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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