Are Medically Prescribed Opioids Killing Australians?

Are medically prescribed Opioids killing Australians?
 
In 1996 Oxycontin a drug more powerful than Heroin hit the medical marketplace. It was touted as the cure for any pain, without addiction and without risk. Drug Companies have made many millions from this drug, at the cost of many deaths.
 
In 2018 we face an evolving crisis following America down a slippery slope, that will cost us our relatives, parents, sons, and daughters if we don’t change.
 
 
But change doesn’t start at the end of a Doctors Pen – it starts with understanding pain, understanding its necessity and better ways to treat it. It starts with opening your mind to alternatives such as physical activity, physical therapies, diet, stress management and lifestyle changes.
 
Almost daily people come to Emerald Medical Group in pain, having been prescribed oxycontin, and been disappointed that the conversation wasn’t what they wanted to hear and that they left without a prescription. Doctors have a duty of care to you that transcends any short-term contract you might perceive to prescribe a drug that you have demanded.
 
Other drugs such as Diazepam (Valium) and the Gabapentinoids (Lyrica and Pregabaline) have been proven to have almost no place in pain management. Medical Marijuana, for all the hype, has little evidence of benefit.
 
We are facing a serious crisis in rural Australian where more people suffer addiction to medically prescribed opioids than the rest of the country. Sometimes people have to live with pain, Oxycontin and other prescribed drugs don’t offer a long-term solution.
 
There are new treatments on the Horizon, but first, you must accept that salvation comes with understanding and acceptance that pain management is a journey, not a cure at the tip of your tongue.
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Some Resources for Patients and Clinicians regards Chronic Pain Management (Thanks to Doc Paul):
Brainman series of Youtube videos:

www.youtube.com/watch?v=5KrUL8tOaQs 

Fantastic website and video explaining persisting pain, for patients: www.tamethebeast.org 

AFP pain management article: www.racgp.org.au/afp/2014/august/gp-pain-management/

NPS resources for chronic pain, including ͚pain management prescription template:
http://www.nps.org.au/…/nervous…/pain/for-individuals/pain-conditions/chronic-pain

Excellent Australian site full of pain resources, including the ͞Explain Pain book.
www.noigroup.com/en/Resources 

UK site: useful pain ͚toolkits͛: http://paincommunitycentre.org/pain-toolkits 

US site: great pain resources – www.instituteforchronicpain.org/ 

The effect of language on pain experiences: https://theconversation.com/the-right-words-matter-when-talking-about-pain-50450 

Great summary article from a Melb-based pain specialist: www.linkedin.com/pulse/top-10-chronic-pains-tips-tricks-general-dr-nick-christelis 

ABC article on chronic pain myths: www.abc.net.au/news/health/myths-about-chronic-pain/7704554 

Explanation of central sensitisations͛ role on chronic pain: www.painscience.com/articles/central-sensitization.php

Article on how our thoughts influence our pain: https://theconversation.com/got-chronic-pain-just-un-learn-to-live-with-it-39060 

More patient information: www.painaustralia.org.au/living-with-pain/what-is-pain.html 

AFP article on the inherited chronic pain patient: www.racgp.org.au/afp/2016/december/the-inherited-chronic-pain-patient/ 

Excellent site with great pain management patient resources: www.aci.health.nsw.gov.au/chronic-pain/painbytes 

Online pain management programs for patients:
https://thiswayup.org.au/how-we-can…/courses/chronic-pain/ costs $60 to enroll and needs a ͞prescription from GP; a comprehensive program developed in conjunction with the St Vincent’s Pain Clinic.

https://mindspot.org.au/pain-course available free; consists of 5 lessons and guidance through those lessons from a Macquarie University based virtual clinic psychologist

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This is how your data in the My Health Record will be used

An important update from Edwin on the secondary use of data in the MyHealthRecord

Doctor's bag

Secondary use of My Health Record

On Friday the Federal Government quietly released its long-awaited framework for secondary use of information contained within the My Health Record. It will generate discussion as it is controversial.

