Best practice opioids management

The John Walsh Centre for Rehabilitation Research (JWCRR) has completed a rapid review on best practice opioid management.

Key findings from the rapid review

Australia’s consumption of opioids is ranked 10th internationally. Whilst the review found no evidence to indicate opioids are a problem for people injured at work or on the roads, data about the public health impacts of opioids in the general population indicate the amounts and patterns of opioid use within the compensation population would at least be the same.

The report found that the effectiveness of therapeutic prescription of opioids for pain is limited. Opioid use is justified in treatment of acute pain where there has been major trauma or after surgery, but evidence to support using opioids to treat long term chronic pain is weak and insufficient. The researchers also reported growing evidence about the risks and harms from long-term opioid use (greater than two weeks).

For compensable populations, the report recommends:

  • Not commencing opioids in the first place.
  • Follow recommendations: i.e set goals with reference to disability and functioning and measure progress towards these
  • Consider non-pharmacological strategies to reduce pain

The report recommends a four-level approach to reduce the potential harms in the compensable setting:

  • Level 1: prevention and education
  • Level 2: harm reduction
  • Level 3: treatment and recovery
  • Level 4: update policies and laws enforcement


An overview of the results of this review were presented by Professor Ian Cameron, Head John Walsh Centre for Rehabilitation Research (JWCRR), via webinar on 16 September 2020.

SIRA has developed a better practice medication guide for SIRA-regulated personal injury schemes. Medication management in the NSW personal injury schemes: Better practice guide.