Dealing with addiction, Australia rethinks opioid analgesia treatment

The Australian Health Care Safety and Quality Commission (ACSQHC) encourages Australian health professionals to rethink the opioid treatments currently being administered.

According to the report, at least one prescription for opioids is dispensed to more than 3 million people annually. 2016-2017 statistics Collected by the Australian Institute of Health and Welfare. However, while opioids are effective in relieving pain, long-term use of the drug can cause serious side effects such as addiction and unintended overdose.

ACSQHC Opioid Analgesic Stewardship in Acute Pain Clinical Care Standards, Provides an overview of proper use of opioids for emergency and surgical aftercare staff. The new standard encourages physicians to administer alternative painkillers if possible and, if opiates are used, to establish an aftercare program to separate the patient from the drug.

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Prescription drug containing oxycodone and acetaminophen. (Canadian Press / Graeme Roy)

Professor Emeritus of Newcastle University and Anne Duggan, Chief Medical Officer of ACSQHC, said at the committee Media release There is no patient aftercare in current opioid treatment.

“Opioid analgesics are very effective in relieving the pain of severe acute pain,” she said. “But it’s important to remember that these medicines can have serious side effects and can put people at risk of harm after discharge.

“We need to fine-tune the prescribing and use of opioid analgesics for acute pain to reduce the harm associated with improper prescribing and prevent short-term use from becoming a long-term problem. . “

Dagan said the balance between avoiding excessive dependence on opioids and achieving sufficient pain relief to prevent patients from suffering unnecessarily is not easily achieved.

“When a patient leaves the hospital, it’s important to discuss it with the patient and develop a clear dosing management plan to withdraw the opioid,” she said.

Opioid Crisis-Tribe
This photo shows a 5 mg pill of oxycodone on June 17, 2019. (KeithSrakocic / AP photo file)

The American Society of Anesthesia Opioids are defined as drugs that attach to the receptor proteins of nerve cells and block the pain messages sent by the body through the spinal cord from reaching the brain. Drugs such as fentanyl, codeine, tramadol, morphine, oxycodone, hydromorphone, buprenorphine, and tapentadol are all opioids and are distributed under many names.

Dr. Jennifer Stevens, an anesthesiologist and pain management specialist at St. Vincent Hospital in Sydney, an honorary assistant professor at the University of New South Wales, said opioid prescriptions in Australia are very different. Stevens said the new standard will ensure that all patients are provided with safe, evidence-based and effective opioid prescriptions by setting guidelines for prescribers.

“As prescribers, doctors have an’opioid first’habit that we need to kick,” Stevens said.

“Clinical care standards encourage the use of simple analgesics such as paracetamol and anti-inflammatory drugs and non-pharmacological therapies for mild to moderate pain,” Stevens said.

However, doctors said that for severe acute pain, “the standard recommends the use of wise opioids.”

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People want to be empowered to participate in their health. (Fizkes / Shutterstock)

Evidence of this “opioid first” habit is National Anonymous Online Survey A survey of hospital pharmacists conducted by the Australian Hospital Pharmacist Association (SHPA) in May 2018. The survey covers 135 hospital facilities, both public and private, and typically targets the pharmacy director or his agent in charge of managing the pharmacy. Policies, procedures and hospital practices.

According to the survey, 70% of the pharmacists surveyed sent surgical patients who did not need opioids 48 hours before being discharged from the hospital with narcotics “just in case”.

In addition, comments from the study showed that the amount of opioids prescribed depends not only on the patient, but also on the trust of the prescriber and sometimes the pharmacist.

According to Australia, more than 2.5 million surgeries are performed each year, so unsafe post-surgery is not important. 2017-2018 statistics Collected by the Australian Institute of Health and Welfare.

Stevens said many other countries in Europe and Asia are significantly less dependent on opioids for primary analgesics than Australia, but show no evidence of poor pain outcomes.

Epoch Times Photo
File photo of oxycodone analgesic. Prescription opioids such as oxycodone often used by addicts. (John Moore / Getty Images)

Dr. Andrew Sefton, an orthopedic surgeon at Dubbobase Hospital in New South Wales and Private Hospital in Sydney North Shore, said it was important to consider when and how opioid treatment would end for doctors to prescribe. rice field.

“If a patient is in pain, opioid prescribing may be quick and easy to repeat, but we need to think about each individual patient to ensure that the benefits outweigh the risks,” Sefton said. Mr. says.

“Clinical care standards emphasize the need to support the transition of care to the community through communication and opioid discontinuation plans.”

“Providing the patient’s general practitioner with a plan to outline the expected duration of opioid use and the amount of opioids supplied is a practical way to work together,” he said.

Duggan said ACSQHC hopes that new standards will allow Australia to better consider opioid use in hospitals and ensure that patients are safe when returning to activities within the community.

“It’s ironic that medicines designed to relieve patient pain can cause long-term distress to individuals who become persistent users of opioid analgesics when they leave the hospital.” She concluded.

A caring doctor helping an elderly patient in her office
If the doctor needs to understand the patient’s condition, the story can be associated and understanding the story can make a big bet on the hospital. (Stock-Asso / Shutterstock)

It should be noted that ACSQHC is not alone in the fight against opioid dependence in Australia. Since 2018, the Therapeutic Goods Department has introduced regulatory reforms in medicines to limit inappropriate prescriptions.

Previous reforms included reducing the pack size of immediate-release opioids and changing the list of drugs in the Benefits Scheme, a list of government-sponsored drugs, in June 2020.

Data suggest that government reforms have succeeded in reducing opioid use, and new criteria with similar strategies should also help Australia further reduce drug use. I am.