The dramatic headlines about the opioid crisis are all-too familiar by now. Australia and New Zealand have followed the lead of the US, and seen a fourfold increase in opioid use over the last thirty years. Most of this prescribing has been for chronic non-cancer pain, but systematic reviews will tell you that that there are no decent trials that would warrant use for this indication.In this podcast we’ll discuss some of the latest studies that have actually followed pain patients long-term, and provided evidence against the efficacy of chronic opioid use. Addiction medicine specialist Professor Adrian Reynolds talks about how to identify patients that have developed dependence on or addiction to opioids and how to wean them off this medication. And pain medicine specialist Chris Hayes describes an alternative approach to therapy, that involves breaking maladaptive pain associations in the nervous system.Guests Dr Christopher Hayes FFPMANZCA (Director Hunter Integrated Pain Service) Clin Assoc Prof Adrian Reynolds FAChAM (Clinical Director Alcohol and Drug Service, Tasmania)Production Written and produced by Mic Cavazzini. Music: Chris Zabriskie 'Out of the Skies, Under the Earth' and 'What True Self Feels Bogus Lets Watch Jason X'; Borrtex 'You Are Not Alone', Jahzzar 'Missing You' courtesy of Free Music Archive. Gunnar Johnsén, 'Task At Hand 2', 'Task At Hand 5' licenced from Epidemic Sound. Image courtesy of WikiCommons. Voice acting by Iain Muir, Bob Kotic and Phillipe Soulaine. Editorial feedback for this episode was provided by members of the RACP's Podcast Editorial Group; Stella Sarlos, Lisa Mounsey, Michael Herd, Atif Slim, Rhiannon Mellor, Leah Krischock, Angela Chen, Genevieve Yates, Adrienne Torda, Philip Gaughwin, Rosalynn Pzcsola, Nele Legge, Marion Leighton, Oscar Russell, Jenae Valk, Li-Zsa Tan, Alan Ngo, Leah Krischock, Seema RadhakrishnanPlease visit the RACP website for a transcript embedded with citations. Fellows of the College can claim CPD credits for listening and additional reading.

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