The doctor who gave up on drugs- BBC TV programme

The doctor who gave up on drugs- BBC TV programme

Prescribed but addictive drugs in NZ

I have recommended this insightful programme to many so want to provide a link here for those who wish to know more about prescribed but extremely addictive drugs dispensed to NZ workers everyday. Cannabis and Methamphetamine are not our only drugs impacting on safety in the workplace.

Whilst this programme doesn’t focus on opioids but on prescriptions in general it does have a very interesting case study of a  person dependent on them. Of note-Recently Oxycodone, a very strong opioid to rival morphine for use with high levels of pain was added to a table of drug cutoff concentrations in AS/NZS4760:2019. Oxycodone was introduced by Pharmac on the early 2000s and prescription levels rose rapidly till 2011 when it has plateaued. Its smaller opioid cousin, Tramadol is too frequently prescribed as a return to work anaelgesic in my experience and should be avoided by those in safety sensitive workplaces. It has the same potentially impairing and addiction predisposition of all opioids and is often dispensed in prescriptions combining slow and fast release versions for 3 month periods at a time, hence it can be stockpiled and given out without thinking to those not needing or able to cope with it too.

Opiates/Opioids in particular have  a recommended prescription max duration of 7 days of use as a pain medication in non cancer/acute pain in the USA in response to their recognised opioids crisis.  The fact that Oxycodone is detailed in Table 1 a of AS/NZS4760:2019 and given a cutoff concentration in the Oral fluid Standards doesn’t mean you are advised to include this in your suite of drugs tested for in the workplace, it is optional. It does however raise the subject which is very relevant to workplaces where workplaces and we all must look closely at the over prescribing, misuse and potential for addiction of some prescribed medications.

I have very personal and close family reasons for understanding and promoting this issue and the programme I provide a link for below. It also hits home for many who have been prescribed or used “Aunties” left over medications for pain in order to “get back to work”. The over the counter sales of Codeine containing medications was stopped in Australia April last year in response to growing concerns and issues arising from Opiate dependence and addiction. On the verge of cannabis law reform this seems a good time to review the issue of  legal drugs , Codeine and the closer scrutiny of opioids in our workplaces.

Opioids can cause sedation, dizziness, choking, breathing difficulties, dysphoria, nausea, Constipation, diarrhoea, reduced oxygen levels, sleep apnoea, itchy skin, dry mouth, tolerance, dependence, addiction

I strongly recommend involving a Medical Review Officer (MRO)of those with long term opiates use in your workplace as part of a wellness programme.
Watch the programme and maybe next GP visit don’t insist on needing a prescription to get value for your visit.

Highly recommended viewing- inspirational – a 2 part programme be sure to watch.

Effect of long tern use of opioids combined with cannabis for workplace

Opiods Not OK

In my current work with Business’s there is increasing discussion around opioid use and safety sensitive workplaces strategy to this issue. I am firmly of the belief that Opioids present a threat to safety not to be dispelled with trust that because it’s so freely available over the counter and prescribed it must be OK. This has led me to this interesting article from the Lancet I would like to share. Opioid use can be impairing and long term use can and does lead to tolerance and more. This Drug class is an important drug class related to potential impairment of a person’s ability to be safe at work and the following study may share some insights into not only the effects of Opioids but also its interaction with another common impairing substance Cannabis. Cannabis is well recognised as a depressant but this article sheds more light on its effects with Opioids.  The following article was written for a study on use of cannabis and opioids for non-cancer chronic pain. Workers with Chronic pain require sensitive support and a strategy to help them manage pain without impacting their safety and the safety of others.


“When people taking opioids for chronic pain become tolerant to the drugs and develop opioid-induced hyperplasia, they often will turn to cannabis for what they think is added pain treatment, but we found there were no reductions in pain,” lead author Andrew H. Rogers, PhD, from the University of Houston’s Department of Psychology in Texas, told Medscape Medical News.

The findings were presented here at the American Pain Society (APS) Annual Meeting 2019.




Interest in the use of cannabis and cannabinoids to treat chronic non-cancer pain is increasing, because of their potential to reduce opioid dose requirements. We aimed to investigate cannabis use in people living with chronic non-cancer pain who had been prescribed opioids, including their reasons for use and perceived effectiveness of cannabis; associations between amount of cannabis use and pain, mental health, and opioid use; the effect of cannabis use on pain severity and interference over time; and potential opioid-sparing effects of cannabis.. read more 

Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study