25 February 2019

UK General Practice Helps Avoid US-Style 'Opioid Crisis', Says RCGP

Responding to an investigation into opioid prescribing, published in The Sunday Times this morning, Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said:

"When pain evolves from being an response to something to being chronic, it frequently becomes a long-term condition in its own right and unfortunately there is no easy cure. The challenge for doctors is to help patients to manage their pain to allow them to have the best possible quality of life and for some patients opioid-based drugs provide relief - sometimes they are the only things that do.

"The opioid situation in the UK is not simple – and neither is prescribing opioids. GPs are highly trained to prescribe considering the physical, psychological and social factors potentially impacting on an individual patient’s health, in line with current clinical guidelines. We will also discuss the risks and benefits of taking opioids with the patient – including the potential for addiction – before prescribing, and we will monitor patients to ensure that the treatment is proving beneficial.

"We do know that modest levels of exercise can usually help with pain control and GPs and our teams will usually advocate this to patients in pain, but for some patients it simply isn't an option.

"The mantra is to prescribe opioids at the lowest possible dose for the shortest possible time. Most patients don't want to take medication long-term – and GPs don't want to prescribe it long-term. It's frustrating for all involved that there is a lack of alternative treatments available – and those that are, for example some psychological therapies that have been found to have benefit for patients with chronic pain, access is patchy across the country.

"More high-quality research into pain is needed, and so are more clinical guidelines for GPs and other healthcare professionals. NICE have produced guidance on lower back pain and neuropathic pain, but guidelines on general pain won't be ready until 2020.
"The NHS - particularly general practice – actually makes it quite difficult for patients to get repeated prescriptions for opioids, which is one reason why we aren't seeing the 'opioid crisis' that is so prevalent in the US. But unfortunately, opioids are too easily accessible illicitly – and the NHS has little control over that."

Further Information
RCGP Press office: 020 3188 7633/7574/7575
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The Royal College of General Practitioners is a network of more than 52,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.