How opioid discontinuations are devastating thousands of cancer and chronic pain patients

Australia is currently grappling with a significant shortage of opioid pain medicines, a crisis that is impacting some of the nation's most vulnerable citizens.

This shortage is due to the discontinuation of more than a dozen types of opioid products in the past year, a move that has drastically limited the options available to doctors for treating their patients.

However, this change might also have enduring and painful implications for certain patient groups.


The Impact of Opioid Discontinuations​

Kathy Claxton, a mother of three, is one of the many affected by this shortage. Four years ago, she lost her pancreas to neuroendocrine cancer and now lives with the pain of neuroendocrine tumours in her liver.

She relied on the liquid morphine product Ordine for pain relief, but all four strengths of the medicine were discontinued mid-year.


compressed-pexels-anna-shvets-3845126 (1).jpeg
The opioid shortage has a painful impact on vulnerable Aussies. Source: Anna Shvets/Pexels


Now, she is about to lose access to their replacements, Sevredol and Oxynorm, after supplier Mundipharma announced that these products would also be discontinued over the next 18 months.

Without these medicines, Claxton says she cannot care for her three teenage children.


'The worst the pain ever gets is when you can't physically do anything—all I want to do is be in bed,' she said.

She recently underwent a five-week hospital stay to manage her pain. If the opioids continue to disappear, Kathy fears she will end up in hospital on a morphine drip for the rest of her life.

‘It's starting to concern me as to why are they going off the market,’ she added.

This discontinuation impacts not only cancer patients like Kathy but also vulnerable individuals experiencing chronic pain who require opioid-based relief.

Previously, it has been reported that one in five Australians live with chronic pain lasting three months or more. Common causes include back and neck pain, headache, and joint pain.

The Looming 'Health Crisis'​

Palliative Care Australia Chief Executive Camilla Rowland warned that a 'health crisis' is looming, with sick children, the dying, and those with chronic pain set to be the most affected.

Palliative Care Australia is among health bodies that wrote to Health Minister Mark Butler to raise concerns about ‘vital’ pain relief medicines.

'This is a serious risk for all Australians requiring management of serious pain,' Ms Rowland said.

Other products being discontinued include four strengths of MS Mono capsules, MS Contin sachets, Jurnista tablets and Dilaudid oral liquid.

An estimated 270,000 scripts of the discontinued drugs are filled each year, meaning limited options for thousands of Australians.


The Reasons Behind the Discontinuations​

The reasons behind these discontinuations are complex and multifaceted. Some suggested that the medicines are not generating sufficient income for the companies. Others point to the fact that these medications may be coming off patent, making them less profitable.

Dr Michelle Gold, President of the Australia and New Zealand Society of Palliative Medicine (ANZSPM) finds it hard to understand why the medicines have been discontinued at short notice.

'Surely they should have some moral obligation to ensure that people are not left without essential medications simply because a product becomes less profitable,' she said.

Tip
Keep track of medicine shortages and discontinuations on the TGA’s Medicine Shortage Reports Database here.

MundiPharma, which supplies the medicines, said that the products were withdrawn 'after careful consideration' and most had alternatives.

'This was a global business decision, based on the complexity of continuing to provide these products in certain markets,' the company said.

‘With Ordine, Mundipharma is currently exploring all possible options and is still seeking continuation of Ordine for Australian patients,’ they added.


In response to the crisis, the Therapeutic Goods Administration (TGA) has stated that the discontinuations are a 'high priority'.

At a meeting of the medicines shortage action group, the topic was addressed, and the TGA has authorised a temporary import of foreign substitutes for some of the discontinued medications.

‘The TGA will meet with affected groups in early 2024 to discuss issues relating to these discontinuations,’ it said.

‘We are also continuing to discuss longer-term supply of Australian-registered alternatives to these discontinued products with other sponsors,’ the TGA added.

What Can Be Done?​

Health groups have also called on Mr Butler to force pharmaceutical companies to extend notice of discontinuation from 6 months to a year, consult with clinicians, review processes so alternatives can get Pharmaceutical Benefits Scheme (PBS) listing quickly, and proactively look for alternative products.

They also want the government to consider ways to manufacture the medicines locally, considering thatn Australia is among the largest producers of pharmaceutical opioid poppies in the world.


In the meantime, patients and their families are encouraged to speak with their healthcare providers about potential alternatives and to plan for possible disruptions in their pain management.

As we navigate this challenging time, let's remember to support those affected and push for solutions that ensure all Australians can access the pain relief they need.

