Fewer Opioids More Options PartridgeGP Movement Theory

Did you know that here have been some big changes with the pack sizes of immediate release opioids/narcotics under the PBS as of June 1?

 

Me neither!

 

What does this mean in English? It means that doctors will be unable to prescribe large packs of addictive medication without ringing the government and asking for permission (with good reason!). 

 

Why?

 

Some good information can be found here

 

But to summarise:

 

The drugs work in the short term – but they don’t keep working

We have better and safer options

These drugs kill people

 

These changes haven’t been well publicised…but here they are:

 

 

pbs changes1

pbs changes 2

pbs changes 3

 

And:

 

Patients who require long-term treatment of chronic pain with opioids will still be able to access larger pack sizes and prescribers will be able to prescribe repeats where they meet the new restrictions requirements.


For chronic pain, increased quantities and/or repeats may be authorised by Services Australia where the patient meets the restriction requirements. Increased quantities to extend treatment up to one month may be requested via telephone/electronic authority request, and up to 3 months’ supply (up to 1-month quantity and up to 2 repeats) may be requested via an electronic/written authority request.


To be eligible for treatment with high strength opioids such as morphine, patients will need to be unresponsive or intolerant, or have achieved inadequate relief of their acute pain, following maximum tolerated doses of other lower strength opioid treatments.


These new arrangements apply to all PBS listings for opioid medications and therefore there will also be amendments to the tramadol and paracetamol/codeine restriction requirements.


All new and amended restrictions will be updated on the PBS website (pbs.gov.au) from
1 June 2020.

 

What does this change mean for prescribers?


The new opioid listings for reduced pack sizes will provide a simplified way for prescribers to  prescribe smaller quantities of immediate release opioids for acute, short-term treatment.


Prescribers must ensure that patients meet the relevant restriction criteria when prescribing opioids under Restricted Benefit and Authority Required (STREAMLINED) PBS listings. The ‘streamlined authority code’ is located on the relevant PBS listing on the PBS website. To prescribe an Authority Required (Telephone/Electronic) item, the prescriber is required to request authority approval from Services Australia through the Online PBS Authorities System or by calling 1800 888 333.


To ensure appropriate use of opioid medicines for the management of pain, patients must be referred to a pain specialist or alternative prescriber for clinical review if opioid use exceeds or is expected to exceed 12 months. The date of the review and name of the medical practitioner consulted must be provided for every authority application.

 
low angle photography of a road
Moving Forward

 

So from June 1:

 

  • If these addictive narcotic medications are required, your GP may prescribe smaller packs for your use
  • Please please please speak to your GP about any issues you are having – we have lots of options including counselling, physical therapy, diversional therapy, physiotherapy, non-drug therapy, other medications, and referrals to non-GP specialists for complex problems
  • We still care, we still want to help, we want to be safer and better for you
  • If you are on medications for 12 months or more, you will need to have a formal consult with another GP or specialist in addition to your usual GP to keep getting medication on a PBS (subsidised) prescription. 

 

We are here to help you

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PartridgeGP

Bookings

If you would like to work with us, call Dr Nick on 8295 3200 or click here

movement theory

Movement Theory

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Risk and COVID19

Did you know that they just released data from 17 million anonymised patients in the UK and analysed risk factors for #covid19 ?

Full Paper here

We are only a phone call (with video if needed!) away if you need more information.

SA has guidelines – the roadmap back!

And in the future

Did you also know that we can Test You for COVID 19 / Coronavirus if

Unexplained fever / chills
Unexplained cough/sore throat/short of breath
High risk settings:

Aged care and other residential care facilities
Healthcare settings
Military – group residential and other closed settings, such as Navy ships or living in accommodation
Boarding schools and other group residential settings
Educational settings where students are present
Childcare centres
Correctional facilities
Detention centres
Workplaces where social distancing can’t be readily practised
Remote industrial sites with accommodation (e.g. mine sites)
Aboriginal and Torres Strait Islander rural and remote communities, in consultation with CDCB
Settings where COVID-19 outbreaks are occurring, in consultation with CDCB

Testing at
Australian Clinical Labs 670 Anzac Highway Glenelg IN YOUR CAR

82952877

You still need a doctor’s referral so
Partridge GP here for phone consults at http://bit.ly/2XmM0n5 or by calling 82953200 or
HIT THE BIG BLUE BUTTON! at http://www.partridgegp.com.au

We’re here to serve you during this difficult time as we always have
To make a phone appointment click here http://bit.ly/2XmM0n5 or call us on 82953200

Typhoid Mary and COVID Colin

Those who don’t know history are doomed to repeat it.

