1 00:00:00,440 --> 00:00:01,360 Speaker 1: Brian Bridge. 2 00:00:01,600 --> 00:00:05,000 Speaker 2: Survey from Massi University has sparks concerns that people using 3 00:00:05,080 --> 00:00:09,280 Speaker 2: prescription drugs are using them for recreational use. One in 4 00:00:09,400 --> 00:00:13,200 Speaker 2: four surveyed reported using pharmaceuticals for non medical purposes in 5 00:00:13,240 --> 00:00:16,240 Speaker 2: the previous six months. But how easy is it for 6 00:00:16,239 --> 00:00:18,920 Speaker 2: someone to actually become addicted to this kind of medication? 7 00:00:19,280 --> 00:00:21,800 Speaker 2: Chair of General Practice, New Zealand, doctor Brian Betty is 8 00:00:21,840 --> 00:00:23,760 Speaker 2: with me this evening, Brian, good evening. 9 00:00:24,120 --> 00:00:26,479 Speaker 1: Well, good evening, Ryan, nice to be here, great to 10 00:00:26,520 --> 00:00:26,840 Speaker 1: have you. 11 00:00:28,080 --> 00:00:30,520 Speaker 2: Are you worried? One in four? Well, first of all, 12 00:00:30,560 --> 00:00:32,600 Speaker 2: does that sound right to you? One in four? 13 00:00:33,840 --> 00:00:37,919 Speaker 1: Oh, look, it sounds very high. I've got to say. However, 14 00:00:38,000 --> 00:00:41,920 Speaker 1: we know there has been issues around about an appropriate 15 00:00:42,040 --> 00:00:46,040 Speaker 1: use of medication and the potential for addiction with certain medications, 16 00:00:46,040 --> 00:00:48,800 Speaker 1: and the illicit use of some medication. So this has 17 00:00:48,880 --> 00:00:51,400 Speaker 1: been something that's been around for a while, and I 18 00:00:51,440 --> 00:00:54,320 Speaker 1: suppose it is worth highlighting that there are issues around 19 00:00:54,360 --> 00:00:56,280 Speaker 1: certain medications. We do prescribe. 20 00:00:56,440 --> 00:00:57,840 Speaker 2: What drugs do people like? 21 00:00:59,440 --> 00:01:03,360 Speaker 1: Yeah? Look, question? I suppose the ones we think of 22 00:01:03,360 --> 00:01:09,720 Speaker 1: often are pain medications, things like opioids, scentives, s, benzodiazepines 23 00:01:09,760 --> 00:01:13,240 Speaker 1: in particular, and something called gabapentins, which are a particular 24 00:01:13,280 --> 00:01:16,399 Speaker 1: medication that can be used for pain or epilepsy. The 25 00:01:16,440 --> 00:01:21,240 Speaker 1: other one that is around is ADHD medication, so that 26 00:01:21,319 --> 00:01:24,360 Speaker 1: can be abused and that can actually be addictive. And 27 00:01:24,440 --> 00:01:29,480 Speaker 1: there are instances where where medications dot methylphenidate, which is 28 00:01:29,560 --> 00:01:35,400 Speaker 1: used for a DHD can be crushed and used intravenously 29 00:01:37,000 --> 00:01:39,560 Speaker 1: or snorted to give a high because in high doses 30 00:01:39,640 --> 00:01:43,080 Speaker 1: or very fast release, it can give a very high 31 00:01:43,120 --> 00:01:46,600 Speaker 1: addictive property which people like. And those are the other 32 00:01:46,640 --> 00:01:49,760 Speaker 1: medications where diversion as we call it can occur. 33 00:01:50,120 --> 00:01:53,760 Speaker 2: How easy is it for a GP to prescribe the 34 00:01:53,840 --> 00:01:55,800 Speaker 2: drugs that you just outlined. 35 00:01:56,880 --> 00:02:02,160 Speaker 1: Look varies, So things like opioids an ADHD have to 36 00:02:02,200 --> 00:02:07,560 Speaker 1: be prescribed monthly, so they are described every month, not 37 00:02:07,640 --> 00:02:11,760 Speaker 1: three monthly lots, and so there is restriction in terms 38 00:02:11,760 --> 00:02:14,520 Speaker 1: of how they used. And in fact opioids are prescribed 39 00:02:14,560 --> 00:02:18,280 Speaker 1: generally every ten days, so there is restricted access to them. 40 00:02:18,320 --> 00:02:21,600 Speaker 1: And we use opioids often in palliative care or pain medication. 