The Courier-Mail

Ex­er­cise to make the pain go away

- JACKIE SINNERTON

DOC­TORS are be­ing urged to treat pa­tients’ chronic pain with diet and ex­er­cise in a bid to curb the grow­ing mis­use of painkiller­s.

The Royal Aus­tralasian Col­lege of Physi­cians is call­ing for a re­think on the pre­scrib­ing of opi­oid med­i­ca­tions such as codeine, oxy­codone and mor­phine.

New ev­i­dence sug­gests opi­oid painkiller­s do not work ef­fec­tively for long-term pain yet are the most over­pre­scribed med­i­ca­tion in the coun­try.

The latest Na­tional Drug Strat­egy House­hold Sur­vey re­port high­lights that the mis­use of painkiller­s in­creased from 4.8 per cent of the Aus­tralian pop­u­la­tion in 2010 to 7.7 per cent in 2013.

Ad­dic­tion spe­cial­ists are treat­ing soar­ing num­bers of peo­ple ad­dicted to pre­scrip­tion and over-the-counter painkiller­s, with many swal­low­ing more than 100 tablets such as codeine-ibupro­fen each day.

“I think it is now ac­cepted that these drugs have caused sig­nif­i­cant public health prob­lems, in­clud­ing over­dose, and we now need to rein in the prob­lem by cau­tious pre­scrib­ing,” RACP pres­i­dent Nick Tal­ley said.

Pro­fes­sor Tal­ley said re­search now showed that pain was pro­duced in the brain and not di­rectly at the site of an in­jury, and this new un­der­stand­ing of pain re­quired a man­age­ment plan which could in­clude phys­i­cal ex­er­cise, psy­cho­log­i­cal as­sess­ment, diet or re­ha­bil­i­ta­tion.

Opi­oid med­i­ca­tions should be for short-term use only as an ad­junct to phys­i­cal and psy­cho­log­i­cal ther­a­pies, he said.

“There are many ways to tackle this prob­lem head on, but the ap­proach needs to be col­lab­o­ra­tive to be ef­fec­tive,” Prof Tal­ley said.

“Ev­ery­one has a role, in­clud­ing the med­i­cal pro­fes­sion, the gov­ern­ment and of course in­di­vid­u­als and fam­i­lies.

“Ac­cess to treat­ment from an ad­dic­tion medicine spe­cial­ist ser­vice is es­sen­tial for peo­ple with prob­lem phar­ma­ceu­ti­cal opi­oid use.”

RACP Chap­ter of Ad­dic­tion Medicine pres­i­dent Matthew Frei said while long-act­ing po­tent opi­oids were widely used for chronic back or other me­chan­i­cal pain, the ev­i­dence for their long-term ben­e­fit in non-can­cer pain was lim­ited.

“Doc­tors need to plan treat­ment care­fully prior to con­sid­er­ing pre­scrib­ing strong opi­oids,” Dr Frei said.

“In the case of non-can­cer pain, once phar­ma­ceu­ti­cal opi­oid ad­dic­tion de­vel­ops, it be­comes very hard to man­age.”

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