Home' Australian Pharmacist : February 2013 Contents 34 Australian Pharmacist February 2013 I ©Pharmaceutical Society of Australia Ltd.
the elements of QUM enables us to
effectively contribute to the more
appropriate use of opioids for our
patients and be seen as caring and
concerned health care providers. We are
Adelaide Hospital's Dr Crowley said the
evidence was that most people who
overdosed or abused these medicines get
them from family members or friends.
'Clearly there is a lot of unnecessary
diversion of these medications that
should be secured better or returned to
the pharmacist,' Dr Crowley said.
'Pharmacists need to be at the forefront of
Dr Crowley said mandatory report
systems would also be a major asset in
combating the problem but feared that,
'there doesn't seem to be the political will
at present for such a system'.
'Ultimately it would be very worthwhile
having some sort of real-time computer-
based system that allows pharmacists to
'We need to use every possible tool to
address this growing problem.'
PSA National President Grant Kardachi
has urged a pharmacy profession-wide
approach and suggested education and
reporting as two prongs in what may
need to be a multi-faceted approach to
managing prescription misuse.
'We are seeing misuse of some OTC
products containing codeine and this is
a trend reflected in the misuse of some
prescription pain relief medicines,' Mr
'I have urged education campaigns and
reporting systems as being possible
tools to help int he management of
OTC misuse and I see these same tools
being applicable to helping control
'Pharmacists must play a leading role in
helping to identify, manage and achieve
better outcomes for patients and be
educated to help identify patients who
may be vulnerable to prescription misuse.
'We must work as a profession also to
educate consumers of the risks of illicit
Professor Louisa Degenhardt of the
National Drug and Alcohol Research
Centre (NDARC), Faculty of Medicine,
UNSW, who is part of the Pain and
Opioids IN Treatment (POINT) study
said, the study research had shown
that anecdotally, one issue was the
extent to which pharmacists had the
capacity to do something if they thought
there was someone coming into their
pharmacy who might be having problems
'We have pharmacists contacting us and
asking what they can do as they feel
the doctor is doing the prescribing and
the patient isn't doing very well but as
pharmacists they are not quite sure what
they can do,' she said.
'One thing would be to work out what
tools and education can be given to
pharmacists so they know what they can
do in such situations. But the reality is,
pharmacists and pharmacies are very
busy so there are a lot of logistical issues
'Obviously there are some people who are
not sure what they can do.
'If there was a way that pharmacists
and doctors could have easier lines of
communication that would be great but I
dont know how that would be achieved.
'Real time reporting is really to aid the
decision made by the doctor to the extent
that it avoids over prescribing by patients
seeing more than one doctor and that is
good. But other than that it is not a direct
help to pharmacists'.
The importance of the role pharmacists
can play as members of multidisciplinary
and collaborative health teams in helping
to identify and manage prescription
addiction seem undisputed with a range
of experts all pointing to a number
of areas where the profession could
potentially make a difference.
North Queensland-based Joyce McSwan,
creator and Team leader for Mackay
Chronic Pain Management Network sees
pharmacists playing a role that can make
quite a significant difference.
However, she warned it would involve
a lot of 'paradigm changing from our
orthodox education on chronic pain
because this has all changed because we
now know a lot more about chronic pain.
'Primarily we now know that it's a
mind-body approach that is needed.
We also know that to treat chronic pain
successfully we need to be within some
kind of a team system or at least be in
communication with that team.'
could be part
of that team, or
lived within the
know of healthcare
professionals other than pharmacists that
they might be able to channel patients to.
'We also need a better understanding of
deeper referral which of course requires
that collaborative working relationship,
but not just with a GP. We need to look at
the core principles at how chronic pain is
now successfully treated and work with
other health professionals accordingly,'
'We must return to the basics of how we
treat chronic pain successfully and it's
clear the answer is not to rely solely on
medication. It is a problem when there
are psychological symptoms as well and
clearly medication is not going to be the
only treatment option.
'Then with our new understanding we
need to get quite creative and be very
proactive in ensuring our counselling
approach addresses the new way
'This doesn't mean that we're phobic
about medications; it doesn't mean that
we deny addicts medication. What it
means is that we have to understand this
very complicated area confidently so that
we can have better skills to differentiate
Ms McSwan said that over time
pharmacists developed a regular clientele
-- addicts or not -- with opioid use and
a huge amount could be done to foster
trust and rapport with these people.
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