Policy for management of people with chronic non malignant pain
The Royal Australasian College of Physicians (RACP), in collaboration with the colleges of Anaesthetists and Psychiatrists, is finalising a policy for improving the management of people with chronic non-malignant pain and opioid drug dependence, the RACP Annual Congress in Adelaide has been told..
Speaking at the Congress, chair of the RACP’s Addiction Policy Committee, Dr Nicholas Lintzeris, said the use of opioid medications in Australia and NZ had been steadily rising in recent years.
“Whilst this is not necessarily problematic, there is mounting evidence that there has also been an increase in harms associated with the use of these medications,” he said.
“The experience from the United States, where there has been similar increases in the use of opioid medications, is cause for concern, and the management of opioid prescribing for chronic non-malignant pain has become a major public health issue in the United States. In recent years in the United States, the numbers of deaths from drug overdose due to pain relieving medications has increased rapidly. Also, opioids are now the most common drug used for injecting.”
To prevent the problems now occurring in the USA from developing in Australia and New Zealand, the College is developing a broad range of policy recommendations, in collaboration with other health professional and community organisations.
Key recommendations include:
• the establishment of a national advisory committee to review and develop the options for improving the management of people with chronic non-malignant pain and management of opioid dependence.
• improved training and greater compliance of medical practitioners with clinical guidelines for the management of chronic non-malignant pain.
• the development of a national system for monitoring the prescription of drugs of dependence (including opioid medications such as morphine, oxycodone, pethidine) for the treatment of chronic non- malignant pain which would be web based, confidential and real time. This would enable doctors and pharmacists to better monitor their patients, as well as public health officials to better monitor the overall use of these medications.
• improving the availability and quality of methadone and buprenorphine treatment of heroin dependence, in order to reduce the demand for black market opioids.
“The College endorses the principle that patients with complex and difficult chronic non-malignant pain conditions are better managed when they are treated by a team of health professionals,” Dr Lintzeris said.
“This team should include general practitioners, specialists in pain and addiction medicine, pharmacists, counselling and family support groups.
“There is much Australia and New Zealand can learn from what has happened in the United States to ensure that people with chronic non-malignant pain and drug dependence have adequate management and to reduce opioids reaching the black market.
“This will enhance patient care, improve safety of individuals in the community, and ultimately reduce health costs for the community.”
The Draft Policy is open for review and the College welcomes submissions from health professionals and community groups. The draft policy can be viewed at the College’s website www.racp.edu.au
