Painkiller use leaps as Kiwis age

17:33, Jan 02 2013

Painkillers are being dished out to Kiwis at twice the rate they were a decade ago as an ageing population fuels the escalation of age-related medical conditions needing pain relief.

In the past 10 years the number of prescriptions for pain medication has almost doubled from 2.16 million in 2002-03 to almost 4.1 million in 2011-12, Pharmac figures reveal.

And it is a situation being mirrored in the Waikato, with 343,900 scripts being written in 2011-12, up from 176,800 a decade ago.

While those figures do not cover what is being dished out in our hospitals, only by GPs, Waikato District Health Board pharmacy manager Jan Goddard said an ageing population was definitely having an impact.

"People are living longer and there's increased rates of cancer and increased management of patients with chronic conditions, so increased use of pain medications would be expected," she said,

She said the DHB endeavoured to promote appropriate prescribing for pain relief, providing advice from a specialist if required.


But Dr Dan Lohr, a pain management specialist based in Tauranga, is opposed to the reliance on pain medication.

"Patients become dependent and that makes it much harder to do our job, when a patient starts treatment, because their body is not only trying to cope with the original injury, but now the medication, as well."

He said medications only covered up the problem, while not addressing the root cause - they could also cause further health issues.

"Sadly, when a patient presents to an A & E complaining of pain, they will often begin taking Paracetamol, which is the highest cause of liver failure in hospitals."

Dr Lohr said there were many alternatives to manage pain, including a simple change of diet.

He said getting rid of as much bread and cereal as possible could work wonders. Acupuncture was also an alternative.

Dr John Barnard, clinical director of pharmacy and consultant anaesthetist at Waikato DHB, said more strong opioid drugs - such as methadone - were being prescribed.

"This increase is not entirely a bad thing and is multi-factorial."

Opioids, which represent the largest pain-therapy class, can cause side-effects such as nausea, vomiting, constipation and drowsiness, and even severe respiratory depression.

They are also considered to be highly addictive.

It was for these reason Dr Barnard said he would be concerned if patients were being discharged with a prescription for strong opioids without adequate education and a time period in which to stop using them.

"We are doing some work currently with the junior doctors to understand how they approach strong-opioid prescribing and looking for areas where further education would be helpful."



Wendy McKeown describes her chronic pain as "cruel".

About 12 years ago the 43-year-old's back went out while she prepared items for a garage sale - since then she's had two unsuccessful back operations.

Neither did much to ease the pain.

"I've fought really hard not to get depressed over it. But it's really hard."

The Waitoa mother had to give up her job as a shop manager because the pain prevented her working - she also gave up helping to coach her childrens' football team.

"I'd always been physically active. So to go from that, to not being able to do anything, was very difficult.

"It's cruel. But there's always someone worse off than yourself, so I try not to feel sorry for myself."

She's taken up making greeting cards as a way to distract her from the pain and hopes to one day start selling them.

Her daily routine still consists of taking a variety of pills to numb the pain including Panadol, Ibuprofen and/or Codeine.

"There's not a day when I wake up that I'm not in pain."

She has tried a few different strategies to try to deal with the pain, including taking up pilates which has helped somewhat.

"It sucks that she has to live on painkillers.

"I've been on so many drugs in the past that I've ended up with a rash on my face now due to the drugs. I used to have really good skin, now it [the rash] is down my arms, legs and my face."

Mrs McKeown isn't surprised by the big jump in the number of people on pain-relieving drugs.

"It's really sad that people have resorted to having to pill pop.

"What concerns me is what they might be doing to my insides - that worries me a lot. I hate taking medication but it's a matter of having to get through each day."

Waikato Times