Are prescription pills and work a dangerous mix?

Tuesday, 08 July, 2014

Flinders University researchers are exploring the potential problems associated with prescribed opioid use in the South Australian workforce.

Professor Ann Roche, Director of the Flinders-based National Centre for Education and Training on Addiction, has been awarded a SafeWork SA grant to investigate the relationship between prescribed S8 opioids, workplace injury and the ability to return to work after a work-related accident.

Opioids, such as oxycodone and fentanyl, are powerful and highly addictive painkillers.

Professor Roche said the two-step study aims to determine whether workers who use prescribed opioids are more susceptible to workplace injury; and if opioids impact a person’s ability to return to the workforce following a WorkCover claim.

“There’s been an exponential increase in prescribed opioids in Australia in last 10 years,” Professor Roche, based in the Faculty of Medicine, Nursing and Health Sciences, said.

“The increase in prescribed opioids is not necessarily a problem but the research shows it’s associated with a high level of adverse outcomes, including addiction, tolerance, fatal and non-fatal overdose,” she said.

“There’s good evidence from overseas studies to suggest that opioid use in the workforce can lead to injury, and that opioid use while on WorkCover can impair a worker’s ability to return to work, but our study is the first of its kind in Australia to quantify that relationship.”

Using data linkage techniques provided through SA-NT DataLink (a linkage service enabling research and analysis of de-identified data from multiple databases), the study will look at the patterns of prescribed opioid use in SA over a 10-year period. Researchers will then compare user profiles with a range of other data to identify links between opioid use and injury, and other adverse outcomes.

As opioids depress the central nervous system, which can impair functionality, Professor Roche said she expects the findings will correlate with international research.

“Opioids can impair your ability to stand and walk. They also affect your hand/eye coordination and your ability to act quickly and think clearly.

“This does not make for a good combination while working, particularly if you are operating heavy machinery or engaging in manual labour.”

Professor Roche said Australia’s reliance on prescription painkillers has increased significantly in the past decade, and will continue to rise with an ageing population.

“In the 90s if you went into hospital for a standard procedure you might stay for a week or so but lots of procedures are now done with keyhole surgery, so people are usually in hospital for 24 to 48 hours and often discharged with large amounts of prescription painkillers - and repeat prescriptions.

“Shorter hospital stays with earlier discharge also contribute to increased use of opioids for chronic non-cancer pain.

“Not only can people build up a tolerance to opioids, they can become dependent on them too because they produce a euphoric feeling which contributes to dependence. Also, one tablet can sell for $80 on the street so it’s not uncommon for people to engage in what we call ‘use a bit, sell a bit’.

“The problem is likely to get worse because we have an ageing population; so there’s going to be more hip and knee replacements, more incidences of rheumatoid arthritis and other conditions that require short and long-term pain relief.”

Adding another layer to the complex issue, Professor Roche said there is no real-time electronic patient prescription record in Australia, therefore a patient could source multiple scripts from multiple GPs without the prescriber knowing the patient is receiving multiple scripts.

“In Australia, it’s easy to go to several different doctors because there’s no way each doctor will know what’s already been prescribed.

“Doctors can also find it difficult to say no when someone comes to them seeking pain relief because they see it as their duty to help. Some are also not sure what else they can offer to help.”

Professor Roche said the research findings will be used to inform best-practice policy on Australia’s use of prescription painkillers.

“We’re not trying to stop people from having access to medication; we’re trying to identify when there is an increased risk of harm, and the people who are particularly vulnerable, so we can develop alternative treatment strategies that produce the best possible outcome.”


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