The release of the framework to guide the secondary use of My Health Record (MyHR) system data comes just months before the participation rules for the Australian national health record change from opt-in to opt-out.

Consent for secondary use is implied if consumers don’t opt out of the MyHR. In other words, people need to take action if they don’t want their health data to be used for purposes other than direct clinical care.

To stop information flowing to third parties, consumers will have to press the ‘withdraw participation button’.

Another hot topic is the use of the data by commercial organisations which, interestingly, is permitted under the framework, provided it is ‘in the public interest’.

And, as expected, one of the…

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Is value based healthcare devaluing care?

Doctor's bag

Value based healthcare

There’s a lot to say for high value care. High value care is healthcare that generates a large amount of benefit for patients and the community compared to the resources invested. But there are also concerns.

Value based healthcare links outcomes with costs: ‘Value’ is derived from measuring health outcomes against the cost of delivering these outcomes. Although it makes sense to fund care that gives us the greatest health benefits, some argue that ‘value’ is more than outcomes.

Dr Jan Kremer is a Dutch Professor in patient-centred innovation and has a passion for patient-focused quality and innovation. In a recent blog post he questioned value based healthcare, stating that value has a different meaning to different people – ranging from efficiency to solidarity, equity and quality of life.

The right things

In healthcare, he said, it is not just about doing things right, but also about doing the right things. The…

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Why I may sign your fitness to drive form

rain0021

“Well, Mr Terry I have some bad news. The results of your tests shows me that it is no longer safe for you to drive.”

“But why, young whipper snipper, you don’t understand, I’ve been driving since before you were born……”

One of the harder things I have do as a GP is to tells someone that they should no longer drive and they need to hand in their license. I have lost a few patients along the way because we have disagreed on their ability or competency.  Generally during a consultation, I consider the patient before me, and sometimes their family. But in this situation, I have a responsibility to consider the wide community. In fact, you also have this responsibility as the F3172 form you gave me to sign for your drive medical stipulates.

“If you hold a Queensland driver licence, or are applying for a Queensland driver licence, you…

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Why Men in Maternity Matter.

An important blog on gender in medicine

Nomadic GP

In Australia, as in many other parts of the world, male doctors are becoming a threatened species in the field of obstetrics and gynaecology. Women now make up the overwhelming majority of trainees – roughly 80% across the country – and the numbers are increasing.  Our very own RANZCOG president, Dr Steve Robson, is a great advocate for women in medicine, and proudly highlights this evolving gender imbalance in his tweets and photographs. It is fast becoming the new normal.

But, as a feminist, I have some concerns.

This issue has garnered a fair bit of discussion in the international media of late, with an article published in the LA times last week stirring up some heated discussion. A number of blog posts have followed (including this, from my personal hero, Dr Jen Gunter and this), plus hundreds of comments, and some pretty robust debate on social…

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Drug seeker basted me like a turkey

Primum non nocere, and that includes not prescribing drugs of addiction. It is hard to say no, but sometimes it is kindest.

drjustincoleman

Turkey, by Ben Sanders Illustration: Ben Sandars

This month I got done over by a drug seeker. Tattoo Man basted me like a Christmas turkey, peppered me with garnished praise and slow baked his way through my seasoned outer crust. Bugger.

Usually, when it comes to slamming the script pad shut, I’m all Fort Knox.

Reception deliberately sends all hopeful newcomers down dead-end street to my brick wall. Five minutes later they exit, loudly proclaiming to the waiting room that, in effect, my clinical decisions are being influenced by the rather unlikely combination of both my genitalia and distal GI tract.

Funnily enough, those occasions are relatively easy. My patients in the waiting room know me well enough to guess what might have happened. And everyone knows their role: the receptionists blame me, as instructed, and I blame our Practice Policy—the only thing I’ve ever written which remains unsigned.

“Sorry madam, I’d love to…

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