Could we see a prescription opioid epidemic in the UK?BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j790 (Published 15 February 2017) Cite this as: BMJ 2017;356:j790
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People with chronic pain that does not respond to other analgesia struggle to get adequate pain control due to measures already in place. Tramadol is now a controlled drug. This has had the effect that repeat prescriptions cannot be sent electronically with other prescription items often and needs to be collected. Many of those who rely on tramadol or other controlled drugs are not mobile and completely dependent on pharmacy delivery services who do not ensure collection of the hand signed scripts. A few CCGs appear to have a blanket ban on some benzodiazepams to stop drug addicts getting them, affecting patients who gained benefit in the past and now some end up sedated for most of the day on alternatives.
Drug addicts are now abusing other drugs for neuropathic pain such as pregabalin and gabapentin. They will try anything they can get. In the past co-proxamol had its licence removed to stop addicts getting it and overdosing. This had the effect of removing the only effective pain relief from many with arthritis who could not take NSAIDs.
It is vital that drug addicts do not get all the attention and that those with long term pain have access to effective drugs along with other coping mechanisms for pain control. The needs of end of life care must not be forgotten.
ATOS clinicians appear to think that tramadol and NSAIDs at their maximum recommended dose are not significant pain medication when doing Personal Independent Payment assessments for the DWP. Are they suggesting that we should be drug addicts to qualify?
Competing interests: No competing interests