Key Takeaways
  • Doctors and pain groups are warning of a health crisis due to the discontinuation of several opioid medicines critical for cancer and chronic pain patients.
  • Kathy Claxton, a cancer patient in need of opioids for pain management, is among those affected by the shortage of these essential medicines.
  • Health advocacy groups are urging the government to take actions such as requiring longer notice periods for drug discontinuations and considering local manufacture of the medicines.
  • The Therapeutic Goods Administration (TGA) recognises the issue as a ‘high priority’ and is working on finding temporary supply solutions and longer-term Australian-registered alternatives.

Have you or a loved one been affected by the opioid discontinuation, members? Share your experiences and thoughts in the comments below.
 
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Australia is currently grappling with a significant shortage of opioid pain medicines, a crisis that is impacting some of the nation's most vulnerable citizens.

This shortage is due to the discontinuation of more than a dozen types of opioid products in the past year, a move that has drastically limited the options available to doctors for treating their patients.

However, this change might also have enduring and painful implications for certain patient groups.


The Impact of Opioid Discontinuations​

Kathy Claxton, a mother of three, is one of the many affected by this shortage. Four years ago, she lost her pancreas to neuroendocrine cancer and now lives with the pain of neuroendocrine tumours in her liver.

She relied on the liquid morphine product Ordine for pain relief, but all four strengths of the medicine were discontinued mid-year.


View attachment 38828
The opioid shortage has a painful impact on vulnerable Aussies. Source: Anna Shvets/Pexels


Now, she is about to lose access to their replacements, Sevredol and Oxynorm, after supplier Mundipharma announced that these products would also be discontinued over the next 18 months.

Without these medicines, Claxton says she cannot care for her three teenage children.


'The worst the pain ever gets is when you can't physically do anything—all I want to do is be in bed,' she said.

She recently underwent a five-week hospital stay to manage her pain. If the opioids continue to disappear, Kathy fears she will end up in hospital on a morphine drip for the rest of her life.

‘It's starting to concern me as to why are they going off the market,’ she added.

This discontinuation impacts not only cancer patients like Kathy but also vulnerable individuals experiencing chronic pain who require opioid-based relief.

Previously, it has been reported that one in five Australians live with chronic pain lasting three months or more. Common causes include back and neck pain, headache, and joint pain.

The Looming 'Health Crisis'​

Palliative Care Australia Chief Executive Camilla Rowland warned that a 'health crisis' is looming, with sick children, the dying, and those with chronic pain set to be the most affected.

Palliative Care Australia is among health bodies that wrote to Health Minister Mark Butler to raise concerns about ‘vital’ pain relief medicines.

'This is a serious risk for all Australians requiring management of serious pain,' Ms Rowland said.

Other products being discontinued include four strengths of MS Mono capsules, MS Contin sachets, Jurnista tablets and Dilaudid oral liquid.

An estimated 270,000 scripts of the discontinued drugs are filled each year, meaning limited options for thousands of Australians.


The Reasons Behind the Discontinuations​

The reasons behind these discontinuations are complex and multifaceted. Some suggested that the medicines are not generating sufficient income for the companies. Others point to the fact that these medications may be coming off patent, making them less profitable.

Dr Michelle Gold, President of the Australia and New Zealand Society of Palliative Medicine (ANZSPM) finds it hard to understand why the medicines have been discontinued at short notice.

'Surely they should have some moral obligation to ensure that people are not left without essential medications simply because a product becomes less profitable,' she said.

Tip
Keep track of medicine shortages and discontinuations on the TGA’s Medicine Shortage Reports Database here.

MundiPharma, which supplies the medicines, said that the products were withdrawn 'after careful consideration' and most had alternatives.

'This was a global business decision, based on the complexity of continuing to provide these products in certain markets,' the company said.

‘With Ordine, Mundipharma is currently exploring all possible options and is still seeking continuation of Ordine for Australian patients,’ they added.


In response to the crisis, the Therapeutic Goods Administration (TGA) has stated that the discontinuations are a 'high priority'.

At a meeting of the medicines shortage action group, the topic was addressed, and the TGA has authorised a temporary import of foreign substitutes for some of the discontinued medications.

‘The TGA will meet with affected groups in early 2024 to discuss issues relating to these discontinuations,’ it said.

‘We are also continuing to discuss longer-term supply of Australian-registered alternatives to these discontinued products with other sponsors,’ the TGA added.

What Can Be Done?​

Health groups have also called on Mr Butler to force pharmaceutical companies to extend notice of discontinuation from 6 months to a year, consult with clinicians, review processes so alternatives can get Pharmaceutical Benefits Scheme (PBS) listing quickly, and proactively look for alternative products.

