Throughout 2017, Australians were advised to seek alternatives to one of the country’s most commonly used painkillers — codeine — in advance of it becoming a prescription-only medication on 1 February 2018.
What is codeine?
Codeine is an opiate medication, coming from the same family of drugs as opium, heroin and morphine. Opiates can be useful in pain management as they block the pain receptors in the body, thereby reducing the impact of the pain messages being sent to the brain.
The readily available nature of the drug gave it a reputation for being a low risk medication, while research has revealed the opposite to be true. Our body’s tolerance of the drug builds up over time, requiring increasingly larger doses. As an over the counter medication, many patients have been dangerously self-medicating, leading to accidental overdose deaths. This is the key reason codeine has been listed as a prescription-only drug.
Codeine is not the only viable option for managing pain. According to the Dean of the Faculty of Pain Medicine (FPM), Dr Chris Hayes, combination drugs containing ibuprofen and paracetamol are a great over-the-counter solution that provide better, non-addictive pain relief. Codeine will still be available, but its use under medical supervision will ensure greater safety for those taking it.
Taking a multi-disciplinary approach
The new restriction has concerned many who have depended on the drug for ongoing pain management. But it’s expected their treatment outcomes will improve in the longer term, with more focused pain management strategies in place. The best action with any long-term condition is to take a multi-disciplinary approach. So, assembling a team that includes your GP and pharmacist — as well as allied health professionals (such as occupational therapists, physiotherapists, dieticians and psychologists) — is essential.
Pain Australia offers a number of resources on how to take a multi-disciplinary approach to pain management.
Understand your own pain
Of course, each experience of chronic pain is unique and it can take a bit of time to refine a program that suits your lifestyle, budget and needs. Pain is controlled by our nervous system, so behaviours and nutrients that strengthen and train us to respond differently to pain can also be enormously beneficial.
Recognising the source of your pain and the secondary pain that results from the primary issue is crucial. This can allow you to manage the direct cause, as well as the additional symptoms, on a case by case basis. Understanding the levels of pain experienced in different situations can be useful too. A niggling headache or muscular pain may only require some relaxation exercises, stretching or magnesium oil, whereas deep tendon pain may need acupuncture, osteopathic treatment and a day or two of anti-inflammatory medication.
Move, eat, restore and revitalise
There are few conditions of chronic pain that are not alleviated in some way by lifestyle changes such as nutrition, physical therapy, exercise and self-care. A more comprehensive approach to pain management will incorporate some kind of physical activity — swimming, walking, or even just 10 minutes of stretching — into your daily routine, as well as supportive treatments such as regular physio visits, remedial massage or even simple home strategies like a hot Epsom salt bath.
You’ll probably be advised by one of your practitioners to drink more water and to make dietary changes – reducing the intake of processed and refined foods may reduce inflammation. There are also a number of natural anti-inflammatories and nutritional supplements that have been widely used in recent years. Fish oils (for lubrication of joints and nerve health), magnesium (for muscle pain), turmeric tablets (or curcumin — for inflammation) and glucosamine (for joint repair) have all been found to offer relief.
If short term treatment is unsuccessful, see your GP to discuss an ideal management plan for your pain.