Authored by the Australian Commission on Safety and Quality in Health Care with medical journalist Nicole MacKee
Breaking the opioid habit Efforts underway to tackle inappropriate prescribing
Dr Jennifer Stevens, anaesthetist and pain specialist at Sydney’s St Vincent’s Hospital Campus
The multitude of harms associated with opioids are well known to clinicians, but many continue to prescribe these drugs for chronic pain in the belief that the benefits outweigh these risks, a leading pain specialist says. ‘We are super aware of the harms — the constipation, the depression, the tolerance,’ says Dr Jennifer Stevens, anaesthetist and pain specialist at Sydney’s St Vincent’s Hospital Campus. ‘But many clinicians still think there is an upside to opioids and it’s worth taking those risks.’ In managing chronic non-cancer pain, however, this couldn’t be further from the truth,
Dr Chris Hayes, Pain Medicine Physician at John Hunter Hospital, NSW
The evidence is in Dr Chris Hayes, Pain Medicine Physician at John Hunter Hospital, NSW, says while opioids retain a role in the management of acute pain, cancer pain and palliative care, three 2018 studies (here, here and here) have strengthened the evidence that opioids are ineffective for chronic non-cancer pain. Speaking for the Australian Commission on Safety and Quality in Health Care’s Better Care Everywhere webinar series, Dr Hayes says there is a large variation in opioid prescriptions dispensed that is ‘unrelated to the patients themselves and more related to the prescriber and their beliefs and
Dr Stevens says. There is mounting evidence that opioids, particularly slow-release formulations, are ‘less
habits of prescription.’ He says the Commission’s Third Australian Atlas of Healthcare Variation (2018) showed that the rate of
helpful and more problematic than we ever thought’, she says. ‘It just makes patients’ lives so much harder.’
Pharmaceutical Benefits Scheme (PBS) prescriptions for opioids dispensed per 100,000 people had increased by 5% in the four years to 2016-17.
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The Health Advocate • MAY 2021
