This article was shared by Chronic Pain Australia, the consumer voice for Australian’s living with chronic pain, as part of National Pain Week.
It quotes the President of Chronic Pain Australia, Nicolette Ellis, an advanced practice pharmacist, discussing the results of the National Pain Survey and the case of Dean Colling who experiences pain on a daily basis from a back injury.
This article makes it clear that Dean’s pain is not well managed, and when he asked for strong pain relief he is treated like an addict.
“At times, when his pain worsens, Dean seeks stronger forms of relief. ‘When I suggest opioid patches, the response is always, “no, I’ll give you anti-inflammatories or Lyrica,” he said.
It doesn’t help when Dean explains his prior experiences with pregabalin. ‘By that point, you’re an arguing drug addict and your appointment is over.’ “
It also highlights that pregabalin, and other medicines, have been over-used and prescribed off-label to replace opioids, resulting in unmanaged pain, and horrific side effects.
While Dean now relies on medicinal cannabis to manage his chronic pain, cannabis is also not a replacement for opioids for severe, daily pain. Sourced through pharmacies in QLD, he says medicinal cannabis costs $1000 per month, and does not manage his pain.
When his pain worsens and he asks for opioid pain medicines, he is give pregbalin, or an anti-inflammatory. Both of which are ineffective for his pain, and come with potentially serious side effects.
When Dean explains his prior experiences with pregabalin:
‘By that point, you’re an arguing drug addict and your appointment is over…
When doctors and pharmacists see a ‘bloke walk in with a crook back and a walking stick’ looking for pain relief, they immediately register it as drug seeking behaviour.”
Dean is not alone. Back pain is particularly maligned, but many types of chronic secondary pain are dismissed, and the people living with painful, progressive disease are treated as drug seekers. Many have been force tapered off their opioid pain medications and given alterntatives that are ineffective and have worse side effects.
The National Pain Survey bore this out. One in five people were forced to reduce their opioids and forced to take anti-depressants, gapapentinoids, and anti-inflammatories instead, even when not appropriate or effective for their pain condition. Anti-depressants and gabapentinoids have a range of side effects, including inducing suicidal ideation.
This, when there is now plenty of evidence that opioids are safe and effective long term, for some patients.
Ms Ellis states:
“I’ve had patients on opioid medications where we have validated the effectiveness and they’ve been stable on those medications for a period of time.”
“When opioid tapering is enforced or patents feel abandoned, this can lead to a significant risk of suicidal thoughts or self-harm”
It doesn’t take a genius to connect the dots – the mass opioid tapering that commenced post June 2020 has led to serious harms for patients living with severe, daily pain. These harms include unmanaged pain, suicidal ideation and death.
The evidence is clear. Opioid force tapering needs to stop. Previously effective doses need to be reinstated, so that people can life functional lives.
Another point raised is that people find it difficult to be physically active. Not surprising. NO ONE can be physically active when they are living with severe, daily pain. Provide pain relief and people will be active. They will get out of their houses, they will cease to be isolated and abandoned. These people had active lives until their pain medications were taken away.
The last few years opioids have been demonized and people have been forced tapered to their great harm. The evidence is in, this was a dreadful mistake. A mistake previously made in the US, that Australia SHOULD have learned from. The US is now softening policies and making opioid pain medications more accessible. Australia needs to follow suit.
We need multidisciplinary care INCLUDING opioids where appropriate, for those with the most severe pain. Opioids are a treatment of last resort, but they are an essential treatment, and its time to end this horrible experiment, playing with people’s lives.
There are NO alternatives to opioids for severe pain.
How many more people who are living with severe, daily pain, most often chronic secondary pain, have to suffer and die? Tapering opioids is not practicing evidence-based medicine. It is not practising ‘medicine’ at all.