Lecture Notes
Opiate Prescribing: The Chronic Pain Perspective – Dr Paul Ferris

Dr Paul Ferris is one of our local pain specialists. He employs a wide variety of techniques to help manage chronic pain in some of the most complex of our patients.

Strategies for managing chronic pain:

  • Opioid contracts
  • Avoiding dose escalation
  • Setting clear goals based on functional improvement, not numerical pain scores
  • Nonpharmacological management including education, exercise, social re-engagement
    • Discussions focusing on collaboration not confontration, autonomy and exploration
    • Advocate for re-engaging with family, friends and community, i.e. the local Men’s Shed, Bowls, CWA, Church, bridge, clubs or craft groups
    • For exercise, consider meditation, pilates, tai chi, yogo
  • Pharmacological strategies including multimodal analgesia, opioid rotation, steroid injections, medicinal cannabis and nerve stimulators for selected patients
    • Consider opioid rotation

Medicinal cannabis is surging in popularity, but it doesn’t help everyone and there are complex issues to consider (including inability to drive with preparations containing THC). Prescribing rights for medicinal cannabis are available for General Practitioners if interested (details to come later in the day today).

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