A PAIN specialist telling a newspaper that his profession has “got it wrong’’ on the treatment of chronic pain, and should apologise to the community for being over-reliant on the use of opioid medications. No matter what you think of his approach, Dr Chris Hayes is a brave man.
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It’s not that there isn’t already at least tacit acknowledgement of what he’s saying in the wider medical community.
There is a culture, particularly among general practitioners, of prescribing opioids for the one in 20 people nationally, about 50,000 in the Hunter, who suffer from chronic pain.
The prescription of opioids in Australia has soared in recent years.
A major study published earlier this year found that the use of the medications in Australia increased from 22 million doses annually in 2001 to 106 million doses annually in 2013.
Oxycodone prescriptions alone increased by more than 152 per cent between 2002-03 and 2007-08. The rising rates of prescription are by no means uniform.
According to the Australian Atlas of Healthcare Variation, nearly 14 million prescriptions were dispensed through the Pharmaceutical Benefits Schedule for opioids in 2013/14, with wild variations between local areas – 10 times higher in some areas than others.
It’s acknowledged that their use for treatment of chronic pain is perhaps least helpful of all.
Any move away from their use is unlikely to be welcomed by large pharmaceutical companies, but for the medical profession to admit it got something wrong is significant.
And yet, for anything to change, people like Dr Hayes will need to continue making statements like the one he has. Dr Hayes and his unit focus on a whole-of-life approach to treatment, coupling healthy diet, exercise, and “active self-management”, and re-training the brain, based on concepts of neural plasticity.
This puts the onus on the individual, as well as their GP, to tackle what he describes as “the hard yards”.
It requires a massive shift away from the widely held and closely guarded notion that analgesics are the answer to issues such as chronic pain.
While not everyone will rush to join Dr Hayes in his desire to apologise for past medical practises, he is to be commended for his leadership.
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