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“The pharmacist really helped her to see that she was taking large and dangerous doses of codeine medication as a result of her dependence on the drug,” Ms Bennett said. “But the important point is the pharmacist didn’t just point it out, but made herself available day and night to advise and support her through her addiction.” Alvin Narsey, owner of Priceline Pharmacy West Brunswick in Melbourne, says the pharmacy takes a holistic approach to patients in pain. This approach involves first gaining information about a patient’s history, symptoms, medical conditions, and medications taken. From there, the pharmacist formulates a plan as to the best treatment for a specific patient. “In addition to treating the symptoms, we also give the patient an understanding of the cause and try and help them manage the cause,” Mr Narsey said. He usually recommends paracetamol or ibuprofen for patients in pain but says this could change depending on whether the pain is acute or chronic, and what medication the patient has taken before the visit. At times, when appropriate, he recommends natural medications. One such natural medication is turmeric, with early research suggesting that curcumin, a chemical found in turmeric, can reduce pain, morning stiffness and joint swelling, among other conditions. “Turmeric is an alternative medicine from \[the traditional Indian medical and nutritional system of\] Ayurveda,” Mr Narsey said. “It’s really good as an anti-inflammatory as well as being a natural antioxidant. We’re finding it useful for a long, active and dull sort of pain and for conditions like arthritis, whereas it’s not so useful for headaches and that type of pain.” Mr Narsey adds that he recommends meditation and yoga, as well as being mindful, when he feels the patient is open to a more holistic approach to their pain. “I work closely with yoga and meditation schools within the community PAIN MANAGEMENT 33 and am happy to refer people when I feel it would help,” he said. Mark Webster, owner of Stay Well Pharmacy, says the biggest problem in pain management today is trying to treat conditions “briefly”. “It’s the biggest mistake healthcare professionals can make – pain is so subjective,” he said. “Pharmacists have to find out so many things – whether pain is acute or chronic, whether there’s a pattern, whether it gets worse as the day progresses and whether it’s rheumatoid, osteo, neuralgia or autoimmune disease ... so many things.” As to treating pain, he says pharmacists can try simple things first such as the paracetamol-ibuprofen combination, but that they might need to recommend stronger pain killers for some patients. He also advises a focus on diet, which can play a “massive role in quantifying pain”. “I often find people with many conditions that are related to dairy,” he said. “If they remove dairy from their diet, these conditions improve.” “Tumeric is really good as an anti-inflammatory as well as being a natural antioxidant. We’re finding it useful for a long, active and dull sort of pain and for conditions like arthritis.” RETAIL PHARMACY ASSISTANTS • JUN 2020