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Better pain management can help NZ avoid an opioid crisis


August 22, 2019

Better pain management can help New Zealand avoid an opioid crisis

One thing that has been learnt from the opioid epidemic in the US is that treating pain with a more multidisciplinary approach can keep patients off opioids according to a visiting Stanford University Professor of Anesthesiology, Perioperative and Pain Medicine, Ed Mariano.

Dr Mariano, who is presenting at the New Zealand Anaesthesia Annual Scientific Meeting (ASM) in Queenstown this week [August 21-24, 2019], is part of an unprecedented grouping of more than 125 private and public organisations in the US that have come together to fight the epidemic that kills an estimated 130 people in that country daily.

Dr Mariano, says they initially looked at guidelines limiting how doctors should prescribe opioids but they came to the conclusion that to best help patients who are suffering from pain or addiction doctors don’t need more rules. They just need more options. "If we treat pain better, with all the options available to us, then patients will not have to rely on opioids as their only method of managing pain.”

He says they are looking at questions such as which patients would benefit from acupuncture or cognitive/behavioural therapy? How should you treat a patient who's been on opioids for years for chronic pain? What about patients with substance use disorders? Under what circumstances are opioids actually indicated?

In New Zealand, the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists is advocating for more investment in chronic pain services throughout the country using multidisciplinary pain clinics as a model.

Dr Mariano says pain is, at the same time, a physical and emotional experience. “As an anaesthesiologist and hospital-based physician, I specialise in developing strategies to prevent and treat the acute pain associated with surgery and traumatic injury. These strategies include non-pharmacologic techniques that do not rely on drugs, interventions such as nerve blocks which are targeted injections of numbing medicine, and various classes of pain medications.”

Dr Mariano explains that acute pain, when not treated appropriately, can lead to chronic pain. “Anaesthetists are well place to help health systems identify gaps in care and develop potential solutions that ensure multimodal and multidisciplinary pain management for all patients.”


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