One of the focus points of chronic pain clinics and one of the focus points for education of health professionals is around medication safety.
We don’t have medications that stop pain immediately once it’s been going for three months but, many patients are put on very strong morphine-type drugs. There’s not much evidence that these help beyond the short-term period and once you’ve been on them for weeks, particularly for months, they have a number of adverse effects. They can increase the depression that you sometimes feel with chronic pain. They can give you new depression. They can lower your testosterone levels in males. They can make you very constipated and they can just make you feel like sitting on the couch and not engaging.
The other problem, of course, is that you can get tolerant of these medications. So you need increasing doses to have the same effect. You can also become dependent on them. That can take a number of different guises. So it may be that just if you stop them suddenly, you’d have a withdrawal syndrome and that can be very confronting for people to realise.
You can also start to use your medications in ways that they weren’t prescribed for, taking extra, sometimes finding extra, in extra places. In Australia, as in the US, there’ve been a lot of deaths associated with these prescription opioids. Not just for the patients for whom they’ve prescribed but for their families who can access those medications, for people who buy them.
So medication safety is seen as a very important component of improving the state of pain management in this country.