CME 24/7/14 – Tackling the Opioid Problem, Analgesic Prescribing in the Emergency Department
Here is Brad Lawther’s great talk on the problems related to opioid prescription and some suggested solutions for patients with both acute and chronic pain.
In essence, we are trying to limit the prescription of oxycodone and oxycontin given the long term social implications (dependency and abuse) related to their use. There are alternatives in most situations, with the SCGH analgesic assessment and management algorithm below giving some guidance on these analgesic options and their prescribing. Note, there is still a place for consideration of low dose oxycodone use (more specifically in the form of Targin) in the elderly patients, who can be more sensitive to the side-effects of other analgesics mentioned below. Don’t forget to also consider non-pharmacological pain management techniques in all suitable patients (i.e. splinting, heat packs, etc…), in conjunction with ensuring the patient has realistic expectations with regard to their pain management.
SCGH Pain Assessment and Management Algorithm:
Requirements for the prescribing of Schedule 4 and Schedule 8 Medicines in Western Australia pdf: