Focus on Opioids and Cannabis in Chronic Pain Media Coverage

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New Zealand media reports on chronic pain are focusing on treatments involving opioids and cannabis at the expense of best practice non-drug treatments, researchers have found.

Chronic pain, defined as persistent or recurring pain present for more than three months, is the leading cause of disability worldwide and affects one in five New Zealanders.

The researchers analyzed 240 news articles on chronic pain published in the New Zealand news media between January 2015 and June 2019. Their report is published in the latest issue of the New Zealand Medical Journal.

Dr. Hemakumar Devan, postdoctoral fellow, University of Otago, Wellington.Credit: University of OtagoLead author Dr. Hemakumar Devan, a postdoctoral fellow at the Centre for Health, Activity and Rehabilitation Research at the University of Otago, Wellington's School of Physiotherapy, says few of the news stories included information about non-pharmaceutical treatments for chronic pain, despite these being the preferred option for most chronic pain conditions.

"Pharmacological strategies are only recommended for some chronic pain conditions, such as cancer pain and neuropathic pain. For other pain conditions, drug treatments are recommended to be used with care and caution because of potential side effects and limited long-term effectiveness."

He says media coverage of pharmaceutical treatments for chronic pain focused almost entirely on opioid-based painkillers and cannabis. Stories on opioids mentioned their ineffectiveness in treating chronic pain and their potential for dependence and addiction, while reports about medicinal cannabis portrayed it as an effective and safe treatment with minimal side effects. This was despite the lack of scientific evidence to support its long-term use for chronic pain.

"The personal experience stories about cannabis focused on its positive effects and fewer side effects compared to opioid-based analgesics. There is, however, limited evidence to suggest cannabis as a substitute for opioids and a lack of high-quality evidence to support the use of cannabis for chronic pain.

"There was no reporting on the potential adverse effects of medicinal cannabis use, such as cognitive deficits, dependency and mood changes, which could particularly affect young people."

The researchers also found media coverage was dominated by the struggle associated with living in chronic pain, with little attention given to the resources available to support people to manage pain successfully and live a meaningful life.

"Non-drug based self-management strategies, which include exercise, relaxation and cognitive behavioural treatments, are a key component of managing chronic pain and are proven to be effective in the long term."

Dr. Devan says the difficulties faced by patients in accessing pain services because of the lack of trained multidisciplinary health professionals, and inequities in terms of access for Maori and Pasifika, were accurately reflected by the media coverage.

The researchers found the level of media interest in chronic pain had increased in recent years.

"We expect this will continue to rise, with chronic pain becoming increasingly relevant in the lead up to New Zealand's 2020 cannabis referendum; and as the number of people living with chronic pain increases as the population ages."

Dr. Devan says given the high level of interest from media, there is a need for media guidelines for chronic pain similar to those developed by the Mental Health Foundation of New Zealand for mental health issues https://www.mentalhealth.org.nz/get-help/media-guidelines.