I’m not dope sick, I’m dying. So don’t make me doctor-shop for pain relief

I had difficulty getting a prescription for morphine when I went to my medical centre a while ago. My regular GP was unavailable, and the young colleague of his whom I saw was reluctant to prescribe the painkiller. He said he felt uncomfortable doing so.

This left me frustrated and angry. I have stage-four prostate cancer. My bones are riddled with dozens of secondary tumours, so the cancer is both painful and terminal. And I am running out of treatments with which to control the disease. I don’t think I will live another year.

Opoids can be dangerous but they can also offer essential relief.Credit: AP

The young GP suggested that I see one of his senior colleagues who might feel more comfortable prescribing opioids, but I didn’t want another lengthy wait or a second consultation. I pointed out that I had been on morphine for several months and that details of my cancer progression were on my medical files. I also pointed out that someone with terminal cancer shouldn’t have to doctor-shop until finding a GP willing to prescribe their usual pain management treatment.

Despite my irritation, I understood the poor bloke’s reluctance. I have come across similar sentiments before. My regular GP – a lovely, caring practitioner – often seemed anxious when writing morphine prescriptions for me until I got a review from my oncologist approving of my opioid use.

These days, drugs such as morphine get bad press. Opioid addiction is a growing problem, entrapping increasing numbers of Australians and often stealing their lives away. In the past, opioids have been prescribed too readily for some forms of non-cancer chronic pain, and medical authorities have been trying to tackle the issue. Unfortunately, they seem to have done so in a blunt manner.

John O’Brien is a part-time primary teacher, children’s writer and cancer sufferer.

In 2018, thousands of GPs were sent letters from the chief medical officer of the Department of Health, pointing out that they were prescribing too many opioids – even though many of these GPs may have had large numbers of patients with cancer or under palliative care. The Royal Australian College of General Practitioners warned that “the letter risked unfairly targeting doctors who had legitimate reasons to prescribe opioids”. And my recent experiences would indicate that some doctors are now worried. It seems we have demonised the drugs, which have become increasingly difficult to obtain.

For terminal cancer patients like me, though, morphine is a wonderful medication. I take time-release morphine twice a day, and I will continue to do so until I die. It doesn’t kill the pain from my bone metastases completely, but it dampens it down like nothing else. Without it, I would be racked with pain. With it, I can teach part-time, write short stories for kids, go for walks, enjoy seeing family and friends, and even craft rants of outrage. In short, morphine is giving me quality of life during my final year on Earth. It makes my life worth living.

We should work hard at reducing opioid addiction in Australia, but we need to avoid placing cancer sufferers at risk while doing so. Perhaps we should take a cautionary look at America, where the reaction to an opioid epidemic has resulted in cancer patients struggling at times to acquire the pain medication they need. Surely we can lower deaths from opioid overdose without making life difficult for those whose bodies are riddled with cancer. Nobody dying of the disease should have to struggle to get adequate pain relief. And no GP should be made to feel anxious about prescribing opioids to patients with advanced cancer.

I discussed all these issues with the young doctor, and in the end he gave me a prescription for morphine. I felt relieved and thankful. But as I left, I felt sorry for fellow travellers on my cancer journey who might not be as articulate or persuasive as me, and who may have left a similar consultation without their pain-relief medication.

We must never let that happen. Cancer will kill 50,000 people in Australia over the next 12 months. I will likely be one of them. And none of us should be denied necessary drugs like morphine. We need a balance here when it comes to opioids, a balance I believe we have yet to find.

John O’Brien is a part-time primary teacher, children’s writer and cancer sufferer.

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