Opioid Reduction Clinics

Opiod Reduction Clinics

At The Green House Surgery we take patient safety very seriously. We follow the latest advances in medical research and continually update and review our clinical practice to ensure patient care is of the highest standard.

Recent research has highlighted a significant risk to patient safety around the use of opioid type painkillers for chronic pain. We know that these drugs are helpful in pain of recent onset such as a broken bone and they are also effective in patients with cancer related pain.

However, recent medical evidence questions the benefit of opioid type painkillers for chronic (lasting more than a few months) pains. There is now better understanding of the risks, including:

- reduced fertility/sex drive/erectile dysfunction in men or irregular periods in women

- reduced ability to fight infection

- increased levels of pain

- dependence

- breathing issues (respiratory depression)

Therefore, we are starting to review those who are on long-term pain killers (including opiates) and we would like to support you to reduce the amount you take. It is important these medicines are not stopped suddenly which can cause withdrawal side effects so we will support you to reduce slowly over time.

If this is a service you are interested in accessing, please contact the practice and ask to be booked into our opioid reduction clinic.

Strong opioid painkillers such as morphine, oxycodone and tramadol may help with some types of pain for a couple of months. But over time they can also cause serious problems such as depression and anxiety, sexual dysfunction and increased infections as well as constipation, drowsiness... the list goes on. If you have been taking these medicines for more than a few months and you have not noticed much change in your pain or what you can do, simply taking more won’t help. It can even make the pain worse! Instead, talk to your healthcare team about better ways to manage your pain. They can support you to reduce your medicines safely and to learn skills to help you manage your pain better. So you can get on with living your life well.
Many of us have a very simple view of how our brain feels pain. But in reality, pain is a two-way street. Pain is one of our protective systems It is designed to keep us safe and well. and it's controlled by the brain. Out brain decides when to protect us based on information it receives from area of the body and many other factors it gathers from elsewhere. It assesses the current situation based on both these types of information. If the brain decides it need to protect, pain will happen. In persistent pain, even though the original trigger for pain may have stopped, the other factors are still there, so the brain keeps the pain going. It's a bit like the brain struggling to turn down the 'volume control'.
Opioids (‘strong painkillers’) can be really useful for a short time – after an injury or surgery. But longer term they aren’t much help. They only reduce pain for about 10 percent of people in the long term. So out of every 100 people, 90 get no benefit long term. And they’ll still get the side effects. If you’re taking opioids, the chances are you’ll be experiencing at least some of the side effects listed here. Tick the ones that affect you, and you may decide it’s time to review your medicines with your clinician. (Remember – never come off your medicines suddenly as this may cause other problems). Other consequences Tolerance – your body gets used to it, so the same dose is less effective than it used to be Dependence – withdrawal symptoms if stopping suddenly or without clinical support Addiction – psychcological dependence and behaviour patterns develop Misuse – not using them in a responsible way
In persistent pain, using opioid pain medicines, such as codeine,tramadol and morphine for more than a few months, has not beenshown to be helpful. As doses increase above the equivalent of 120mg oral morphineper day, there is a much greater risk of harm and little extra painrelief. Harms can include: • Muddled thinking • Dizzines • Tiredness • Poor sleep • Weight gain • Mood changes • Depression • Headaches •Vision changes Opioids can even make pain worse. Use this thermometer to check the dose. The higher the dose, the greater the risk of problems. If more thanone opioid is being taken, the total dose will be even further up thethermometer. Wherever the dose is on the thermometer, if there are side effectsor any other concerns about pain medicines, it should be reportedto the healthcare team. People using pain medicines arerecommended to have a review at least once a year. Medicines that are not helping should be carefully reduced andstopped, even if there are no alternative medicines to try. For more information and ideas on other ways to manage persistent pain, visit www.livewellwithpain.co.uk
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