Exercise to make the pain go away
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.”