© Provided by ABC Health Chrissy Pantlin is sad to leave her Leneva home, moving to Melbourne to be closer to pain specialists. (ABC Goulburn Murray: Jackson Peck)

Pain experts and people suffering from chronic pain say doctors are failing patients by refusing to prescribe opioids rather than wean them off them — especially as regional areas lack specialist pain services.

There is up to a nine-month wait for a local pain doctor, and up to six months' wait to get access to a pain management program in an area spanning Canberra to Melbourne.

Chrissy Pantlin has therefore made the hard decision to move to Melbourne from Wodonga to be closer to her pain specialists.

"It has been a hard decision. I have a beautiful house here in Wodonga, the cost of living is a lot lower, it's a lot less stressful up here," she said.

"But trying to get that specialist knowledge is quite difficult in a regional area."

She said that one doctor told her "I'm sure you've heard of Heath Ledger" while she was picking up her regular script.

Another told the 39-year-old "you should just be on Panadol".

Ms Pantlin said the comments were commonly directed at her while she said she was simply doing all she could to manage her chronic pain.

Government crackdown

Dr Esther Langenegger, the manager of Albury Wodonga Health's pain management program, said since the Federal Department of Health sent a warning letter to the top 20 per cent of opioid-prescribing doctors in mid-2018 there has been a "knee-jerk" reaction.

"Doctors felt very threatened by that and stopped prescribing opioids, so a lot of patients have been left in the lurch," she said.

"Patients have nowhere to go. It's very unfair."

Ms Pantlin has been in pain since she was 11 years old.

She has inflammatory arthritis and a connective tissue disorder that has caused early-onset osteoarthritis.

Then, two and a half years ago, a botched surgery that was meant to help left her with a rare and debilitating condition called arachnoiditis.

"It's got nothing to do with spiders, although I am afraid of them," she joked.

Ms Pantlin can stand for about ten minutes or sit for an hour before needing to lie down and rest.

She is in almost constant pain, needs crutches to walk, and will likely need a wheelchair soon.

"Given that GPs don't have the time to sit and do a full assessment and decide what a good holistic approach would be … the approach was 'here's some opioids'," she said.

"Six years in, having another doctor then say to me 'well, you just need to stop the opioids and take Panadol' — as if it's that simple, as if I just sit around taking drugs and feeling sorry for myself."

Opioid crisis spills over

The opioid crisis in the US has put a spotlight on the impact they can cause, and Australia has not been immune to the consequences either.

"More people are dying in Australia from accidental overdoses of prescription drugs than in car crashes each year," Dr Langenegger said.

While it is now acknowledged that opioids have been over-prescribed, thousands of Australians have been on them for years.

"They need to be withdrawn gradually and I don't think GPs have the time or the skills at this point to be doing that, which puts the patients in a bad situation," Dr Langenegger said.

Dr Hester Wilson from the Royal Australian College of GPs said dealing with chronic pain patients is often complicated and time-consuming.

"I will spend a number of conversations with them and it can take me quite a number of weeks and months to actually get to a point where we get the right process in place," she said.

"We are in an environment where the longer you spend with your patient, the less money you earn. We're small businesses and we do need to make ends meet."

Dr Wilson said the Health Department letter had a significant impact.

"If you get a letter saying 'you are going to get into trouble' it makes you quite anxious," she said.

But she urged colleagues not to leave chronic pain patients without options.

"Please don't just say to your patients 'I'm not doing this anymore, go elsewhere', because they don't have anywhere else to go," Dr Wilson said.

"It needs to be a multidisciplinary approach and the reality is unfortunately, in metropolitan areas, it isn't easy.

"But it's certainly easier than it is for rural, regional or remote GPs."

Wodonga local Tracie Jarvis, who experiences chronic pain, agreed.

"The incidence of suicides and attempted suicides are so great in regional areas because they're not getting access to the services that they desperately need. And pain does terrible things to your mind," she said.

The 49-year-old mother of three suffered a disc injury in her back 14 years ago and a series of surgeries, including some failures, and hospital infections has led to permanent spinal cord damage.

"I'm still unable to work, which is unfortunate, because working was part of my identity," she said.

"When I lost that I lost my identity, and that happens with a lot of people with chronic pain."

Ms Jarvis frequently travels to Melbourne for specialist pain care but refuses to move there despite — conceding it would make life much easier.

"We live in a regional area for the lifestyle," she said.

"My pain takes over my entire life and it affects my husband and it affects my children's lives so greatly that we need to hold on to some of our old life.

"It just makes you even more depressed if you don't."

Ms Jarvis' doctor received one of the letters from the Government indicating he was in the top 20 per cent of opioid prescribers.

"He didn't at any time consider taking me off them because of how complex my situation is. But that's not the case for all of his patients. He had to stop prescribing to quite a few of them," she said.

"I can really see where the doctors, and even the Government, are coming from in reducing how many prescriptions are filled, but I think that they're targeting the wrong people.

"They shouldn't be targeting the people that have genuine pain problems, they should be targeting the people who are doing it for illegal purposes."

A new approach

However, Wodonga-based pain medicine specialist and anaesthetist Dr Brett Todhunter said his region had "a lot more support" for people with chronic support compared to other regional areas.

"There is a three-week inpatient program at Wodonga hospital [Albury Wodonga Health], for example, and I work in the field of chronic pain and have done so in the local area for nearly 30 years," he said.

"[But] there are no other specialists in pain medicine in regional areas, in New South Wales, realistically."

The demand for his services — as both a consultant on pain medicine and management for other physicians, and a treating physician himself — is so high that it can take up to nine months to get a consultation with Dr Todhunter at Albury Wodonga Private Hospital.

Dr Langenegger runs the three-week program which helps wean people off opioids while giving them practical skills to manage their chronic pain.

But there is a two to three month wait for an initial assessment, and another two-month wait to start the program — if you're accepted.

And not everyone is accepted.

Patients need to be able to sit for four hours for the initial assessment which means Ms Pantlin can not take part.

"I want to do everything I can to help myself with my pain and yet they're telling me I can't go to a pain clinic because it hurts me to sit," she said.

"Isn't that why I am coming to the pain clinic? So that we can build on things like that?"

For her, moving to Melbourne seems like the best option.

"The reality is I need help for the rest of my life. This is not ever going to go away," Ms Pantlin said.

Ms Jarvis is in the process of weaning herself off opioids. But it has not been easy.

"I had an increase of pain for a while because as my body was withdrawing. [It] kind of screams out and amplifies the pain," she said.

"It's been quite rocky. It hasn't been all sunshine and roses.

"I'm fortunate I have insurance that helps to pay for my treatment, but most people don't have that.

"They don't have that luxury. And a lot of the treatment that you may get in Melbourne or Sydney or other capital cities is quite expensive."