Patients being overdosed on painkillers after surgery
by Sue Dunlevy
19th Nov 2019 6:02 AM
EXCLUSIVE
Patients will be urged to quiz hospital doctors about whether they really need codeine and other opioids after surgery in a bid to slash the death toll from the highly addictive pills.
A new patient guide to managing pain and opioid medicines will be released this week by
Choosing Wisely Australia, an initiative of NPS MedicineWise, in partnership with health professionals and associations.
The guide will be given to patients being discharged from hospital.
Panadeine and other over the counter opioids became prescription only in 2018 as fears grew
the drugs were killing more than 800 Australians a year and that we could soon face an opioid addiction crisis like that in the US.
Recent studies have found Australian patients are still being routinely discharged from hospitals with large packs of the drugs even though they don't need them.
Even when they do need the drugs, patients are not being warned they could be addictive and are not given a management plan to wean themselves off the medicines after a few weeks.
Monash University research found 50,000 of the 1.9 million Australian patients prescribed the addictive drugs every year end up becoming long-term users.
And US research found patients actually needed much lower opioid amounts after surgery than doctors thought they did.
NPS MedicineWise CEO Adjunct Associate Professor Steve Morris said: "With statistics showing three lives are lost, 150 people are hospitalised and 14 people present to emergency departments every day due to harm caused by pharmaceutical opioids, we need to ensure more information is available to people at the point these medicines are prescribed".
Pain Australia CEO Carol Bennett said it was "about time" people had access to help with managing pain medication.
"A lot of people don't recognise opioids are dependence inducing and giving people a sense of the seriousness of taking these medications is important," Ms Bennett said.
The new guide, developed in consultation with the Queensland Clinical and the Society of Hospital Pharmacists (SHPA) instructs patients before they leave hospital to ask their doctor five key questions:
* What is causing the pain?
* What are the risks and benefits of this medicine? Opioids reduce pain - they won't take the pain away completely. Any benefit needs to be weighed against potential harms. Opioids have major side effects, including the possibility of dependence and overdose.
* How long should I take this medicine? Opioids should only be used for the shortest time and at the lowest dose possible. Discuss with your doctor or pharmacist when you can lower your dose or stop the medicine altogether.
* Are there other ways to manage the pain? There are lots of effective and safer ways to manage pain, such as building activity slowly, gentle exercises and relaxation. Most people need to use a combination of strategies.
* What is my pain management plan? Work with your health professional to develop a plan that works for you.
The guide also gives patients advice on other ways they can manage their pain.
THE BEST WAYS TO MANAGE PAIN
* Build activity slowly
* Physiotherapy, yoga or other gentle exercises
* Massage
* Heat or cold pack
* Relaxation, Mindfulness, Distraction, Cognitive behavioural therapy (CBT)
* Stop smoking, Healthy eating, Reduce alcohol, Better sleep habits, Stay socially active
* Pain medicines - Paracetamol, Anti-inflammatory medicine, Opioids
HOW PATIENTS CAN GET ADDICTED
Seven years ago, 55-year-old Doug Wright, from the Gold Coast, survived a head on collision but suffered major trauma that led to him having is right leg amputated this year.
Mr Wright's pelvis split in half as a result of the accident, his hips, knees and ankles were broken and he needed multiple surgeries and spent four months in hospital in 2012.
"I was taking three Endone tablets four times a day and a fairly hefty dose of Panadol," he told News Corp.
The mining industry employee was never given any advice about getting off the high-dose opioids but decided himself he needed to cease the drugs after he saw fellow patients become addicted.
"I'm surprised now I wasn't given a plan to get off them," he said.
"I think giving patients a list of questions to ask their doctor is a good idea, I probably didn't ask enough questions," he said.