There was really never enough when it came to this drug Leah Dwyer In early 2019, the World Health Organisation changed its own guidance on opioids, recognising that while they have a role to play, that role should be limited. Patient groups in the United States sued the pharmaceutical companies for promoting the use of these drugs in the treatment of chronic pain. In response to this global trend – which is particularly prevalent in the US – researchers, governments, doctors and medical bodies started to look again at opioid prescription practices.
Every day in Australia there are 150 hospitalisations due to opioids, and 14 emergency department visits – a 25% increase between 2007-17. Of the opioid deaths, 70% involved pharmaceutical opioids. That accounted for two-thirds of all drug-related deaths. In 2018 three people died every day due to opioids. These numbers do not include codeine, which was available in pharmacies without a prescription until February 2018.Īnd harms have increased too. In 2016-17, nearly 15.5 million opioid prescriptions were dispensed through the Pharmaceutical Benefits Scheme. In the five years between 20, opioid prescribing in Australia increased by 30%. But drug companies in the 1990s began to market the drugs as safe and effective for long-term pain relief, a promise welcomed by doctors keen for a safe fix for patients presenting with chronic pain. Safe fix or over-use and abuse?įor decades opioids were reserved for short-term and severe pain relief, prescribed after surgery or accident or in palliative care. O’Neil knew her body was reliant on the drug. She spends about half her day in bed, every single day, just to get relief. Her chronic pain means she can only work six hours a week. Physiotherapy, cognitive behavioural therapy, psychological treatment – all these cost money she does not have. She fears a fall or an injury, and she fears that when she goes for an upcoming hysterectomy that she will not receive adequate pain relief. She doesn’t go out with friends like she used to, because she fears she’ll return home in pain with no medicine to help her. Without her Endone prescription she now limits what she does. “It’s like your muscles are being clamped, and clamped, and clamped.” So you don’t sleep and you spend most of the night trying to walk off this pain because if you lie down it’s just so intense,” she says. “It’s like someone is wringing out your muscles like they would wring out a wet rag. What followed from her Endone being cut off was three days of intense withdrawal. I was pretty devastated actually,” she says. “What do I do for those nights when I don’t sleep and the Palexia isn’t working? So yeah, a lot of fear. But she was also terrified of how she would cope with her pain in the long term. She knew what she facing – she had accidentally gone through withdrawals before, when forgetting to take her medication on a night away. She walked out of the doctor’s surgery shaking. ‘I wake up with pain, I go to bed with pain’ - Louisa O’Neill O’Neil did not want him to get into trouble. The doctor told her he could not re-prescribe.
O’Neil was told that her GP had received notice from the government that she and other patients were using Endone in a way it was not intended, which is for acute and short-term pain, “even though it was working for me”. Then, earlier this year, she went to her GP in Melbourne for a routine prescription renewal. She was told that she was managing her pain well. Five or six times a year she would take an additional Endone to help with what she describes as “breakthrough pain”. Once asleep Palexia, a slow-release form of the opioid tapentadol, would kick in to help keep her asleep. She says it would help reduce the pain sufficiently for her get to sleep. In the end, she found that Endone, a medicine containing the opioid oxycodone, worked for her. Over the course of the past 16 years she has been on a medical merry-go-round, and tried multiple drugs and techniques for pain management.
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