41 00:02:22,120 --> 00:02:25,240 Speaker 1: And these medications, all of them, when used appropriately, are 42 00:02:25,560 --> 00:02:28,960 Speaker 1: very very beneficial and have a real role to play. 43 00:02:29,480 --> 00:02:32,160 Speaker 1: So there are restrictions and how they are used, and 44 00:02:32,240 --> 00:02:35,440 Speaker 1: most gps are very careful with how they prescribe these 45 00:02:35,480 --> 00:02:40,560 Speaker 1: medications and will often do things like say prescribed ten 46 00:02:40,639 --> 00:02:43,160 Speaker 1: daily or if I've got concerns, we'll only give three 47 00:02:43,240 --> 00:02:47,120 Speaker 1: days worth at once if something is happening. But we 48 00:02:47,280 --> 00:02:49,480 Speaker 1: do know that there are appalled to patients who have 49 00:02:49,520 --> 00:02:53,639 Speaker 1: addictive who are addicted to medication, who do doctor shop 50 00:02:53,880 --> 00:02:57,919 Speaker 1: and look for amount of these medications to accumulate, So 51 00:02:57,960 --> 00:03:01,560 Speaker 1: it can be a problem, but most gps are aware 52 00:03:01,600 --> 00:03:05,400 Speaker 1: of the issue and are very careful when prescribing these medications. 53 00:03:05,520 --> 00:03:09,360 Speaker 2: What impact do these men like you talked about the 54 00:03:09,680 --> 00:03:12,680 Speaker 2: opioids in particular, what impact do they have on your body? 55 00:03:12,760 --> 00:03:15,240 Speaker 2: If you're if you're using them at the dose that 56 00:03:15,280 --> 00:03:18,160 Speaker 2: your doctor has prescribed, does that mean num impact on 57 00:03:18,200 --> 00:03:20,440 Speaker 2: the body, And only if you go over that does 58 00:03:20,480 --> 00:03:22,280 Speaker 2: it start to affect you long term? 59 00:03:22,880 --> 00:03:25,240 Speaker 1: Yeah, we need to be very careful about why the 60 00:03:25,320 --> 00:03:28,840 Speaker 1: medication is being used. So for instance, where a lot 61 00:03:28,880 --> 00:03:31,640 Speaker 1: of these medications are used as actually im palliative care 62 00:03:31,800 --> 00:03:35,160 Speaker 1: end of life, and where they're being used for pain, 63 00:03:36,320 --> 00:03:38,440 Speaker 1: there is really no risk of addiction to the person 64 00:03:38,520 --> 00:03:40,600 Speaker 1: they've been used with, and we need to be very 65 00:03:41,120 --> 00:03:44,360 Speaker 1: very clear on that where they used for the purposes 66 00:03:44,400 --> 00:03:47,000 Speaker 1: of pain and palliative care, they're not addictive and they 67 00:03:47,000 --> 00:03:50,480 Speaker 1: are totally appropriate. They can be titraded, and they need 68 00:03:50,520 --> 00:03:53,720 Speaker 1: to be used where the problem arises. We know that, 69 00:03:53,840 --> 00:03:58,000 Speaker 1: particularly things like opioids, where they are used inappropriately, that 70 00:03:58,160 --> 00:04:00,600 Speaker 1: is the weare they're not used for the persevere pain, 71 00:04:00,680 --> 00:04:04,280 Speaker 1: so in a pallie of care situation, they do can 72 00:04:04,360 --> 00:04:07,400 Speaker 1: give you for a very addictive type property when they're 73 00:04:07,440 --> 00:04:10,040 Speaker 1: not used for pain, and it's in that that people 74 00:04:10,080 --> 00:04:12,440 Speaker 1: can become very addicted to them. And in fact, opioids 75 00:04:12,480 --> 00:04:15,680 Speaker 1: have a very very strong addictive property. So when they 76 00:04:15,840 --> 00:04:19,120 Speaker 1: used outside of their indication, which in this case is 77 00:04:19,120 --> 00:04:23,440 Speaker 1: for severe pain, there is certainly a problem in terms 78 00:04:23,440 --> 00:04:25,320 Speaker 1: of what they do to the body and the potential 79 00:04:25,400 --> 00:04:25,960 Speaker 1: for addiction. 