They also want the government to consider ways to manufacture the medicines locally, considering thatn Australia is among the largest producers of pharmaceutical opioid poppies in the world.


In the meantime, patients and their families are encouraged to speak with their healthcare providers about potential alternatives and to plan for possible disruptions in their pain management.

As we navigate this challenging time, let's remember to support those affected and push for solutions that ensure all Australians can access the pain relief they need.

Key Takeaways

  • Doctors and pain groups are warning of a health crisis due to the discontinuation of several opioid medicines critical for cancer and chronic pain patients.
  • Kathy Claxton, a cancer patient in need of opioids for pain management, is among those affected by the shortage of these essential medicines.
  • Health advocacy groups are urging the government to take actions such as requiring longer notice periods for drug discontinuations and considering local manufacture of the medicines.
  • The Therapeutic Goods Administration (TGA) recognises the issue as a ‘high priority’ and is working on finding temporary supply solutions and longer-term Australian-registered alternatives.

Have you or a loved one been affected by the opioid discontinuation, members? Share your experiences and thoughts in the comments below.
It shouldn't be about the money. They are supposed to be helping people not their pockets!
 
Cannibas here we come. Supposed to be a good pain reliever and being legalised in some of Australia. Just hope not too many people get high using it or life could get very interesting. My daughter has used it for chronic pain, and said it does help a lot, she thinks I should try it for my bad arthritis pain, I’m not sure I want to go down that track just yet.
 
Australia is currently grappling with a significant shortage of opioid pain medicines, a crisis that is impacting some of the nation's most vulnerable citizens.

This shortage is due to the discontinuation of more than a dozen types of opioid products in the past year, a move that has drastically limited the options available to doctors for treating their patients.

However, this change might also have enduring and painful implications for certain patient groups.


The Impact of Opioid Discontinuations​

Kathy Claxton, a mother of three, is one of the many affected by this shortage. Four years ago, she lost her pancreas to neuroendocrine cancer and now lives with the pain of neuroendocrine tumours in her liver.

She relied on the liquid morphine product Ordine for pain relief, but all four strengths of the medicine were discontinued mid-year.


View attachment 38828
The opioid shortage has a painful impact on vulnerable Aussies. Source: Anna Shvets/Pexels


Now, she is about to lose access to their replacements, Sevredol and Oxynorm, after supplier Mundipharma announced that these products would also be discontinued over the next 18 months.

Without these medicines, Claxton says she cannot care for her three teenage children.


'The worst the pain ever gets is when you can't physically do anything—all I want to do is be in bed,' she said.

She recently underwent a five-week hospital stay to manage her pain. If the opioids continue to disappear, Kathy fears she will end up in hospital on a morphine drip for the rest of her life.

‘It's starting to concern me as to why are they going off the market,’ she added.

This discontinuation impacts not only cancer patients like Kathy but also vulnerable individuals experiencing chronic pain who require opioid-based relief.

Previously, it has been reported that one in five Australians live with chronic pain lasting three months or more. Common causes include back and neck pain, headache, and joint pain.

The Looming 'Health Crisis'​

Palliative Care Australia Chief Executive Camilla Rowland warned that a 'health crisis' is looming, with sick children, the dying, and those with chronic pain set to be the most affected.

Palliative Care Australia is among health bodies that wrote to Health Minister Mark Butler to raise concerns about ‘vital’ pain relief medicines.

'This is a serious risk for all Australians requiring management of serious pain,' Ms Rowland said.

Other products being discontinued include four strengths of MS Mono capsules, MS Contin sachets, Jurnista tablets and Dilaudid oral liquid.

An estimated 270,000 scripts of the discontinued drugs are filled each year, meaning limited options for thousands of Australians.


The Reasons Behind the Discontinuations​

The reasons behind these discontinuations are complex and multifaceted. Some suggested that the medicines are not generating sufficient income for the companies. Others point to the fact that these medications may be coming off patent, making them less profitable.

Dr Michelle Gold, President of the Australia and New Zealand Society of Palliative Medicine (ANZSPM) finds it hard to understand why the medicines have been discontinued at short notice.

'Surely they should have some moral obligation to ensure that people are not left without essential medications simply because a product becomes less profitable,' she said.

Tip
Keep track of medicine shortages and discontinuations on the TGA’s Medicine Shortage Reports Database here.

MundiPharma, which supplies the medicines, said that the products were withdrawn 'after careful consideration' and most had alternatives.

'This was a global business decision, based on the complexity of continuing to provide these products in certain markets,' the company said.

