The health of people with chronic conditions who use prescription opioids for pain relief is being put at risk by changes made by the Therapeutic Goods Administration limiting the amount that can be issued at one time, advocates say.
The changes, which came into effect on June 1, halved the pack size for drugs such as oxycodone, codeine and tramadol, many used by those with chronic illnesses as a last resort for pain flare-ups.
Instead of receiving a week's worth of painkillers, patients with prescriptions for opioids will instead be given enough only for two or three days at a time.
Health professionals have also been advised to only prescribe opioids if no other treatment options are working.
Under the changes, those who require prescription opioids for 12 months or longer must also be referred to a pain specialist for a clinical review, or have a second medical opinion, before they are prescribed.
While the changes made by the administration were brought in to deal with opioid addiction, advocates say they unfairly disadvantage those living with chronic pain,
Executive director of Chronic Pain Australia Akii Ngo said many with chronic conditions rely on prescription opioids to go about their day.
"With the new regulations, there's a lot of fear because it's another change and step to making access to something that brings a quality of life more difficult," she said.
"Sometimes people need opiates to be able to have a life. Generally, people with chronic pain take them regularly because they are always in pain."
Ms Ngo said for those who required opioids for longer than 12 months at a time to manage their condition, the changes represented an extra obstacle to get access to pain relief, due to large wait times to be referred to a pain specialist.
"It's another hoop that people have to jump through," she said.
"Some pain specialists have a waiting list 18-to-24-months long, so there's a bit of fear and anxiety."
The changes were made in response to figures that show 150 people in Australia were hospitalised every day in relation to opioid use, with three people dying.
In the ACT, a real-time prescription monitoring system for prescription opioids has been in place since 2019, following recommendations from a coronial inquest into the death of Canberran Paul Fennessy, who died of a prescription drug overdose.
Despite the reasons stated by the administration for the changes, chief executive of Women with Disabilities ACT C Moore said the decision was short-sighted.
"It is targeting those people with chronic conditions, and for some, there isn't an alternative," Mx Moore said.
"While it has addictive effects in some cases, some people do need to take [prescription opioids] fairly regularly, and it is unfairly discriminating against these people."
Kambah resident Sarah Fowler, who has chronic regional pain syndrome, said prescription opioids were used as a last resort when a particularly bad flare-up of the condition occurs.
"I might not have my flare-ups as frequently, but it's sometimes a week of severe pain, and I have to manage that around other medication," Ms Fowler said.
"In the past when I was younger, I did have to use it much more frequently."
Ms Fowler said the changes adversely affect herself and others with chronic conditions who rely on the medication for pain relief.
"You don't know when a flare-up comes up. The last thing you want to do is to wait three days for a doctor's appointment to get another prescription," she said.
"People are anxious and they're disappointed that things have become so extreme.
"From my experience, when the pain is really bad, so bad that I was in a wheelchair when I was younger, opioids were the things that got me out."
The changes have also led to concern about access to prescription opioids for palliative care and cancer patients.
Chair of the Palliative Care Australia board, professor Meera Agar, said further clarity was needed on the new restrictions.
"We've been rapidly trying to ensure that people have the required supply that they can remain in their home environment without presenting to the hospital for pain relief," professor Agar said.
"The intent of the changes was to ensure people with cancer and palliative care patients were not impacted, and currently there is a lack of consistency, which has meant an impact on palliative care patients who do not have cancer.
"For people with cancer pain and breathlessness, there is strong evidence that opioids play a role in the management of those symptoms."
A federal health department spokeswoman said existing patients requiring opioid treatment on an ongoing basis would still be able to access their medications.
"Prescription opioids can still be prescribed for chronic palliative care pain, however, the revised PBS restrictions provide a set of criteria which must be met if opioids are to be used for chronic pain that is not related to cancer," the spokeswoman said.
"People who require long-term pain relief, such as people with cancer and those receiving palliative care, are likely to receive the same opioid medicine and pack size."