If you’re a regular reader of this site, you’ll have seen several articles about America’s war on painkillers. Here I discussed how opioid medication had become public enemy number one in the US, with politicians competing to become the most stringent on limiting prescriptions and effectively, trying to abolish usage of strong painkillers at all.
In this piece I wrote about how the tragic suicide of Bryan Spece was likely directly linked to a 70% reduction in his painkiller prescription. And just last week, Richard Lowes wrote about the tabloid feeding frenzy driven by the revelation that Anthony McPartlin (one half of TV presenting duo Ant and Dec, if you don’t recognise the name) has entered rehab due to an alleged addiction to prescription painkillers.
The question lying underneath all of this has been: will the UK follow America’s lead? And if so, what does that mean for those living with intractable chronic pain?
The opening shots in a British war
Those questions may just have been answered: in news that will be deeply worrying for any CRPS patients in the UK, I think we have just seen the opening salvos in our very own war on prescription painkillers.
In a piece on Pulse, a website for GPs, they reveal “the British Medical Association has written to health ministers and the House of Commons health select committee calling for an inquiry into drug dependency.” They also state that the professional membership body for GPs, the Royal College of General Practitioners, is proposing annual GP reviews of patients on opioid painkillers and that this has the support of a parliamentary group.
Is there a problem with opioid medication in the UK?
The statistics say yes. Analysis of NHS data shows that prescriptions for opioid painkillers have doubled in recent years, with huge increases in prescriptions of oxycodone, morphine and fentanyl. Concurrently, deaths involving heroin and/or morphine have doubled between 2012 and 2015, and are now the highest on record.
Just like in the US, expert groups of addiction specialists have been claiming for several years that there is a ticking time bomb of patients becoming addicted to opioid medication. Back in 2015, Action on Addiction claimed that as many as one in ten adults could be affected by dependence on painkillers. Last year, the head of the charity Drugwise told MPs that we are “in the midst of a great public health disaster, which is killing hundreds of people a year and ruining the life of millions”.
To those familiar with the situation in America, these soundbites and statistics are worryingly similar; the trends cannot be ignored.
What does it mean for chronic pain patients?
To put it simply, it means that the government and medical organisations are starting to look much more closely at how strong painkillers are prescribed and used, and the effect that has on patients. At the moment, these are simply recommendations and requests so it will have no direct effect on you just yet.
And some of these recommendations are probably beneficial to patients; I think a yearly review of medication, where you get an opportunity to openly and honestly discuss how and if your medication is helping you, in principle, should genuinely help a lot of us. I also don’t think there’s anything wrong with looking at whether these drugs are appropriately prescribed and if people are given them for the right length of time.
Reduction of opioid usage is the aim
However, it’s clear that these new initiatives are not about justifying the need for opioids and illustrating that they help those in pain; this is a movement towards cutting the number and dosage of opioid painkillers prescribed. Pulse’s article is headlined “Opioids: GPs set to be central in reduction drive”; we can all see which way the wind is blowing.
If the UK chooses to follow the path of the US in demonising these medications then there will be problems. If the focus becomes simply about removing or cutting down the drugs regardless of the patient’s experience, as is now happening widely in the US, then it could destroy the lives of CRPS patients who currently manage their pain using painkillers amongst other techniques (like me and many others I know).
Personally, I’m seriously scared. I think we may well be moving towards a situation where all opioid painkillers are demonised and those who wish to take them are categorised as drug-seeking, their pain dismissed and disrespected. I’ve already seen an increase in these kind of stories amongst CRPS sufferers, where patients requesting extra medication to get through a flare or even those just seeking to refill a prescription are treated essentially as addicts rather than patients, with no respect, understanding or kindness shown towards their evident and considerable pain.
My own experience
I myself went through this recently; I bashed my CRPS leg and rang my GP in tears, begging for some additional medication for the next few days to get me through the massive pain flare I was experiencing as a result. As my normal GP wasn’t available, I spoke to another doctor who didn’t know me and was put through a Stasi-esque interrogation about my request. Why did I need more medication? Why couldn’t I cope with what I had? If they gave it to me, what would I do at the end of the week when I ran out of the extra? I tried to point out that I’d never asked for more before, that my medication had been stable for over a year, that I was not impaired by my tablets, that my prescribed dosage was vastly lower than the maximum but none of it mattered; she’d decided that I was a statistical risk, not a human being in terrible pain.
I ended the conversation in floods of tears, feeling utterly abandoned and uncared for in my agony. The next day I managed to speak to my normal doctor who was horrified at how I was treated and immediately supplied additional tablets and sleeping pills to get me through the flare. Despite that, the experience was stressful, hideous and unfair. It terrifies me that this could become the norm rather than the exception, that every conversation about my pain could become nothing more than an attempt to force me to cut down my medication. And even more, that the decision could be taken without my input at all; that one day I’m simply told that my prescriptions are stopping. It’s a thought that keeps me awake at night.
Be afraid. America’s war on painkillers is killing chronic pain patients and it may just be about to start here. One thing I know for definite is that we must stand up and fight for our rights to have our pain respected and treated appropriately. We are patients not addicts. Watch this space for the next step in this burgeoning conflict.