The pitfalls of opioid prescribing – what prescribers need to know
18 SEPTEMBER 2015

In an online-first article for Australian Prescriber, Dr Walid Jammal and Ms Grace Gown urge prescribers to recognise that opioid prescribing can lead to patient harm as well as pose medicolegal risks. The authors, from medical indemnity provider Avant Mutual Group Limited, say the regulation of opioids is a public health issue that urgently needs action to address the inconsistencies across states.

“Each state and territory in Australia has the power to impose control over the supply, access, record keeping, administration and disposal of all medicines and poisons. When prescribing opioids, doctors must be aware of their clinical, ethical and legal responsibilities, particularly the legislative requirements in their state or territory. Failure to comply with these can result in disciplinary action.”

These state and territory authority requirements are different from those of the Pharmaceutical Benefits Scheme, and both should be taken into account when prescribing opioids.

To avoid potential conflict with differing state regulations, the authors advise that doctors should tell patients to get their prescription dispensed in the same state in which it was written.

Jammal and Gown say practitioners need to re-examine how they prescribe opioids in order to comply with established guidelines. “Treating patients with chronic non-malignant pain is always challenging, but prescribers must consider what’s in the best interest of their patient.”

In order to prescribe opioids safely, effectively, responsibly and lawfully, the authors recommend that GPs address a number of questions following a comprehensive assessment:

w  Should opioids be prescribed at all?

w  Have all non-pharmacological options of management been considered?

w  Is there a plan of management in place?

w  Have the goals of treatment been defined?

w  Have all of the psychosocial factors been considered?

w  Is the patient at risk of dependence?

w  Are there potential drug interactions?

w  Have the maximum dose and exit strategy been defined?

To read the full article visit http://www.australianprescriber.com/online-first/87/opioid-prescribing-pitfalls-medicolegal-and-regulatory-issues