Exclusive: Millions of Australians suffering chronic pain are becoming addicted to opioid drugs while they wait up to four years for specialist care - and the bill is a shocking $140 billion a year.
A damning new report to be launched by Health Minister Greg Hunt today shows chronic pain is killing three people a day, causing depression and unemployment, adding $360 million to the welfare bill.
More than 3.2 million Australians are crippled by headache, back ache, arthritis and other chronic pain the Deloitte Access Economics report for Pain Australia shows.
“The rising rate of deaths associated with prescription opioids is just one indicator that we aren’t dealing with chronic pain well in this country,” said Associate Professor Malcolm Hogg, Head of Pain Services at Melbourne Health, and Painaustralia Director.
There were 823 deaths and 3011 hospitalisations for prescription opioid misuse in 2017-18, costing the health system $13.4 million.
A further 10,756 Australians used medicines to treat opioid misuse the report found at a cost of $60 million, the report found.
Underlying the huge social and financial cost of pain is poor treatment.
There are only 316 pain specialists across the country to treat the millions living in pain, only one in every 100 people with chronic pain ever receives the multidisciplinary care they need.
To solve the problem Pain Australia wants access to specialist pain clinics, usually run by public hospitals, doubled at a cost of $70 million a year.
The measure would actually save more than four times as much as it costs by getting people off subsidised medicines and welfare and back to work the report shows
A specialist led national GP training program costing $45 million to train GPs how to better manage chronic pain is also needed.
A switch to doctors prescribing atypical opioids rather than conventional opioids could potentially save as many as 249 lives per year and yield savings of $209 million in overdose-related costs alone.
The report makes a compelling case for change by breaking down the alarming cost of pain.
Last year alone, people living with chronic pain spent $2.7 billion in out of their own pockets on medicines, physiotherapy, and other health costs to manage their pain, the analysis shows.
The health system spent a further $12.2 billion on hospitals visits, subsidised medicines and Medicare rebates for those in pain.
A further $12.7 billion was spent on care, aids like wheelchairs and home modifications.
On average, Australians with chronic pain were estimated to be absent from work for an additional 8.6 days per year compared to people without chronic pain and this cost the economy $3.2 billion in 2018.
People with chronic pain were 30 per cent less likely to be employed than those without pain and this cost them and the economy $36.18 billion or $16,338 per working age Australian living with chronic pain.
People with chronic pain also experience a substantial reduction in their quality of life, valued at an additional $66.1 billion and close to 1.45 million Australians living with chronic pain also live with depression and anxiety.
“Without genuine reform, quickly implemented, our research shows the cost of chronic pain will climb from $139.3 billion today to $215 billion by 2050, putting even more pressure on the back pockets of patients and an already struggling health system that is ill-equipped to adequately manage chronic pain,” said Pain Australia CEO Carol Bennett.
Sarah Fowler ended up in a wheelchair when she was in fifth grade because of severe neurological pain caused by chronic regional pain syndrome.
“I’d walk through cobwebs and my body would scream at me, someone would touch my skin and it would feel like a knife,” she said.
Unable to access specialist pain clinics Sarah was misdiagnosed as having a mental illness and teased at school by students and others who did not believe her pain was real.
“Considering I was a 12-year-old girl stuck in a wheelchair in a capital city and couldn’t get treatment that shows we need more services,” she said.
The Canberra student finally got access to a pain clinic at Randwick Hospital in Year Seven and got specialist treatment including physiotherapy, hydrotherapy and cognitive behavioural programs that allowed her to retrain her brain to cope with her agony.
She finished Year 12 with high marks and is now studying engineering at Canberra University.
“The pain is always there but my brain is able to deal with it without much impact on myself,” she said.
Chronic pain mismanagement is leaving too many of us hurting
Painaustralia CEO Carol Bennett
April 4, 2019 2:00pm
Today, millions of Australians will visit their local GP or other health professional to seek help for one very common condition: pain.
