Opioid Reforms

Opioid reforms announced by Federal Minister Greg Hunt MP on 1 June  see smaller quantities, changes to the ‘indications’ that will be funded, and changes to the authority process required for opioids to be subsidised. MR Paracetamol will also be up scheduled to an over the counter pharmacy product.

These regulatory changes will impact the prescribing of opioids as well as access to Modified Release Paracetamol for the management of pain. They form part of a broader suite of measures intended to support appropriate use of opioids and other pain medications including education and awareness campaigns, changes to clinical guidelines and ongoing prescription and compliance monitoring.

These reforms are the culmination of years of sector wide consultation as well as research and growing evidence of harm related to an over-reliance on medications to manage what are often complex and chronic conditions.

A new report by the Australian Institute of Health and Welfare released earlier this month shows that more than half of the people living with chronic pain (57%) were dispensed analgesics, compared with 1 in 5 (21%) people without chronic pain. The report found that people with chronic pain are almost 3 times as likely to be dispensed opioids and other analgesics and migraine medication as those without pain.

While the new changes will promote more appropriate treatment for the over 3.37 million people living with chronic pain, they also acknowledge that medicines remain a viable option for the long-term treatment of chronic pain for many Australians.

Importantly, the regulatory changes will not lead to a ban on prescribing opioids to any category of patient if it is considered to be clinically appropriate, which is a vital measure as research now also shows us that we may cause more harm than good if people are not appropriately supported through the tapering process.

These measures were intended to align with broader Australian Government initiatives to improve appropriate pain management, particularly the National Strategic Action Plan for Pain Management. This strategic plan, which is still before the Council of Australian Governments, if endorsed,will address the need for improved access to pain support and treatment in areas of need.

Painaustralia will continue to work with the Federal Government to inform these ongoing reforms and to ensure that these measures carefully support and maintain the safe and clinically appropriate use of opioids without restricting prescribers from accessing them for their patients when needed.

Painaustralia has released a new consumer factsheet that addresses the changes.

New Opioid Information videos for consumers

NPS MedicineWise and the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists (ANZCA) have developed a new video that provides information to people who may be considering taking opioids for chronic (ongoing) non-cancer pain.

The video aims to help people make an informed decision in partnership with their doctor about whether to start taking an opioid medicine for chronic (ongoing) non-cancer pain.

Painaustralia’s Consumer Advisory Group members were an integral part of the development of this video, right from the script to the animation. This inserts the critical perspective of consumers into this resource, ensuring it is well targeted and responsive to consumer needs.

The video highlights that while opioids can reduce the sensation of pain, they may also produce unwanted side effects, ranging from constipation to dangerous slowing down of a person’s breathing.

Faculty of Pain Medicine: Better Pain Prescribing

The Therapeutic Goods Administration (TGA) recently initiated a campaign to further improve prescribing decision-making processes and foster the safer use of opioids. Endorsed by leading pain, addiction and palliative care experts across Australia from the Opioid Regulatory Advisory Group (ORAG), this important campaign seeks to drive awareness of and educate healthcare professionals around regulatory changes and measures that will help reduce opioid-related harm.

The Faculty of Pain Medicine (ANZCA) has partnered with the TGA, developing a targeted better pain management and safe opioid therapy eLearning program for primary care providers involved in managing those with chronic pain.

Available at no cost to health care professionals residing in Australia, this course will help develop greater clarity and confidence with six key eLearning modules dedicated to best-practice opioids prescribing and pain management techniques. Targeted educational content developed by specialist FPM clinicians includes essential clinical tools, doctor/patient videos and individual case studies that will:

• Show prescribers how to develop sustainable techniques that help achieve genuine and clinically-responsible patient outcomes for those experiencing chronic pain
• Demonstrate how to further improve results with the use of alternative treatment options that provide clear pain management choices
• Provide prescribers with non-pharmacological therapies that make a real difference in reducing opioid dependence, whilst optimising non-opioid medicines
• Reveal risk-assessment tools that will assist in recognising complex pain management needs critical for use prior to commencing opioid therapy.

More information on the new modules can be found here.

Rural peak bodies, the Rural Doctors Association of Australia (RDAA) and the Australian College of Rural and Remote Medicine (ACRRM) also joining with the ANZCA FPM and providing access to online education to increase the clinical knowledge of rural doctors in relation to pain management. There has been a great deal of interest in further education on pain management among their members More information can be found here.