80 00:04:26,720 --> 00:04:30,000 Speaker 2: But is the problem that you would take the dose 81 00:04:30,080 --> 00:04:33,320 Speaker 2: and double it and that affects your body, or could 82 00:04:33,360 --> 00:04:36,600 Speaker 2: you actually take a prescribed dose that a doctor would 83 00:04:36,600 --> 00:04:38,960 Speaker 2: give you for pain for the rest of your life 84 00:04:39,000 --> 00:04:42,640 Speaker 2: and actually experience no side effects on your body. 85 00:04:43,279 --> 00:04:45,920 Speaker 1: Well, but that potentially happens. But again I go back 86 00:04:45,920 --> 00:04:48,440 Speaker 1: to the basic premise that if you are being prescribed 87 00:04:48,440 --> 00:04:52,280 Speaker 1: it for pain, for a say cancer, for instance, then 88 00:04:52,320 --> 00:04:57,240 Speaker 1: it's absolutely appropriate and we don't get too concerned about 89 00:04:57,240 --> 00:04:59,160 Speaker 1: addictive properties in those situations. 90 00:04:59,240 --> 00:04:59,840 Speaker 2: Oh totally. 91 00:05:00,200 --> 00:05:02,920 Speaker 1: It's when it's been diverted outside of that that that's 92 00:05:02,920 --> 00:05:04,279 Speaker 1: the way the problem starts to arived. 93 00:05:04,320 --> 00:05:05,920 Speaker 2: I mean, for good to say, if you've got cancer, 94 00:05:05,920 --> 00:05:07,440 Speaker 2: the last thing you've worried about it is whether you're 95 00:05:07,440 --> 00:05:09,240 Speaker 2: addicted to some medicine. Do you know what I mean? 96 00:05:09,960 --> 00:05:11,719 Speaker 1: And we have to be very careful of that that 97 00:05:11,800 --> 00:05:14,560 Speaker 1: the message that goes out that these medications do have 98 00:05:14,600 --> 00:05:18,920 Speaker 1: an absolute role to play. They are incredibly beneficial in 99 00:05:19,000 --> 00:05:22,080 Speaker 1: certain circumstances. Do you worry you need to be used 100 00:05:22,080 --> 00:05:22,719 Speaker 1: to the right place? 101 00:05:22,839 --> 00:05:25,159 Speaker 2: Do you worry sometimes that the more we talk about this, 102 00:05:25,279 --> 00:05:29,560 Speaker 2: that we might start regulating medicines like this and take 103 00:05:29,600 --> 00:05:31,039 Speaker 2: them away from people who need them. 104 00:05:32,000 --> 00:05:34,640 Speaker 1: Look, I think this is always a balancing act between 105 00:05:34,720 --> 00:05:38,480 Speaker 1: how much regulation do you put in place because there 106 00:05:38,560 --> 00:05:42,640 Speaker 1: is perceptional there is an actual problem versus you know, 107 00:05:42,680 --> 00:05:45,640 Speaker 1: denying people who actually need access to these medications. I mean, 108 00:05:45,680 --> 00:05:48,800 Speaker 1: the other one I interested was ADHD medication that is 109 00:05:48,880 --> 00:05:54,640 Speaker 1: incredibly beneficial for patients who do suffer from ADHD, and 110 00:05:54,680 --> 00:05:58,400 Speaker 1: it is an incredibly important medication for those patients. But 111 00:05:58,520 --> 00:06:01,760 Speaker 1: again when it's used in appropriate greatly, it becomes a problem. 112 00:06:02,400 --> 00:06:05,280 Speaker 1: So yes, that's always this balancing act between how much 113 00:06:05,320 --> 00:06:09,160 Speaker 1: restriction versus making sure we do give access to these 114 00:06:09,200 --> 00:06:10,560 Speaker 1: medications to those that need it. 115 00:06:10,760 --> 00:06:12,479 Speaker 2: Brian, thank you. Great to have you on the show, 116 00:06:12,520 --> 00:06:14,880 Speaker 2: Doctor Brian Biddy, Chair of General Practice, and his Dylan. 117 00:06:15,720 --> 00:06:18,919 Speaker 2: For more from Hither Duplessy Allen Drive, listen live to 118 00:06:19,000 --> 00:06:22,039 Speaker 2: news talks it'd be from four pm weekdays, or follow 119 00:06:22,080 --> 00:06:23,840 Speaker 2: the podcast on iHeartRadio.