Together Medical Newsletter February 2018

Together Medical clinic
Together Medical Newsletter December 2017
October 17, 2018
Influenza & flu vaccine
Together Medical Newsletter March 2018
October 17, 2018
Opioid Medication

From The Doctor's Desk - Opioid Medication


Together Newsletter February 2018

From The Doctor's Desk - Opioid Medication

Opioid Medication

Opioid medication are those medications made up of a compound related to the morphine family of medications and includes Codeine which gets metabolised to morphine-like substances in the body. They are potent medications which work on receptors in the central nervous system to affect the experience of pain. They are sometimes referred to as schedule 8 medications which describes their highly regulated nature in how they are prescribed in Australia.

The main reason for this is their highly addictive nature and potential use for abuse. Opioids do have a place for intractable pain where there is a significant pathology or disease taking place for example a fractured bone, metastatic cancer, severe organ failure, immediate post major surgical treatment, significant neuropathic pain.

It is not this doctor’s belief that conditions such as Fibromylagia and Osteoarthritis where there is no, or minimal evidence on imaging of severe disease warrant the use of opioids. As such I will attempt to refrain from using these medications in favour of other forms of treatment.

Ultimately opioid and opioid-like medication (including drugs like Palexia®) used in the long term are not only not useful in the management of chronic pain but also not healthy leading to things like: dependence (addiction), tolerance (constantly needing escalated doses of the medication), constipation, affected cognition, drowsiness (potentially harmful to yourself or others), dysphoria (negative sensorial symptoms). Regards, Dr Waj Dib.

Dr. W. Dib

MBBS FRACGP BSc. (Biomedical) HONS
Rear, Level I, 1571 Ferntree Gully Road, Knoxfield 3180
Clinic Hours
  • Monday 10am to 6pm
  • Tuesday 10am to 4pm
  • Wednesday 10am to 5pm
  • Thursday 9am to 7pm
  • Friday 9am to 5pm
  • Saturday 9am to 12.30pm
  • *closed 1 Saturday each month & Public Holidays

Appointments: If you are unable to attend your appointment, please call us and let us know as someone else may be in need of the appointment.

Fees: We Bulk Bill concession card holders, children under 16 and all new patients first appointment. Patients without concession cards will be charged a fee. Please see the sign at reception for further details. EFTPOS is available. Your Medicare rebate will be processed at time of payment.

Practice Update

Our continued aim is to provide the most up-to-date medical service possible and to focus on preventative health to help you avoid disease before it starts.

Our Doctor is committed to ongoing education and skill development by attending conferences, seminars and lectures.

Computerised information sources further enhanced access to the most up to date information. Parking facilities are provided on Otway Street.

Privacy: This practice is committed to maintaining the confidentiality of your personal health information. Your medical record is a confidential document. It is the policy of this practice to maintain security of personal health information at all times and to ensure that this information is only available to authorized members of staff.


Our Doctor does not take phone calls during consultation hours. If you need to speak with the doctor, you must make an appointment. Results are not given over the telephone, they are given in consultation. You may receive a telephone call from the Doctor if the matter is urgent, otherwise our receptionist will call you to make a follow up appointment.

Urgent matters will be triaged and it is likely that you will be given an urgent appointment on the same day.

Our practice is committed to preventative care. We may issue you with a reminder notice from time to time offering you preventative health services appropriate to your care. If you do not wish to be part of this system please let us know at reception.

Health Promotion: February is the month for Ovarian Cancer Awareness, Bowel Cancer Awareness and Hearing Awareness. If you have any concerns regarding the above topics, please speak to your Doctor during your next consultation.

Signs of Ovarian Cancer? The symptoms most frequently reported: abdominal or pelvic pain, increased abdominal size /persistent bloating, needing to urinate often/urgently, feeling full after eating a small amount. If you have any of these symptoms or they are new for you and you have experienced them multiple times during a 4-week period, go to your GP. Take the time this month to find out what you need to know about the above awareness topics and share this important information with your family, friends and colleagues.

Knoxfield Pharmacy has a wonderful Baby Range including Sepal bottles endorsed by the Royal Children’s Hospital, Melbourne. These bottles are exclusive to Knoxfield Pharmacy as a supplier to the public. You can find out further information about these products by visiting our Pharmacy and having a chat to one of our staff or by looking up the Sepal website

Knoxfield Pharmacy offers Document Certification at a cost of $1 per page. This is donated to the National Geographic Uproar Program. Helping to save big cats in the wild!

Lets Quit Smoking

Pharmacy News - Lets Quit Smoking

by: Amir Dib, Pharmacist

About 80% of smokers want to give up, and about half will try to quit each year. The majority of smokers think they should quit through willpower alone, by going ‘cold turkey’. However, many smokers don’t understand that they have to beat the physical addiction to nicotine and also recognise their habits and triggers around smoking to address the habitual and emotional elements of an addiction to cigarettes.

There is strong evidence that the best way to quit is by combining behavioural support with nicotine replacement products or prescription medication. Furthermore, combining slow-acting nicotine replacement products (patches) with fast-acting nicotine products, such as gum, lozenges or an inhalator to deal with any sudden cravings, is more effective than one form alone.

Another key barrier is that a lot of people avoid using nicotine replacement therapy (NRT) because of myths. Some of these myths include: NRT products are addictive (they’re not), and are expensive (not compared to continuing to smoke or even the cost of smoking cigarettes for 12 weeks). What about e-cigarettes? A comprehensive review of all published studies shows there is ‘low to very low’ evidence that e-cigarettes help people quit, and we have no data on long-term effects.

Much research has shown that a brief intervention by a GP or a pharmacist can lead to increased quitting. Furthermore, by visiting your pharmacist you will gain a better understanding of the options available to you and whether or not it would be best to see the GP to gain access to even more treatment options. At Knoxfield Pharmacy and Together Medical we can help you achieve your quitting goals…together!