It is the one complicated thread that links nearly every ailment and malady our medical system can treat. And that is just the start of the problem.
For many years we have grappled with the complexities of chronic pain. Sometimes pain cannot be ‘treated’, cannot be explained, cannot be ‘killed’ with medication.
Effective pain management, the way we respond to chronic and persistent pain, has now become one of those glaring public health challenges. Like pain itself, this challenge is often overlooked or invisible to the public eye.
A new report has shone a light on the true magnitude of the issue. We now know that more than 3.2 million Australians live with painful conditions, from arthritis to low back pain, to endometriosis and fibromyalgia.
Across all these chronic conditions sit a labyrinth of treatment pathways. Sometimes these pathways manage to get people headed in the right direction, but more often they lead to further problems and ongoing suffering.
New data by Deloitte Access Economics shows that more than 68 per cent of pain management consultations will end with a GP prescribing pain medication. Another 13 per cent will end in imaging, but less than 15 per cent can hope to be referred to an allied health professional.
This is a situation that is problematic on two fronts. Not only are we pushing millions of Australians towards a pharmacological pathway of pain management, we are also depriving them of what is an evidence-based way of best practice pain management.
The first of these issues, the over-reliance on pain medication now has a name: the opioid crisis. This epidemic is expanding on a global scale. In Australia, the rise in prescribing of pain medications, particularly opioids, has had devastating results, with the levels of harm and deaths due to opioid misuse rising exponentially.
More than three million people were prescribed 15.4 million opioid scripts in 2016-17. Most concerningly, opioids now account for 62 per cent of drug-induced deaths, with pharmaceutical opioids now more likely than heroin to be involved in opioid deaths and hospitalisations.
In 2016-17 there were 5,112 emergency department presentations and 9,636 hospitalisations due to opioid poisoning, with three deaths per day attributed to opioid harm — higher than the road toll.
While these numbers may seem enormous, of even more concern are the very real struggles faced by the people behind these figures. Every day millions of Australians battle with the physical, mental and emotional toll of chronic pain impacting every facet of their lives. Nearly 1.45 million people in pain also live with depression and anxiety.
Unfortunately, a lack of pain specialist care and GPs with limited options to deal with chronic pain means many of these Australians are falling through the cracks of the country’s health system. They are not receiving the multidisciplinary care they deserve and are inappropriately prescribed opioids, which is not recommended for the ongoing treatment of chronic pain.
This has also led to some truly staggering economic costs.
Chronic pain now costs Australia 73.2 billion dollars each year including $48.3 billion in lost productivity; and even larger is the impact on quality of life — costing our society an estimated $66.1 billion each and every year and bringing the total cost to $139.3 billion.
The stakes are clearly very high. If our policy framework to treat pain doesn’t change, then the annual cost of pain in Australia will rise from $139.3 billion in 2018 to an estimated $215.6 billion by 2050.
This seems like an insurmountable challenge. Where do we begin to start unravelling an issue so complex, and so entrenched across the spectrum of our health, social and economic structures?
As always, the answer often lies at the heart of the issue, the person living with chronic pain. We must go back to basics and provide consumers with the support they need to make informed decisions around their pain management options and pathways. We need to educate both consumers and health practitioners that chronic pain is not just a physical condition or a symptom, but a chronic condition in its own right.
This approach to pain management, the psycho-social-bio approach, is central to the aims of both the National Pain Strategy and the National Strategic Action Plan for Pain Management. Both these visionary documents provide a blueprint for the treatment of pain, recommending an interdisciplinary approach to deliver best practice pain management which takes into account the complex physical, psychological and environmental factors that underpin pain conditions.
We have extensive evidence to show the impact of poor pain management. It is clear too many people are suffering, too many have waited for too long to get the help they need.
We now have a responsibility to these people to move beyond all the statistics, all the words, all the policy documents and their well-meaning sentiments. We have the solutions clearly outlined in an agreed National Action Plan. Failing to address chronic pain in Australia is no longer an option.