How Opioid Withdrawal Triggered Mental Health Battles in Chronic Pain Patients

The Drug Administration has also sent a message to health professionals on best prescribing practices and has sent a letter to: GPS They were among the top 20 percent of opioid prescribers. The crackdown has led to a sharp decline in prescriptions for opioids. From 2016 to 2021, the opioid dispensing rate will be 18% reductionthe overall amount of opioid drugs dispensed is reduced by 30%.

And last September, the National Health and Medical Research Council approved evidence-based clinical practice guidelines for patient opioid withdrawal.

But Pain Australia CEO Julia Jones said there is still room for opioid use as long as they are prescribed “carefully and sensibly”, raising concerns over regulations restricting pain relievers. expressed. “There are a lot of people who are very distressed by the changes that have happened,” she says.

Opioids have been shown to: reduce chronic pain Although slight, it has nothing to do with cancer. The Therapeutics Goods Administration recommends that opioids be used only “in exceptional circumstances” or “as needed” for non-cancer pain relief.

Daniella Gnidich, associate professor of pharmacy at the University of Sydney who helped develop the guidelines, said the guidelines, with regular review, provided a pathway to stop or cut back on opioids from the moment they were prescribed.

“This is a person-centered approach to empowering patients and supporting them if they choose to taper off opioids,” she said. “These guidelines are not meant to say ‘stop opioids,’ but to help clinicians, GPs, and patients work together to identify the most appropriate approach to reducing opioid use over time. It’s in.”

Pharmaceutical opioids cause more deaths and hospitalizations than heroin and methadone. In 2016, half The proportion of people who use pain relievers and opioids for non-medical purposes buys them over the counter at a pharmacy, with 1 in 5 buying them by prescription.

“These guidelines are not there to say ‘stop opioids’, they are here to help clinicians, GPs and patients… [reduce] Use of opioids. ”

Daniella Gnidich, Associate Professor of Pharmacy, University of Sydney.

The dangers of opioids are largely unknown among patients. 2020 TGA Report Fewer than half of opioid users were aware that they were taking opioid drugs, and only 17% said they were not dependent on them.

One study found that people addicted to opioids have higher rates of suicide and self-harm than the general population. almost 1 in 10 In New South Wales, people with disabilities taken to hospital for self-harm.

But people with chronic pain at least twice as likely Suicidal behavior should be reported, and stopping opioids may increase the risk of self-harm.

U.S. data show that discontinuing opioid treatment among veterans Increased risk of death from overdose or suicideespecially among long-term users.

Australia has yet to collect data on links between opioid prescription discontinuation, overdoses and mental health crises. But Professor Suzanne Nielsen, deputy director of the Monash Center for Addiction Research, said the international data underscore the need to “proceed with caution.”

Nielsen also said an emerging “worrisome” trend after the reassessment of opioid drug use was an increase in heroin-related mortality. “There is some evidence to suggest that we may have pushed some people out of the healthcare system and into illicit opioid use,” she said.

Increased heroin consumption 10 percent It will be the second most consumed illicit drug in 2021-2022, after methylamphetamine.

Neilson said the new guidelines emphasized the importance of working with patients, and because they could help identify and refer patients with opioid use disorders to specialist treatment, the new guidelines are likely to have positive outcomes. He said he “expects” that it will.

In the last fiscal year, approximately 131,000 Australians He sought alcohol and drug treatment. “Some estimates suggest we’ll need to double the number of treatment facilities in Australia to reach everyone who needs it,” Mr Nielson said.

Neen Monty was first prescribed opioids eight years ago for mixed connective tissue disease, arthritis and ankylosing spondylitis, a spinal condition.

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After surgery in 2020, she suggested to her GP to cut back on her opioids, reducing her dose from 40 milligrams to 10 milligrams. However, when her pain returned, she asked to return to her original dose. Ms. Monty said her family doctor refused and she planned to go off opioids completely.

“I tried all these alternatives and they were terrible for me,” she said. The effects of her medication caused her weight gain and fatigue, and her pain was still at a high level.

Monty, who lives in Canberra, runs two small businesses, and cares for his son, is back on 20 milligrams, combining opioids with daily exercise, meditation, and hot and cold compresses.

“I’ve had all my education about pain…but when they take the painkillers away, there’s nothing I can do but lie in my bed and feel awful. It’s not life,” she said. Told. “When you know there is a cure that can alleviate that pain and keep you alive, and you know people won’t give it to you…that’s torture.”

Physicians are encouraged to offer alternatives to patients when they stop taking opioids, Jones said, but many consumers haven’t. “Some of those people have yet to find alternatives or alternatives.”

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2022 Research conducted by Pain Australia We found that 59.6% of respondents reported difficulty accessing treatment options for pain management. The organization receives research grants from pharmaceutical companies. 43% reported that their health care professional did not offer them alternative treatments or support to manage their pain.

From 2016 to 2018, the median waiting time for persistent pain services was 60 daysHowever, some clinics have had wait times of up to three years.

Pain Australia supports multidisciplinary pain management consisting of psychological training, physical exercise and, in part, pharmacotherapy. The goal, Jones said, isn’t to take a strong pain reliever every day, but to allow people to take it when symptoms worsen. “Pain consumers are being slandered. You wouldn’t want to inflict chronic pain on your worst enemy, but we ignore it and pretend people are exaggerating.” ”

The lifeline is 13 11 14.

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