More people reliant on morphine as waitlists for joint replacement surgeries grow

An increasing number of people are relying on morphine to ease their pain as they face lengthy waits for joint replacement surgery.

Doctors are worried older patients are getting addicted to morphine, which is prescribed to handle pain, while they wait for surgery.

District health boards (DHBs) are faced with growing waiting lists for elective surgeries in part due to an ageing population.

Sixty-five-year-old Ian Lovatt is waiting for a hip replacement, but he can't get the surgery. As a result, he's been housebound for two years.

"Can you imagine broken glass in your hip - that's what it feels like every time you take a step or move."

The Hawke's Bay DHB admits he needs surgery but told him others take priority. He's been declined time, and time, and time again.

"Annoyed, saddened, it's very depressing actually. I feel like a prisoner because I'm just trapped, I can't get out."

Lovatt has been on morphine for 18 months and is concerned about how addictive it is, so he's managing the amount he takes.

"I try and cut back on the morphine so I'm not relying on it all the time, but you are reliant on it because the pain gets so bad."

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The DHB says there's increased demand for elective surgeries, and it's working hard to meet it by building an eighth operating theatre and partnering with a private hospital.

But local GP Dr Darran Lowes worries the DHB isn't keeping up.

"It's been getting worse and worse over time, and now the threshold for actually getting onto the surgical waiting list is extremely high," he says.

"We just don't have enough beds, enough theatres, enough services to do it."

It's a similar situation in Northland. Margaret Pohl is the Northland DHB's clinical director of orthopaedic surgery and has seen a growing wave of people needing joint surgery.

She says there isn't enough operating theatre space for elective surgeries, and many people aren't even getting onto a waiting list.

"We're turning away about 50 percent of people referred for joint replacement surgery," she says.

"Year by year it has been getting worse, and the hardest thing for all surgeons is the patients they've declined."

The number of people getting joint surgery has climbed. Figures from the Ministry of Health show in the nine months to March 2019, 7524 people had joint replacement surgery. And in the nine months to March 2021, it was 8007 people.

But the number of people on the waiting lists has grown too - from 3881 people in March 2019 to 5407 people in March this year.

The ministry attributes some of that to the COVID-19 backlog, but Dr Lowes argues it has long been a problem.

"The population here is ageing and with that comes an increased demand for surgery."

As a result, he's seeing more morphine prescribed for pain relief.

The amount of publicly funded morphine prescription dispensed between 2016 and 2020 increased by about 22,500, from 511,896 to 534,389.

Most of that is for 60 to 69-year-olds, an increase of 12,473.

Dr Lowes is worried about people becoming addicted to it.

"We certainly see tolerance and dependence within days of starting it, so it is a big issue."

Stu Desmond from Kaitaia is another taking morphine to deal with pain.

"You try not to cry, it gets pretty excruciating," he says.

He's waiting for a hip operation and is well aware the drug is addictive.

"I'm lucky I can limit myself to two or three a day."

But not everyone's as lucky as Desmond, and some end up addicted.

"We are seeing an increasing amount of pain, and an increasing amount of drug use to manage their pain," says Dr Pohl.

In last year's Budget, the Government injected $282 million into DHBs to help clear a backlog of elective surgeries, partly caused by COVID-19.

Health Minister Andrew Little is aware of the problem.

"We know there are long waiting lists and we know people are struggling to get on waitlists," he says.

"It disturbs me that people are just being given morphine to relieve their pain because there is no end in sight, that's not good enough."

He hopes the health reform, which scraps the DHB structure, will also help.

"We should be able to refer people to where there is the available capacity."

It can't come soon enough for Lovatt.

"All I want is to get it done, get back to normality."

Back to a life without constant pain and without morphine.