‘With Ordine, Mundipharma is currently exploring all possible options and is still seeking continuation of Ordine for Australian patients,’ they added.


In response to the crisis, the Therapeutic Goods Administration (TGA) has stated that the discontinuations are a 'high priority'.

At a meeting of the medicines shortage action group, the topic was addressed, and the TGA has authorised a temporary import of foreign substitutes for some of the discontinued medications.

‘The TGA will meet with affected groups in early 2024 to discuss issues relating to these discontinuations,’ it said.

‘We are also continuing to discuss longer-term supply of Australian-registered alternatives to these discontinued products with other sponsors,’ the TGA added.

What Can Be Done?​

Health groups have also called on Mr Butler to force pharmaceutical companies to extend notice of discontinuation from 6 months to a year, consult with clinicians, review processes so alternatives can get Pharmaceutical Benefits Scheme (PBS) listing quickly, and proactively look for alternative products.

They also want the government to consider ways to manufacture the medicines locally, considering thatn Australia is among the largest producers of pharmaceutical opioid poppies in the world.


In the meantime, patients and their families are encouraged to speak with their healthcare providers about potential alternatives and to plan for possible disruptions in their pain management.

As we navigate this challenging time, let's remember to support those affected and push for solutions that ensure all Australians can access the pain relief they need.

Key Takeaways

  • Doctors and pain groups are warning of a health crisis due to the discontinuation of several opioid medicines critical for cancer and chronic pain patients.
  • Kathy Claxton, a cancer patient in need of opioids for pain management, is among those affected by the shortage of these essential medicines.
  • Health advocacy groups are urging the government to take actions such as requiring longer notice periods for drug discontinuations and considering local manufacture of the medicines.
  • The Therapeutic Goods Administration (TGA) recognises the issue as a ‘high priority’ and is working on finding temporary supply solutions and longer-term Australian-registered alternatives.

Have you or a loved one been affected by the opioid discontinuation, members? Share your experiences and thoughts in the comments below.
I feel sorry for those who need to take them. I hope they & their doctors can find something to move onto that helps them.
On the other hand, not all of us can handle opiods. I have the same allergies as close family members and the closest being my elderly mother - she is intollerant to them and after breaking my arm and being on them so am i.
So i a hoping neither of us or other close family members have to be in a situation where doctors put any of us on them.
Mum lives in horrible pain because without opiods all the doctors can give her is brufen (due to other medicinal allergies/ intollerances) for Osteoporosis/Osteoarthritis/bad knees/some kind of hernia on her belly button. Opiods almost killed my mum, mainly because a neglectful doctor put her on fentanol patches then switched her to the pills without the patch being out of her system. All the authorities & the doctor's clinic covered it up and backed up the doctor who blamed an asthma attack (she only ever had smoking related asthma which cleared up completely after my dad who smoked departed 12 years ago - no exposure to the smoke so no problem as the rest of don't do that filthy money wasting habit). The doctor wouldn't come to see her after i rang him when she couldn't get out of bed and was having breathing trouble and REFUSED to let me ring a ambulance (mum is not the kind who would forgive me afterward and she is capable of making her own decisions and has made it clear to the doctors she NEVER wants to go to hospital - so what else could i do but call her doctor?). In return for complaining about the doctor the doctors clinic DUMPED her and BLACKLISTED her around the area so she has no choice but to get ibuprofen from the supermarkets etc and that was after they took her off the osteoporosis meds claiming she was at risk of suffering a heart attack if she stayed on them because of the level of it in her system - it was a once a week pill!!! There is no way it could have built up as it was designed not to (according to the makers info sheet). As she refuses to go to the hospital, there's little i can do to relieve her pain. I can't force her, i can't persuade her there's no trying to change her mind she just fights me over it and i hate the screaming matches trying to and she threatens to kick me out - i'm the one here living with her looking after her and she's my carer (I have my own problems) she gets the carer payment and i can't cause of the rules at Centerlink. She won't even allow me to get rent assistance which i am entitled to for paying board to her as she is scared she will lose out on her payment. So while she is SANE i am trapped putting up with her practically screaming in horrible pain and wanting me to unlock the door so she can walk out onto the road and get hit by a vehicle to end her misery (which i keep the keys away from her - duh, i don't want her to die but i need to stay here - i can't afford to move out and someone has to look after her and do the shopping etc). She won't go to hospital as she blames them for killing dad when he was rushed there late the night he died that they didn't do enough to save him chasing the wrong diagnosis and that she almost died in hospital herself the last time she had a operation from anesthetic as i did once too. She has no trust in hospitals especially after they bullied her into having to have an operation and she refused.
So yes i feel sorry for those who are in a far worse cruel situation living with cancer and i feel sorry for those in torturous pain too without access to relief.
The governments need to do something drastic about the state of the health system to help those who really need it.
 
