Action needed to prevent opioid crisis in New Zealand

Wed 7 November 2018

The overuse of prescription opioid medications overseas and skyrocketing opioid addiction that has followed is one of the greatest public health crises of our time and New Zealand needs urgent action to ensure we avert a similar disaster, says Dr Mike Foss, a Specialist Anaesthetist and Pain Physician at the Waikato District Health Board.

Dr Foss, who is speaking at the New Zealand Anaesthesia Annual Scientific Meeting in Auckland, says that while the structure of New Zealand’s health system, coupled with caution around opioid prescribing has safeguarded us from the extreme situation in the US, we are far from immune.

“The fact is that the use of strong opioids in New Zealand is on the rise. The rates of fentanyl for example have more than doubled since 2011 and the variation has increased to more than 12-fold.”

“Some of the key drivers that have led to the US epidemic of opioid addiction and dependence are present in New Zealand – most notably an ageing population with increases in the treatment of chronic illness and the need for more palliative care, upward rates of stimulant use, and more illicit drugs such as fentanyl arriving at the border.”

Another major risk factor is likely to be hospital admissions with almost half of those dispensed a strong opioid experiencing a ‘trigger event’ in a public hospital the week prior, suggesting these prescriptions ae generated in hospital.

The situation is compounded by the needs of trauma patients and patients with complex pain problems.

Dr Foss explores a range of measures in his talk to reduce the reliance on opioids, including the use of an opioid risk tool to better identify patients at risk of medication misuse, and a greater focus on non-drug treatments to reduce pain, including post-operative pain, such as psychological interventions that prepare patients before surgery.

“Studies have shown that psychologically preparing patients before surgery can reduce the length of hospital stay and shorten the delay in a patient’s mobility. Unfortunately, in New Zealand psychological treatments for pain are grossly under-used and under-funded.”

A major issue for New Zealand is that our acute pain services have limited access to non-opioid medications. “We need to dramatically improve access to effective, acute pain relief medicines so that it’s on par with other jurisdictions.”

“As pain specialists, anaesthetists are best placed to take a leadership role within the health sector to ensure that as medical practitioners we can reach consensus on which medications to prioritise for our patients and advocate Pharmac for.”

The NZ Anaesthesia Annual Scientific Meeting (ASM) is hosted jointly by the Australian and New Zealand College of Anaesthetists (ANZCA) and the New Zealand Society of Anaesthetists (NZSA).

One of Australasia's largest specialist medical colleges, ANZCA is responsible for the training, examination and specialist accreditation of anaesthetists and pain medicine specialists, and for the standards of clinical practice, in Australia and New Zealand.

The New Zealand Society of Anaesthetists (NZSA) represents and champions the professional interests of anaesthetists and the optimal care of their patients through advocacy, promoting education, and supporting anaesthesia networks throughout the country.

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