Treatment delays‘fuel painkiller addiction in over-60s’
LONG NHS delays for knee and hip replacement surgery could be fuelling a rise in prescription painkiller addiction in the over-60s, an expert has warned.
Latest data reveals that one in ten of the 700,000 patients needing orthopedic treatment – the vast majority of whom suffer with arthritis – has been on the waiting list for more than two years.
While most can be treated with paracetamol and physiotherapy to ease pain and improve the mobility of damaged joints, the extreme delays means more patients – most of whom are aged 65 to 75 – are left in agony and forced to go back to their GP for stronger treatment.
Experts say this may be one reason why prescriptions for highly addictive opioids have more than doubled in the past six years. ‘The only thing GPs can offer are stronger painkillers,’ says Professor John Skinner, consultant orthopaedic surgeon at the Royal National Orthopaedic Hospital and president of The Hip Society. ‘Patients are only supposed to be taking these drugs for very, very short periods – in the weeks before an operation, for instance. But because of the delays,
‘Patients get depressed as they aren’t seeing anyone’
it’s possible they could be taking highly addictive drugs like tramadol and morphine for over a year.’
Last year health chiefs issued new guidance to doctors, advising them to refrain from prescribing opioid painkillers to treat chronic pain, and use other medicines and lifestyle treatments instead.
Not only are these drugs highly addictive, they can also increase the risk of surgical complications.
Prof Skinner is also concerned about the number of arthritis sufferers losing independence as they await surgery. ‘The longer patients wait, the more they are forced to adapt their life to their level of pain,’ he says. ‘So perhaps they stop using the stairs, stop driving or working. All of a sudden their life shrinks and, once that’s happened, it’s very difficult to go back to the life they had before. We see patients become incredibly depressed because they aren’t seeing anyone, and everything they do causes them pain.’
Tracey Loftis, head of policy at charity Versus Arthritis, says: ‘Every day of waiting [for treatment] takes patients further away from a life free from pain, being able to work, and having some semblance of independence. This will not be a quick fix – any credible plan to tackle waiting times needs to make treatment and support accessible to all.’
Last week, Health Secretary Sajid Javid announced measures that he vowed will mean that no patient waits longer than 18 months for a non-urgent operation by 2024.