Long delays for persistent pain management

By Dr. Ananya Mandal, MDApr 1 2012

Chronic pain sufferers like cancer survivors are among scores of people waiting up to a year to be treated for pain.

An article in The Medical Journal of Australia reveals that taxpayers are paying $34 billion a year to treat persistent pain. Pain specialist Dr Timothy Semple, and president of the Australian Pain Society, told the Herald Sun chronic back pain, arthritis, nerve injuries and people who needed care after surviving cancer made up significant numbers.

He said 25 per cent of pain sufferers waited up to a year to receive treatment while in Victoria the median wait time was almost four months. He said, “It's just not really acceptable…It's awful to happen to anyone if you have severe pain because it impacts on your quality of life.'”

The study, published on Monday surveyed 57 public and private pain management services and five specialized pediatric services across Australia. Pain management services are offered at private clinics and as outpatient services at some major hospitals. The services help people suffering chronic pain such as back, neck, nerve and post-trauma pain, headaches and shingles.

Patients in South Australia waited up to 420 days, followed by Victoria on 370 days and NSW and Western Australia with 365 days each. Co-author Dr Malcolm Hogg, head of pain services at Royal Melbourne Hospital, said the median wait time for publicly-funded adult pain management services was five months compared to 38.5 days for private services. A quarter of those surveyed had waits of one year and the longest wait time was more than two years, he told AAP. He said overseas studies suggested patients' physical and psychological health deteriorated if they waited more than six months for treatment.

Rural patients and children were found to be particularly poorly served, with only two states, NSW and Victoria, having dedicated pediatric pain services, all of which had a 60-day waiting time for initial access.

Dr Hogg said 20 per cent of the community had recurring or persistent pain and five per cent were seriously impacted. The problem would continue to worsen as Australia's population aged, he said. “We are going to have this large population of people with chronic pain, particularly chronic musculoskeletal pain, who would benefit from these services,” Dr Hogg told AAP.

Dr Semple said there was a rise in the number of opiates being prescribed to pain sufferers without other alternatives being accessed first. “Our concern is they (opiates) are not being used as they should be,” he said. Dr Semple called for better resources for GPs, a public campaign on the issue and increased specialist services.

The federal government has committed to introducing a real-time prescription monitoring system this year. In a letter also published in MJA Dr. Semple wrote, “Regulation needs to be increased, but only in parallel with significantly improved system-wide pain management capacity so that Australians living with pain do not continue to wait in pain.”