People with chronic pain
Some people using opioids for longer-term pain may find these new regulations challenging.
But the changes will hopefully help people in this group in the longer term, as opioids are not always appropriate for chronic pain. The need for second opinions may help facilitate appropriate use and discussions about alternative approaches to pain management.
However, second opinions might be hard to arrange in practice. Opioid use is higher in places where pain services are harder to access, most commonly outside metropolitan areas.
The large shifts towards telemedicine we’ve seen as a result of COVID-19 may be useful in addressing the disparity of service access in rural areas, if these changes are maintained.
What don’t we know?
Almost all the studies that help us predict the effects of these changes were conducted in the US. Opioid-related harm in the US is much more severe than in other parts of the world, and the health-care system is vastly different. Get oxycodone
That said, Australian trends in pain related harms are quite similar to USA, though they are five to ten years behind the US.
The aim is to use opioids for the shortest period at the lowest effective dose, rather than to avoid their use altogether. While we want to minimise their misuse, opioids are effective and important medicines for pain. In many countries, a lack of supply is a key health issue. We don’t want the pendulum to swing too far.
We will need to carefully monitor the outcomes of these changes to identify any unintended consequences.
Opioid medications are synthetic cousins of opium and the drugs derived from opium, such as heroin and morphine. These drugs are often prescribed for acute pain that stems from traumatic injury, such as surgery or a broken bone. Opioids currently cause the most prescription drug-related overdose deaths in the United States — and that rate is still rising. Because the risks are so great, opioids are used at the lowest dose possible, usually for just a few days.
Brand names. Hydrocodone (Hysingla ER, Zohydro ER); hydrocodone-acetaminophen (Norco, Zyfrel, others); fentanyl (Actiq, Duragesic, Fentora), oxycodone (OxyContin, Roxicodone, others); oxycodone-acetaminophen (Percocet, Roxicet, others); others
How they work. Opioids, just like real opium, mimic the natural pain-relieving chemicals — called endorphins — produced by your brain. These drugs “turn down the volume” on the pain signals your nervous system sends through your body. They also muffle other nerve cell functions, such as your breathing, heart rate and level of alertness.