People prescribed opioid drugs as painkillers are being kept under close scrutiny, says a Tauranga pharmacist.

A Capital and Coast District Health Board doctor has raised concerns about other doctors prescribing oxycodone, otherwise known as ‘hillbilly heroin' to patients suffering severe pain.

Tauranga patients are closely monitored if they are being prescribed opioid pain medication. File photo.

According Dr Peter Moodie, a Wellington GP and Pharmac medical director, between 2007 and 2011, the number of patients dispensed oxycodone nationally increased 254 per cent, compared with a 37 per cent increase in morphine.

Bay of Plenty District Health Board pharmacist Helen Cant says oxycodone is a strong opioid used for moderate to severe pain.

She says all opioids, including morphine and oxycodone, have the potential for dependence.

'Tauranga Hospital's pain service recommends that when people are discharged from hospital still needing opioids, that only a small amount is prescribed and further prescribing, if required, should be from a GP.

'For people with complex pain needs the pain service will liaise with a GP involved to plant appropriate reduction and cessation of opioids.”

Helen says oxycodone is in the same class of medications and is similar to morphine.

She says some people find oxycodone is better morphine for their individual situation and pain levels and vice versa, some people find morphine better.

Oxycodone is medication which is marketed in New Zealand under the brand names OxyNorm, OxyContin, Oxydone BNM, Oxycodone Orion or Arrow-Oxycodone.

Helen says it is on the list of medications subsidised in New Zealand; it is more expensive than morphine and Pharmac's recommendation is that it be used as a second-line opioid treatment if morphine is not controlling the pain adequately.

'Opioid medications act on receptors in parts of the brain and spinal cord to alleviate pain.

'Opioids are used when other pain relieving medications are not controlling the pain, or when a person is in acute pain that requires immediate control. For example many people being treated in the emergency department or people who have just had surgery require opioid medication to control their pain.”

She says once a patient has had an initial dose of an opioid their pain may be controlled with other medications such as paracetamol or anti-inflammatory medications for on-going pain relief.

'Other people with on-going pain, for example some people with cancer, require opioid medications on a regular basis.”

Helen says like all medications, there are sometimes unwanted effects.

For the opioid class of medications, side-effects can include effects on the digestive system, eg nausea, vomiting, or constipation, effects on the skin such as a rash, sweating or itching, or effects on breathing or heart rate.

She says these side effects are often controlled by other medications, but may sometimes require stopping the medication or changing to an alternative.

Further information can be found on the Medsafe website Consumer information: http://www.medsafe.govt.nz/Consumers/cmi/CMIForm.asp

More detailed information can be found on the NZ Formulary http://nzf.org.nz/nzf_1.html