Publication date: Feb 11, 2020
What is happening in the US with respect to opioid use is not happening in the UK, according to a UK-based expert in pain medicine, dispelling common myths about opioid use and misuse.
Opioids have a valuable place in pain management, said Dr Cathy Stannard, consultant in pain medicine at NHS Gloucestershire, speaking at a news briefing in London earlier this week.
The briefing addressed prominent issues relating to opioid use in the UK including whether misuse was as great a threat as in the US.
Busting prevailing myths around pain and pain management in the UK, Dr Stannard highlighted that “what is happening in the US is not happening here in the UK”.
She referred to data on opioid consumption levels, pointing out that the US prescribed more than 40,000 daily doses per million inhabitants compared with 12,500 in the UK.
“The US prescribes nearly four times as much as the UK, and in terms of Europe, we are also low prescribers,” said Dr Stannard.
Department Internal Medicine 1, Klinikum SaarbrcFCcken, SaarbrcFCcken, Germany. Since 2009, guidelines in Germany on opioids for chronic non-cancer pain have always been cautious in recommending opioids for these conditions, and in 2014 we defined potential indications as well as contraindications of opioids for chronic non-cancer pain. “
In comparison with the opioid epidemic in the US, Dr Stannard pointed out that there had been time to look at what happened in the US and learn from it.
The UK also provides ready access to opioid substitution treatment for those who need it, whereas in the US this is expensive.
Looking at records of the General Medical Council (GMC), there has never been an incident due to a clinician undertreating pain,” said Dr Stannard, noting an important difference between the countries.
Opioids work well in short-term pain and in anaesthesia, and in some people in the long term, said Dr Stannard.
In the real world, only around 1 in 10 people with long-term pain gain effective relief with opioid treatment.
“Yes, we should have responsible opioid stewardship and prescribe appropriately, but actually we need to change the picture of our relationship with dependency medicines and this includes reconceptualising persistent pain as something other than a medical condition needing treatment.
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