Typhoid Mary was a cook who moved from one rich employer to another in New York and Long Island, infecting seven households with typhoid between 1900 and 1907 before doctors traced her as the common cause of the infections. The key point is that she was in good health herself throughout. When confronted, she indignantly refused to submit stool samples for analysis, until eventually imprisoned for this refusal.

After three years she was released while promising not to work as a cook. Unhappy with the low wages of a laundress, she changed her name, resumed cooking and resumed causing typhoid. After a 1915 outbreak in a hospital for women in which 25 people fell ill and two died, Mary Mallon/Brown was again arrested and kept in quarantine for the rest of her life, refusing to have her gall bladder removed. When she died in 1938, an autopsy revealed a thriving colony of typhoid bacteria in her gall bladder. For some genetic reason they had not caused any symptoms in her.

Clear!

What is the current understanding of the ability to return to work and risk of reinfection/further complications for clinicians who have recovered from COVID-19?
The department will determine when a confirmed case no longer requires to be isolated in hospital or in their own home, in consultation with the treating clinician. This will be actively considered when all of the following criteria are met:
• The patient has been afebrile for the previous 72 hours, and
• At least ten days have elapsed after the onset of the acute illness, and
• There has been a noted improvement in symptoms, and
• A risk assessment has been conducted by the department and deemed no further criteria are needed.
Apparent re-infection has been reported in a small number of cases. However, most of these reports describe patients having tested positive within 7-14 days after apparent recovery. Immunological studies indicate that patients recovering from COVID-19 mount a strong antibody response. It is likely that positive tests soon after recovery represent persisting excretion of viral RNA, and it should be noted that PCR tests cannot distinguish between “live” virus and noninfective RNA.
For further information, go to the department’s website and see Advice for clinicians / epidemiology!

Stay home | Save lives

Now, if you really really must leave home…

Flu Vaccine

Plastic Pain…and a bit of stimulation!

2018 is here and what have You done? What are You going to do?

 

 

Partridge Street General Practice is moving forward with Our Ethos of Professional, Empowering, Comprehensive care from Great GPs!

 

 

Dr Gareth Boucher

 

 

 

Dr Katherine Astill Partridge Street General Practice new female registrar
Dr Katherine Astill

 

 

Dr Monika Moy
Dr Monika Moy

 

 

Dr Penny Massy-Westropp
Dr Penny Massy-Westropp

 

 

when the drugs don’t work

 

 

We are known for not prescribing lots of narcotics. (Not a lot of benzodiazepines either, but that’s another post!). Why is that?

 

 

 

Have a look here…

 

 

 

.💊💊💊💊💊💊💊💩💊💊💊💊💊💊💊.

 

 

 

Firstly, narcotics work differently for acute and chronic pain. Evidence shows that narcotics are effective for short term relief of acute pain after surgery or in an emergency situation, like a broken leg. As time goes on and the acute injury (the break or the surgical procedure) heals or finishes, the side effects of the narcotics increase. Itching and constipation occur, and tolerance leads to a decrease in pain relief. This is chronic pain where opioids are ineffective. Your body produces its own pain relieving chemicals in response to pain or adversity. When you take narcotics or other painkillers, the body STOPS doing this. If you then stop the tablets, the body has to catch up again. This is painful and uncomfortable – We Can Help With That! (without more narcotics…)

 

 

 

There are better alternative  options. We empower our patients in regard to managing their chronic pain. That’s the Partridge Street General Practice way!

 

 

 

 

Acute pain alerts us to injury or disease by sending a signal to the brain, saying “This is where you are hurt – attend to it”. Chronic pain is the afterlife of this acute pain, when the initial pain has affected the bodily tissues and the neurons in our pain system with false alarms, making us believe the problem is in our body when it is mostly in our brain. 


 

 



This evocative description comes from Dr Norman Doidge‘s book ‘The Brain’s Way of Healing’. He describes a scientific theory of neuroplasticity, whereby the brain’s structure and function can be changed without medication, achieving long lasting positive changes.

 

 

 

A book for the mind and the body.

 

 

 

 

Long Lasting Positive Changes are what we’re about at Partridge Street General Practice!

 

 

Partridge Street General Practice drugs of dependence policy

 

 

We’re Here to Help You.

 

 

 

 

 

You can see any of our Great GPs right here:

 

 

Dr Gareth Boucher

 

 

Dr Penny Massy-Westropp

 

 

Dr Monika Moy

 

 

Dr Katherine Astill

 

 

Dr Nick Mouktaroudis

 

 

Dr Nick Tellis