This is very significant research. Other health boards should act on it

This is a very significant study. It’s probable that this is not exceptional for Fife. It reflects the expectations of patients that their pain will be dealt with by a pill.

In fact, there is good evidence that long-term use of an opioid resets the pain perception pathways so that they are worsening pain. The lack of maximum dose information on 4% of prescriptions is particularly alarming due to the relatively narrow safety threshold for opioids.

Small increases can cause serious harm, such as death from respiratory depression – not breathing. GPS will argue that they have judged the quality of life for the patient could be improved with the opioid and that the risk to benefit ratio is favourable.

However, this study will not have been able to demonstrate whether the patient was given a verbal warning about addiction and the risk of overdose. It’s unlikely that researchers will have been able to find that data in the wonderful study they did. But the fact they were able to look at the prescription data and see no maximum daily dose had been entered for many patients, that is negligent.

I think other health boards should take it very seriously and act on the recommendations in this study of Fife patients, or do their own study, or indeed both.