Using opioids in general practice for chronic non-cancer pain: an overview of current evidence

We note with interest the recent article by Currow and colleagues,1 discussing the use of opioids for the management of non-cancer pain. This piece highlights increased opioid use occurring in Australia and elsewhere. As large scale providers of residential medication management reviews (RMMRs) in the residential aged care facility setting, we write to provide a different insight into the use of these analgesics among older people. We recently analysed aggregated, de-identified data from 15 178 RMMR reports — provided in response to general practitioner referrals from 2014 to 2016 — examining the use of potent oral analgesia. We found that there was little use of methadone or hydromorphone, and the subsequent analysis was limited to addressing only oral morphine, oxycodone and tramadol. Unlike the data from the Australian statistics on medicines,2 the RMMR represents a snapshot picture of all medicines prescribed, regardless of whether these were subsidised by the Pharmaceutical Benefits Scheme.