Submissions and Policy Updates

University of Sydney IMPLORE Trial through the Consumer Advisory Group

Painaustralia and our Consumer Advisory Group have been working with the University of Sydney on the IMPLementing an Opioid stewardship intervention to REduce opioid use (IMPLORE) trial.

Back pain and osteoarthritis are the two leading causes of opioid prescription and use in Australia and worldwide. However opioid medicines provide limited benefit and have an established profile of harms when used for these conditions.

An opioid stewardship intervention is needed for people commencing (or have recently commenced) opioid analgesics for their back pain or OA as unfortunately these conditions commonly end up being managed with ongoing opioid therapy. Previously, opioid reduction strategies have targeted patients who have been using opioids for an extended period of time, often years. However limited success has been demonstrated in this context, and management is widely regarded as complex. This highlights the urgent need for early intervention in order to reduce opioid use and transition to persistent use.

The trial will therefore enrol participants who present to the community pharmacy with a new prescription for an opioid analgesic to treat their back pain or knee/hip OA.

Painaustralia and our CAG will work with the research team to provide consumer insights that inform this project.

Chronic Pain Project- How to adapt your consumer pain program during the COVID-19 period

Painaustralia is a member of the Steering Group for Improving the Prevention and Management of Chronic Pain in Primary Care and recently participated in the Australian Prevention Partnership Centre session on how to adapt your consumer pain program during the COVID-19 period. The session aimed to provide PHNs and their commissioned providers of face-to-face consumer pain programs an opportunity to learn from two examples of how programs have been adapted to alternative formats during the COVID-19 restrictions.

Professor Michael Nicholas outlined his Adaptation of the Brief Pain Self-Management (BPSM) program as well as some tips and challenges and Joyce McSwan outlined her adaptation of the of the Turning Pain into Gain (TPIG) program.

Read more about the Australian Prevention Partnership Centre in this month’s guest article.

Upcoming Consultation: TGA Proposed rescheduling of cannabidiol (CBD)

The TGA is currently consulting on a proposal to create a new Schedule 3 (Pharmacist Only Medicine) entry for cannabidiol (CBD) at doses up to 60 mg/day or less. 

A safety review conducted by the TGA established that low doses of CBD may have possible clinical utility when used via the oral route in the management of some conditions that do not require medical practitioner oversight. See the report at Review on the safety of low dose cannabidiol. The evidence in the report establishes that CBD has an acceptable safety and tolerability profile at the proposed dose.

In Australia, CBD is currently a Schedule 4 substance and therefore only available with a prescription. The access controls on CBD in Australia are notably more restrictive than comparable regulations in other countries. CBD is available as an over the counter product (for products without medicinal claims) in the UK and some US states.  It is proposed that down-scheduling to Schedule 3 is more appropriate than Schedule 2, as pharmacist advice is necessary to mitigate safety risks associated with CBD's high potential for drug-drug interactions when used concomitantly with many other commonly prescribed drugs that are metabolised via CYP pathways. Schedule 3 requires that both Product Information and Consumer Medicine Information is available to reinforce and/or expand on the safe use of CBD. While consumers can identify the ailments or symptoms that may be treated by the medicine, counselling and verification by a pharmacist is required before use to identify potential drug-drug interactions.

Painaustralia will be providing a submission to this consultation. Please provide your comments via email to admin@painaustralia.org.au by 15 May 2020.