronic pain, which could include physical exercise, psychological assessment, diet or rehabilitation.
“There are many ways to tackle this problem head on, but the approach needs to be collaborative to be effective,” he said.
Opioids, which are a depressant used to reduce chronic pain, are one of the most over-prescribed pain medications in Australia, Professor Talley said, and can lead to addiction.
“I think it is now accepted that these drugs have caused significant public health problems, including overdose, and we now need to reign in the problem by cautious prescribing.”
Figures released by the state coroner in May revealed that fatal prescription drug overdoses had reached record levels, with 314 deaths investigated by the coroner, or 42 per cent, ascribed to prescription drugs.
Simon Holliday, chairman of the pain management network at the Royal Australian College of General Practitioners, said people have a right to be pain-free but admitted balancing needs and potential dangers was a difficult issue. However, he believed that there was room for GPs to be trained in how to identify problematic behaviours in patients and basic psychotherapies as an alternative.
“There is an increasing number of people needing acute pain management and medication helps them get on with their lives and live a quality life,” he said.
“This is a very contested and complex area but most people using opioids are doing alright; they’re not addicted and they’re managing their pain,” he said.
At the International Medicine in Addiction conference held in March this year, it was revealed that opioids were the second most common prescription drugs involved in deaths, at 48.4 per cent. Benzodiazepines are the most common.
Overseas, the United States Food and Drug Administration recently finished a study that concluded there was no adequate or well-controlled studies of opioid use longer than 12 weeks.
RACP Chapter of Addiction Medicine President Dr Matthew Frei? said that while long-acting potent opioids were widely used for chronic back or other mechanical pain, the evidence of its long term benefit in non-cancer pain was limited.
“Doctors need to plan treatment carefully prior to considering prescribing strong opioids. In the case of non-cancer pain, once pharmaceutical opioid addiction develops, it becomes very hard to manage,” Dr Frei said.
“There needs to be a clear message that these medications are for short-term use, as an adjunct to physical and psychological therapies.