Two medical groups yesterday urged the Ministry of Health and Welfare to relax the restrictions on opioids for patients with end-stage non-cancer diseases and people older than 65, to help relieve their pain.
On this year’s Global Day Against Pain yesterday, the Taiwan Pain Society and the Taiwan Academy of Hospice Palliative Medicine said the tight restrictions on prescribing controlled pain relievers have forced many chronically ill patients to have to endure pain.
Taiwan Pain Society director and physician at Mackay Memorial Hospital’s Department of Anesthesiology Lin Chia-Shiang (林嘉祥) said that many older people suffer chronic pain from degenerative joint diseases, backache, spinal stenosis, post-herpetic neuralgia or neuropathy, and the prevalence is between 45 and 80 percent.
According to an overseas study, about 28 percent of patients with non-cancer diseases have thought about taking their own lives due to the constant pain, he said, adding that when other types of painkillers cannot stop the pain, in between 70 and 80 percent of cases the pain can be controlled by the use of opioids.
However, the tight restrictions on the drugs make it difficult for these patients to get a prescription for opioids, because they need to get the approval of physicians in several different departments, prescriptions are limited to 14 days and the approvals need to be renewed every six months, Lin said.
“Some older patients who even have trouble turning their body over in bed have to call an ambulance to take them to hospital every time they need to get a new prescription from the doctor,” he said.
“Many chronic pain and intractable pain sufferers are in pain every day, from the moment they wake up in the morning,” Taiwan Academy of Hospice Palliative Medicine director Weng Yih-chyang (翁益強) said.
A study has shown that about 70 percent of end-stage non-cancer patients suffer severe pain, Weng said.
The groups said that while an estimated 400,000 people suffer from moderate to severe pain from non-cancer diseases, only about 800 prescriptions have been granted because the procedure to prescribe opioids is so complicated.
Lin said if the government is afraid of drug addiction, it should re-educate physicians to prescribe medication only for those suffering chronic pain.
In response, Food and Drug Administration Division of Controlled Drugs head Ho Shu-hui (何淑惠) said the tight restrictions on opioids are to protect patients, because abusive use of painkillers can lead to drug addition.
She said having the patient revisit a doctor regularly is a mechanism by which the doctor can adjust the dosage and be made aware of any possible side effects, Ho said, adding that the agency would continue to communicate with physicians and specialists about the issue.
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