Above: Cover of the 'Life Before Death' DVD, which will be screened this Wednesday 8 February at a special free Palliative Care Australia event at Parliament House, Canberra.

By Yasmin Noone

Dying patients, in Australia and around the world, are being denied opioids to treat their pain because some medical and aged care professionals have not received the necessary education or training required to tackle their fear of prescribing the drugs.

Palliative Care Australia (PCA) has raised this issue on the eve of World Cancer Day (Saturday 4 February) to make the sector and the broader community more aware of the situation currently facing those in need of pain management, while stressing the need for an improvement in quality palliative and end-of-life services.

The organisation’s CEO, Dr Yvonne Luxford, estimates that around 3.3 million people worldwide– those with cancer, HIV and AIDS – die each year with untreated moderate or severe pain.

And although there are no statistics available, specific to Australia, Dr Luxford believes inadequate access to pain relief and opioids for medical purposes is a “big problem” in Australia, especially in rural and remote areas.

“I do think that people are not being prescribed opioids at the level they need them, especially in palliative and at the end-of-life care,” Dr Luxford said.

She explained the cause is “inadequate” training, especially of general practitioners working in residential aged care.

“It’s in no way intentional.

“The term that has been used a lot in palliative care advocacy is ‘opioid phobia’.

“A lot of healthcare professionals feel uncomfortable [prescribing them] as they just don’t receive sufficient education required. Most health professionals don’t get training in end-of-life care or palliative care, so they are less likely to be trained in opioid use for pain management.

“I certainly do understand that health professionals feel concerned about patients becoming addicted to opioids…That’s why training is something that the PCA consensus statement calls for.

“The Productivity Commission in its final report also says really clearly that everybody working in aged care should be trained in palliative care as it is core business.

“That’s going to help us.”

To raise further awareness about the importance of providing adequate access to pain management and training professionals in opioid use, PCA will be hosting a free World Cancer Day screening of the award-winning documentary, Life Before Death, at Parliament House this Wednesday evening (8 February). 

The Minister for Mental Health and Ageing, Mark Butler, will officially launch the event that will be attended by more than 200 people, including Senator Claire Moore; chair of the Senate inquiry into palliative care, Senator Rachel Siewart; local clinicians; aged care providers; and other stakeholders, and politicians.

The film, which will screen in 160 venues throughout 35 countries in recognition of World Cancer Day, explores pain management and palliative care practices among over 40 different nationalities in 11 countries: Australia, India, Uganda, South Africa, Canada, Ireland, Singapore, China/Hong Kong, Georgia and the United Kingdom.

Visiting the dying, their carers, families and health professionals, the filmmakers delve into the thoughts and feelings of those suffering from pain.

“It’s a really moving film. It’s a vey honest film but it needs to be honest to get the message across,” she said. 

There will be time to discuss the Senate inquiry with the politicians in attendance, and the issues raised by the film with its director, Mike Hill, at the end of the screening.

“This was the first project, as far as we know, that has taken a broad global view of untreated pain and palliative care services,” Mr Hill said. 

“Pain and suffering and death and dying were really furthest things on our minds when we were looking for a documentary project to do. But we realised [this field] was so rich for storytelling, mostly because of the courage you see from persons facing death…And the health care professionals in this field are a remarkable bunch.

In making this film, he said, “we were forced to think about our mortality”.

“And it’s a subject that most of us, like myself, approach with trepidation.

“But you realise that you don’t need to have that fear about death. There’s nothing to fear.”

Dr Luxford invites as many interested people as possible to attend the upcoming screening in Canberra. 

“People should come along to learn more about end-of-life care,” she said. 

“It’s really important to see a film like this and understand better the policies we need to lay down in order to guarantee adequate palliative care services and access to opioids.

“We also all need to be talking about death and dying. Greater education about end-of-life care is needed.

“We have to dispel some of the myths around morphine and opioids and respect these extremely strong drugs.

“At the same time, we have to understand their great value in managing pain and helping people to be more comfortable at the end of their lives.”
 
More event attendees are welcome but RSVP is essential.

Call 02 6232 4433 or email pcainc@palliativecare.org.au for more information.

For details of other screenings around Australia or to order a copy of the Life Before Death dvd, click here.

Further reading: Teaching Doctors How to Close Life’s Last Door is a sensitive an interesting article on a new medical school curriculum being taught at Boston University in the United States, about good 'end of life care'.