I feel sorry for those who need to take them. I hope they & their doctors can find something to move onto that helps them.
On the other hand, not all of us can handle opiods. I have the same allergies as close family members and the closest being my elderly mother - she is intollerant to them and after breaking my arm and being on them so am i.
So i a hoping neither of us or other close family members have to be in a situation where doctors put any of us on them.
Mum lives in horrible pain because without opiods all the doctors can give her is brufen (due to other medicinal allergies/ intollerances) for Osteoporosis/Osteoarthritis/bad knees/some kind of hernia on her belly button. Opiods almost killed my mum, mainly because a neglectful doctor put her on fentanol patches then switched her to the pills without the patch being out of her system. All the authorities & the doctor's clinic covered it up and backed up the doctor who blamed an asthma attack (she only ever had smoking related asthma which cleared up completely after my dad who smoked departed 12 years ago - no exposure to the smoke so no problem as the rest of don't do that filthy money wasting habit). The doctor wouldn't come to see her after i rang him when she couldn't get out of bed and was having breathing trouble and REFUSED to let me ring a ambulance (mum is not the kind who would forgive me afterward and she is capable of making her own decisions and has made it clear to the doctors she NEVER wants to go to hospital - so what else could i do but call her doctor?). In return for complaining about the doctor the doctors clinic DUMPED her and BLACKLISTED her around the area so she has no choice but to get ibuprofen from the supermarkets etc and that was after they took her off the osteoporosis meds claiming she was at risk of suffering a heart attack if she stayed on them because of the level of it in her system - it was a once a week pill!!! There is no way it could have built up as it was designed not to (according to the makers info sheet). As she refuses to go to the hospital, there's little i can do to relieve her pain. I can't force her, i can't persuade her there's no trying to change her mind she just fights me over it and i hate the screaming matches trying to and she threatens to kick me out - i'm the one here living with her looking after her and she's my carer (I have my own problems) she gets the carer payment and i can't cause of the rules at Centerlink. She won't even allow me to get rent assistance which i am entitled to for paying board to her as she is scared she will lose out on her payment. So while she is SANE i am trapped putting up with her practically screaming in horrible pain and wanting me to unlock the door so she can walk out onto the road and get hit by a vehicle to end her misery (which i keep the keys away from her - duh, i don't want her to die but i need to stay here - i can't afford to move out and someone has to look after her and do the shopping etc). She won't go to hospital as she blames them for killing dad when he was rushed there late the night he died that they didn't do enough to save him chasing the wrong diagnosis and that she almost died in hospital herself the last time she had a operation from anesthetic as i did once too. She has no trust in hospitals especially after they bullied her into having to have an operation and she refused.
So yes i feel sorry for those who are in a far worse cruel situation living with cancer and i feel sorry for those in torturous pain too without access to relief.
The governments need to do something drastic about the state of the health system to help those who really need it.
You are having a tough time. I hope things improve for you soon. You are to be commended for staying and taking care of your mum the way she treats you.
 
Cannibas here we come. Supposed to be a good pain reliever and being legalised in some of Australia. Just hope not too many people get high using it or life could get very interesting. My daughter has used it for chronic pain, and said it does help a lot, she thinks I should try it for my bad arthritis pain, I’m not sure I want to go down that track just yet.
From what I gather, the medical version doesn't have the ingredient that makes you high. Shame in some ways, but means it can be taken any time
 
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From what I gather, the medical version doesn't have the ingredient that makes you high. Shame in some ways, but means it can be taken any time.
From what I gather, the medical version doesn't have the ingredient that makes you high. Shame in some ways, but means it can be taken any time
That is correct. Also not everyone gets a positive effect. I had it trialed for a few mnths with regulated doses as required for effectiveness. It only made me very sleepy which was greaat night but during the day, and at $300 per month a costly sleeping assistance. It did nothing for my pain. Also as you have it in the system if you get pulled over and breathalised you will prove positive and have to deal with the usual legal situations until you can prove you are taking medicial CBD. That alone made me stop taking it. I was surprised how many wanted me to give what I had left thinking it would give them a buzz..it has no buzz.
 
I remember all that now that you mention it, an I remember the cost being ridiculous. I was invited to take part in a trial a while back, but I wasn't right for it for some reason. It would have been interesting if nothing else.
 

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