Key findings
In 2013–14, nearly 14 million prescriptions were dispensed through the Pharmaceutical Benefits Scheme (PBS) for opioids – medicines that relieve moderate to severe pain. These medicines are very effective in relieving acute pain and cancer pain, and in palliative care. However, studies have shown they are also being prescribed for chronic non-cancer pain. Current evidence does not support the long‑term efficacy and safety of opioid therapy for chronic non-cancer pain.
The number of prescriptions dispensed was more than 10 times higher in the area with the highest rate compared to the area with the lowest rate. However, even when the areas with the lowest and highest rates were excluded considerable variation was still seen in prescribing (2.9 times more in the areas with the highest rates than in the areas with lowest rates). No apparent explanation is available for this, although differences in access to alternative pain management options may be a factor.
Recommendations
5a. The Australian Government Department of Health reviews the level of Medicare support available for effective multidisciplinary non-pharmacological treatment options and opioid dependency services, in particular for opioid prescribing for chronic non-cancer pain.
5b. State and territory health departments work with primary health networks to address the barriers in access to non-pharmacological treatments for people with chronic pain who are socioeconomically disadvantaged and those who live in rural and regional settings.
5c. State and territory health departments support Telehealth to enhance rural and remote consultations for assessment and management of chronic pain.
5d. Primary health networks and the Australian Government Department of Health progress implementation of information systems for real-time monitoring of opioid dispensing.
5e. National boards and the Australian Health Practitioner Regulation Agency consider what actions could be taken to ensure relevant registered health practitioners have up-to‑date knowledge of prescribing guidelines for opioid medicines.
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