GP clinics to tackle painkiller addiction

A SPECIALIST ‘addictions service’ has been launched for the soaring numbers of patients dependent on overthe-counter and prescription opioid painkillers. The problem has grown so urgent that specialist clinics have been set up in GP surgeries.

The pharmacist-run service is focused on those taking powerful painkillers such as co-codamol, which is available over the counter, as well as prescription opioids such as dihydrocodeine, tramadol and morphine.

The drugs can all treat acute or chronic pain but patients can become dependent on them if taken regularly. NHS figures show 2.7 million such prescriptions were handed out in Scotland last year, compared to 1.6 million a decade earlier.

The clinics have been launched in NHS Lanarkshire and are run from GP surgeries to avoid ‘stigma’.

However, critics said the SNP must ‘up its game’ on the problem.

Opioids are prescribed to treat severe symptoms, such as back or neck pain after an injury, as well as arthritis.

Duncan Hill, specialist pharmacist in substance misuse for NHS Lanarkshire, said many patients end up in a ‘trap’ of addiction.

He said: ‘The clinic was set up in general practice to tackle some of the issues were seeing.

‘In the addictions service we had started to notice an increase in the number of patients addicted to prescribed opioid analgesics rather than illicit drugs.

‘We wanted to set up a different model to help these patients caught in this trap.

‘Patients take opioid painkillers for a myriad of reasons and they can start off on a short course that has been prescribed appropriately but become dependent.’

If patients are referred into the scheme while on a repeat prescription for opioid painkillers a specialist pharmacist can review this.

If appropriate, the patients can be helped to reduce their dose or be given advice on leaving longer gaps between doses.

Patients had doses reduced gradually to minimise side effects such as flu-like symptoms.

The cost of prescribing the drugs in Scotland has soared from just under £18million in 2004/05 to around £29million last year.

In a research paper published last week the NHS Lanarkshire team revealed that the scheme has been a success.

In one practice, prescriptions of dihydrocodeine fell from almost 900 daily doses per 100,000 population in the first three months of 2016 to around 500 in the first three months of 2019.

It was initially launched in two GP practices but may be extended.

The paper, published in the scientific journal Pharmacy, states: ‘Opioid analgesics have an important role in the management of pain but they must be used cautiously and appropriately to prevent dependency.’

Mr Hill said other health boards could follow the model.

‘Help patients caught in this trap’