Lack of understanding Twice as potent as morphine

Less ‘stigma’ compared with morphine

Addiction Studies identifying oxycodone as being more

desirable Studies identifying oxycodone as being more

addictive (approx. 2 weeks)

55 year old female Presented to ED Diagnosis (from iSoft) ▪ Sprain and strain of unspecified joint and ligament of

trunk (lumbar) ▪ Injured lower back at work 4 days prior to presentation

Discharged with paracetamol, ibuprofen ▪ 30 x OXYNORM 5mg

Pharmacy received phone call from GP expressing concern

Obstetric case post c-section – a mother described receiving a medication that was so great all she wanted was more of the medicine and didn’t care about baby ▪ (on reflection it ‘was scary’)

Post orthopaedic surgery – patient went back to GP for

more because they were so good and was very angry when GP declined script. ▪ (patient reflected that they were really addictive)

Cardiothoracic surgery patient – kept on oxycodone (3+

years post surgery). GP unable to stop and now unlikely to ever be off opioids for the rest of his life (being changed to Methadone).

Significant discussions with our Acute Pain Service Agreement to use morphine first line ▪ Oxycodone had become the first line agent ▪ Oxycodone removed from the MedChart ‘quickacol’

Education, education, education Junior Doctor protected teaching Ward in-service Clinical Nurse Educators Grand Round

Discussion at local Medicine Review Group meetings and District Medicine Management Meeting

Education comprised of Background of problem WHO anaglesic ladder ▪ Discussion of different steps

Philosophy of what we were trying to achieve Points to remember ▪ To highlight the lack of understanding and reinforce the

challenges we see. ▪ Comparison with morphine

Prescribing tips ▪ Quantity

Southland Hospital Intern Pharmacist follow up project - audit ▪ To determine if the education had had an on-going

effect ▪ To determine if oxycodone is being used appropriately

for pain ▪ 2nd line which is consistent with hospital wide and Ministry of

Health campaigns

▪ To determine use on discharge ▪ Short term ▪ Long term

0

500

1000

1500

2000

2500

3000

Uni

ts

Oxycodone Use

Capsules

Tablets

Linear (Capsules)

Linear (Tablets)

0

200

400

600

800

1000

1200

1400

Uni

ts

Morphine Usage (Units)

Cap

Tab

Linear (Cap)

Linear (Tab)

Thank you!