‘Working out’ opioids. Presented by Dr Pene Wood
Exercise Physiologists can contribute to minimising opioid harm
Pain is debilitating, exhausting and has an impact on all parts of a person’s life. Multimodal management, including exercise, as we know, is recommended for chronic pain management. And another- medications including opioids - are in the mix. You’ll likely have clients who have been prescribed opioids. You may be aware of their potential for harm and the challenges which make opioid use complex.
The problem with opioids is…well, that there are lots of problems with them. From adverse and long-term side effects, toxicity, dependence and hyperalgesia- yes that’s right, opioids can sometimes worsen pain - there’s a multitude of ways use can present challenges, often far beyond their initial value.
And yet, it’s not straightforward. They do have an effective role in short term pain relief. For those who are long-term users, the impact of discontinuing prescription can result in worsening well-being outcomes.
As allied health professionals, we can monitor and identify clinical time points where we can proactively contribute to multidisciplinary care within our scope. Learning to recognise opioid use red flags is the first step. From there we can contribute proactively to meaningful communication and education with the GP, prescriber, other health professionals and the client. Understanding how opioids impact cognition, drowsiness and falls risk ongoingly elevates the importance of exercise safety assessments and planning. By simply adopting the perspective of “risky drugs not risky patients” we bring compassionate understanding to our role in minimising opioid-related harm.
Dr Pene Wood has practised in pharmacy for over 20 years including Community Pharmacy, academia, and at the Western Victoria Primary Health Network as the Opioid Management Team lead. Her current role is as a GP practice pharmacist specialising in pain and addiction, working in both Aboriginal Health and Community Health. Pene also holds an honorary position at La Trobe University as an adjunct lecturer in pharmacy. 2021 saw Pene complete her doctorate with her thesis “Opioids: What Role Can The Pharmacist Play?”.
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