7 May 2019

The Royal Australasian College of Physicians (RACP) will gather in Auckland today to discuss the need to adopt a multidisciplinary, evidence-based approach to pain management in order to address the opioid epidemic occurring in New Zealand and abroad.

RACP President, Associate Professor Mark Lane, said “We already know that opioid addiction here in New Zealand and across the world is a serious problem that is taking lives.

“While opioid medicines are effective for managing acute pain, cancer pain and pain in palliative care, opioids are increasingly being used outside these indications, leading to misuse, abuse overdosing and potentially fatal overdose.”

“Between 2011 and 2015, twice as many people died from overdoses associated with a prescribed opioid medicine as from an overdose of heroin, highlighting the serious risks associated with the misuse of the prescription opioid medication.”

“In order to tackle the opioid crisis, we as physicians need to change the way we practice by engaging with new, evidence based models of pain management. 

“This shift requires us to engage in a multidisciplinary model of thinking – rather than just using the traditional medical model of a pain ladder whereby doctors prescribe stronger medication for higher pain levels.

“Chronic pain management needs to be addressed in a way that incorporates disciplines across the health sectors in order to truly move away from a dependence on opioids for chronic pain management.”

In 2018, the RACP provided feedback on the Therapeutic Goods Administration consultation paper: Prescription strong (Schedule 8) opioid use and misuse in Australia – options for a regulatory response and put forward a series of recommendations:

• Establish a national integrated real-time prescription monitoring system
• Improve access to advice from pain and addiction specialists for primary care practitioners
• Implement a national approach to educate and train medical students, hospital medical officers and GPs to better recognise, prevent and manage drug dependence
• Methadone and buprenorphine treatment needs to be more affordable and available for patients with opioid use disorder
• Improve access and affordability of Naloxone, an opiate reversal agent
• As part of the Evolve initiative, both the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) and the Australasian and New Zealand Association (ANZAN) of Neurologists have also put forward a number of recommendations in relation to opioids:
• Don’t use opioids for the treatment of migraine, except in rare circumstances (ANZAN top 5 low value practices and interventions)
• Do not prescribe opioids for the treatment of acute or chronic pain without assessing the patient’s clinical condition, potential side effects, alternative analgesic options, work status and capacity to perform safety-critical activities such as driving a motor vehicle (AFOEM top 5 low value practices and interventions)

Click here to view the program for RACP’s Annual Congress.