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CHRONIC pain sufferers, their doctors and carers have had a mixed response to pain specialist Chris Hayes’ apology on opioids.
Dr Hayes said this week that pain medicine specialists and health professionals have got it wrong, “running ahead of the evidence” by prescribing opioids to treat chronic pain.
While opioids work for acute pain, and flare-ups, they are not suitable for the treatment of long-term chronic pain, Dr Hayes said.
“The evidence was there for the use of opioids to treat acute pain, but as the evidence shakes out 10 to 15 years later, we’ve realised these drugs don’t work as well as we thought,’’ he said. “Now the buzzword is de-prescribing.”
Common prescription opioids include oxycodone, brand-named Oxycontin, as well as morphine, pethidine, codeine and hydrocodone, known as MS Contin, Endone, OxyNorm and other brand names.
Dr Hayes, Director of the Hunter Integrated Pain Service at John Hunter Hospital, will become the new dean of the Pain Medicine faculty of the Australian and New Zealand College of Anesthetists in May.
The body adapts to opioids over time, building up tolerance in the body which renders them ineffective, Dr Hayes said.
Instead, patients should be encouraged to adopt a holistic “active self-management” approach to chronic pain involving a healthy diet, regular exercise, and re-training the brain, with strategies based on the concept of neural plasticity, and understanding the way the brain interprets pain.
All of those elements have been part of the journey for 44-year-old Tanya Baker, of Medowie, who said she gained a great deal from the pain management course she attended at the Hunter Pain Clinic.
She started to experience ongoing pain in 2013, through her right shoulder, and associated numbness in her arm.
“I thought I had pulled a muscle but it wasn’t getting better, it was progressively getting worse,” she said.
After seeing several GPs and a specialist, having X-rays and an MRI, she visited a surgeon who told her there was nothing he could do. She was giving medication but it “did not sit well” with her.
Eventually she attended a pain management program.
“It was really good,” she said. “It gave me an education on how to manage my pain and the fact that I had to change my lifestyle so my pain didn’t take over my life.
“I just had to change my lifestyle - the way you do things, your posture, everything that you do… I had to pace it out, by not cleaning all of the house in one day, or not doing a full grocery shop.
“It was awesome for me because I felt like this was not going to beat me.
“I’ve seen people on medication and the effect that it has to people, I wasn’t going to become dependent on medication for the rest of my life.”
Mrs Baker went on to have targeted surgery to relieve underlying issues, and has recently returned to full-time work.