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Toolkit launched to help prescribers ‘taper’ opioid doses

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A toolkit has been launched to help fill a dearth of information for primary care clinicians on tackling chronic opioid use associated with non-cancer pain.

Practice nurses and GPs must be better-equipped to support patients to manage the psychological challenge of reducing opioid use, according to those behind the initiative at the University of East Anglia.

“Prescribers need to better understand the consequences of excess opioid use”

Debi Bhattacharya

The toolkit, launched today, outlines seven areas of best practice to tackle chronic opioid use – based on international research evidence, the experiences of health organisations and individual practitioners.

It comes after figures for England and Wales revealed an increase in opioid prescriptions of more than 60% over the last decade, from 14 million in 2008 to 23 million last year.

The toolkit has been supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England, hosted by Cambridgeshire and Peterborough NHS Foundation Trust.

Lead researcher Dr Debi Bhattacharya, from the University of East Anglia, said: “Opioids, like morphine, tramadol and fentanyl, can be effective for the short-term management of severe pain.

“However, they are highly addictive which makes stopping difficult yet long-term use can impair quality of life and overuse can be deadly,” she said.

“GPs and other health professionals need to urgently, proactively work with patients prescribed long-term opioids for non-cancer pain to gradually reduce or ‘taper’ their doses,” she said.

However, to do so, they must be equipped with training to manage the psychological challenges experienced by patients when trying to reduce their opioid use, she noted.

She highlighted that, without such training, prescribers were “reticent to open ‘a can of worms’ that they know they don’t have the skills to manage.”

Dr Bhattacharya said: “There needs to be a clear expectation that opioid de-prescribing is the responsibility of the prescriber.”

She suggested that incentives may help clinicians to prioritise reducing the amount of opioids being prescribed to patients, particularly among those who have been taking them long-term.

She added: “Prescribers need to better understand the consequences of excess opioid use, and they need better guidelines about how to gradually reduce or ‘taper’ doses.”

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