New warning on powerful painkillers

Don’t prescribe them for chronic aches with no known cause, GPs told

MILLIONS of patients suffering chronic pain with no known cause should not be prescribed painkillers, say new health guidelines.

NHS watchdog Nice said they should instead be offered exercise programmes or therapies.

In a victory for a Daily Mail campaign, it said there is ‘little or no evidence’ that painkillers make a difference to sufferers’ quality of life, pain or psychological distress.

But drugs – including benzodiazepines like diazepam or

‘Alternative, safer options’

opioids such as tramadol and codeine – ‘can cause harm, including possible addiction’.

Chronic pain, defined as lasting more than three months, typically involves diagnosis of a cause. The guidelines focus on chronic primary pain, where doctors have been unable to find the cause, which is estimated to afflict between 1 and 6 per cent of the country – up to 3.3 million people.

It suggests sufferers should be offered exercise programmes, psychological therapies, acceptance and commitment therapy and acupuncture. Antidepressants can be considered, it added. But patients should not be started on commonly used drugs including paracetamol, non-steroidal anti-inflammatory drugs, benzodiazepines or opioids, they say.

Dr Paul Chrisp, director of the Centre for Guidelines at Nice, said the evidence suggests drug treatments other than antidepressants are unlikely to provide an adequate balance between benefits and risks.

He added: ‘People shouldn’t be worried that we’re asking them to simply stop taking their medicines without providing them with alternative, safer and more effective options.’

The Mail has been campaigning for greater recognition of the prescription drugs addiction crisis since 2017.

Lucy Ryan, a patient representative on the guideline committee, said: ‘I am pleased it has highlighted the potential risks of some of the drugs as I feel people are sometimes not made aware of these.’ Nick Kosky, consultant psychiatrist at Dorset NHS Foundation Trust, said GPs and specialists ‘find chronic pain very challenging to manage’.

He said: ‘This guideline underlines the importance of appropriate assessment, careful drug choice, exercise programmes, psychological therapies, and consideration of acupuncture in improving the experience and outcomes of care for people with chronic pain.’