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CANNABIS has no role in the treatment of acute pain, contrary to popular belief, according to Australian guidelines designed to improve doctors' and patients' "abysmal" knowledge of pain relief options.
Although many experts believe cannabis may help relieve chronic (or long-term) pain, the guidelines launched in Sydney yesterday by federal Health Minister Tony Abbott say solid evidence now shows it has little efficacy with acute pain. Acute pain is defined as pain lasting up to two to three weeks after surgery, trauma or a medical condition such as kidney stones.
The previous edition of the guidelines by the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine, published in 1999, had no position on the role of cannabis in acute pain.
College president Michael Cousins said relief from pain was "a universal human right", but doctors had "abysmal knowledge" of pain treatment and were taught "virtually nothing" about it in medical school. In the entire four-year postgraduate medical course run by Sydney University, just two lectures were devoted to pain management, he said.
Partly as a result, less than half of people who experienced pain after surgery, trauma or illness were effectively treated. The new guidelines could lift that to 95per cent.
Treating pain effectively from the start could stop it becoming chronic. Mr Abbott said chronic pain cost the country more than $5billion a year in lost productivity. Professor Cousins said workers took 36million sick days because of it.
Doctors previously thought pain, while unpleasant, did no permanent harm, but studies now showed it could cause physical damage and slow a patient's recovery by interfering with breathing, and increasing blood pressure and stress on the heart, he said.
Pain could also break down muscle proteins, causing fatigue, delayed recovery and possibly psychological stress.
The 346-page document lists paracetamol as an effective treatment for acute pain, but when more is required, a variety of options exist. These include "multimodal treatment" combining very small doses of drugs such as morphine and aspirin, and other drugs such as older tricyclic antidepressants, to target different pain receptors. A small dose of ketamine before surgery can reduce the need for painkillers after operations.
Mr Abbott has agreed to consider making pain a vital sign on patient charts, alongside blood pressure, heart rate, temperature and breathing rate.