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Chronic pain is a mental health issue, too

Debilitating chronic pain affects more than 1 in 5 New Zealanders and is increasing among New Zealanders who are over 55, particularly for Māori, according to the Royal Australian and New Zealand College of Psychiatrists (RANZCP).

The Chair of New Zealand Faculty of Consultation Liaison Psychiatry, Dr Adam Sims, said, ‘The need to invest in the pain services is now urgent, this is a physical and mental health care issue as well as an equity issue’.

Dr Sims welcomed the recent report from the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists, which highlights the costs to the NZ community of chronic pain and specific system changes, including investing in best practice care and improving data capture.

‘Chronic pain affects the mind and body, yet is often invisible to others, so the impact it has on mental health, lifestyle, general health, family and work is frequently misunderstood. People who access pain medicine services have better outcomes because all these dimensions are treated’.

Dr Sims emphasised that consultation–liaison psychiatry is a specialty within the field of psychiatry and offers significant benefits to those suffering from chronic pain.

‘These psychiatrists work in a particularly holistic way to bridge the gap for people with mental health and physical problems, helping them to overcome barriers to accessing pain services and linking people to a range of therapies and interventions’.

However, as Dr Paul Vroegop who is trained in both medical sub-specialities stressed, both pain specialists and consultation–liaison psychiatrists are in severely short supply in New Zealand and this situation requires urgent action.

‘Without addressing the specialist workforce shortages, the ever expanding population of chronic pain sufferers will remain untreated, or they may receive little more than medication to manage their pain which could result in increased opioid dependence nationwide’, said Dr Vroegop.

Dr Sam McBride, Chair of the RANZCP New Zealand Faculty of Addiction Psychiatry, warned that the inability to access specialist pain services risks a reliance on medications such as opioids which will have little benefit on functioning, may worsen chronic pain and result in addiction and associated harms to the individual and others.

‘We know that linking people to integrated, multidisciplinary models of care will improve outcomes of health and wellbeing – evidence shows this reduces the amount of pain medication required and can reduce the burden on other health services’.

Dr McBride said, ‘The report provides solid evidence – upfront investment in pain management services and informing consumers and carers would produce long-term gain for people of all ages and ultimately for the health system’.

For more information see: The Problem of Chronic Pain and Scope for Improvements in Patient Outcomes and the RANZCP Faculty of Consultation–Liaison Psychiatrists' submission to the inquiry into mental health and addiction.

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