The opioid crisis in the UK? Is there one and is our treatment for chronic pain part of the problem?
Over the last several months there has been a lot of discussion regarding the opioid crisis in the USA. Spikes in deaths from overdoses and reported addictions have been noted throughout the states. Easy access to drugs such as fentanyl and carfentanil has fuelled this, although it should be noted that death by heroin overdose is included in many statistics. For someone who lives in the UK this seems quite foreign. I read and heard an awful lot about the opioid crisis but didn’t specifically know what it was referring to.
Since the 1990s numbers of patients prescribed opioid painkillers has risen staggeringly. The relationship between pharmaceutical companies and doctors isn’t quite the same in the states as it is over here. For example it is quite common to see adverts for prescription medications on your television over there, where as in the UK that would be unheard of. Still, that doesn’t mean that there isn’t a problem with the use of opioid painkillers outside of the US. Drug related deaths have increased in England and Wales, in 2017 3756 deaths related to drug poisoning were reported. (https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrelatedtodrugpoisoninginenglandandwales/2017registrations). As with a lot of statistics this included controlled and non-controlled drugs, cocaine and heroin.
It seems that doctors are prescribing opioid painkillers more and more, but what does that mean for us? Chronic pain sufferers?
I have been on codeine for 18 months. That has ranged from taking over the counter co-codamol with 8 milligrams of codeine to 30 milligram tablets. This is the only opioid painkiller i have taken beyond hospital stays, and in comparison to some it’s child’s play. But! I’m still taking a painkiller designed to treat acute to moderate pain short term, it’s still addictive, it still has side effects and I’m still always batterling to be prescribed it at an adequate strength for my current pain levels.
And this is where we have a problem. I’ve been discouraged on many occasions to continuously take codeine for my pain, but never have i been offered an alternative means of pain management. I’ve not been offered physiotherapy, acupuncture or alternative pain medications.
The NHS is a wonderful thing but it is stretched, and underfunded. My GP can easily discourage me from taking codeine and they can easily give me another prescription is I convince them otherwise, but waiting times and lack of eligibility all mean alternative treatments are hard to come by. Of course I could fund these myself, but money is tight and for someone working full time short term fixes sometimes are a necessary evil.
Of course doctors and patients should be held to account, patients should be protected if they are being prescribed very addictive potentially life threatening drugs but surely that should not just mean preventing chronic pain sufferers accessing analgesia? It can be incredibly damaging to your mental health if your visits to your primary care doctor, GP, consultant or A&E department involve a constant battle to receive pain relief. Most chronic pain sufferers already have a hard time getting their pain taken seriously, a higher level of resistance from their doctors will not help with this.
Let me make myself clear opioids should not be prescribed willy nilly. They shouldn’t be given to those that don’t need them or for longer than they are needed. For example for an acute injury. Alternatives should be offered to those with chronic pain, and support given to those that find themselves addicted BUT people like me need their pain relief to live.
Not a doctor, definitely not an expert but would love to hear your experiences with opioid pain relief and your fight to access it.