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Independents' Day

NICE announce prescription drug dependence guidelines to cut deaths

NICE is set to develop new guidance for GPs and other health professionals on prescription drug dependence and how to manage withdrawal.

The health body said the recommendations – requested by the Department of Health and Social Care - will help tackle the problem of opioid-related deaths and 'growing concerns about dependence on prescription drugs'.

The final guidelines should be published in October 2021, NICE said.

Last month, the Government medicines regulator MHRA announced a major review of opioid medicines, which will assess the scientific evidence with the aim of cutting overprescribing and drug misuse.

An ongoing review into prescription drug addiction – including opioids – is also underway by Public Health England. This is due to report in spring.

NICE deputy chief executive and director of health and social care Professor Gillian Leng said: 'NICE has been asked by the DHSC to develop a guideline covering safe prescribing of drugs associated with dependence, and the careful management of withdrawing from these drugs.

'In summer 2019, we will recruit a committee to develop this guideline, and consult on a document outlining areas to be included. We expect to publish the final guideline in October 2021, following a detailed review of the evidence and consultation with the public and other stakeholders.

'With an average of five opioid-related deaths reportedly happening in the UK each day, and growing concerns about dependence on prescription drugs, our evidence-based recommendations will help drive improvements across the health and care system. They will complement existing NICE guidelines in tackling the problem.'

RCGP chair Professor Helen Stokes-Lampard said: ‘Most patients don’t start out wanting to take medication long-term – and GPs don’t want to prescribe it - but for some patients who experience chronic pain, for example, there are few options available.’

She continued: ‘We know that lifestyle changes can be hugely beneficial for patients, but for some patients in pain, even moderate exercise simply isn’t possible – and we know that psychological therapies can sometimes help, but access to these is patchy across the country.

‘This puts GPs, who ultimately just want the best for their patient, in an extremely difficult position.

‘We look to these forthcoming guidelines for clarity as to best practice, safe and evidence-based prescribing of opioids and other dependence-forming drugs – and the alternatives that are available – in the best interests of our patients and the care we can deliver to them.’

Previous NHS Digital data revealed one patient in 11 (8.9%) has been prescribed an addictive medicine.

Readers' comments (10)

  • David Banner

    5 deaths a day and urgent new guidelines.... October 2021.

    Well, that’s that sorted then.

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  • it would be preferable that benzodiazepines long term are only allowed to be prescribed by psychiatrists and morphine based medicines long term by pain clinics, every one else short term only - say max 4 weeks at a time and only repeat if justified ie post op or a fracture or in palliative care, there is no evidence that long term pain relief is managed any better than with nsaids and codeine at most especially in back pain. most back pain gets better with exercise over time. if you don't prescribe them they can't be abused. please stop prescribing them, its a nightmare weaning patients off them.

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  • NICE having helped create the problem in the first place.....

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  • @ d in vader : I don;t like your plan. Copnsultant psychiatrists are already responsible for many of the addicts started on long-term benzodiazepines, and probably ALL of the addicts commenced on quetiapine!
    and so far as I can tell, Quetiapine is ONLY of any use as a drug of abuse, despite supposedly being an antipsychotic as well.......

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  • Took Early Retirement

    What about people like me with a degenerate spine, who are intolerant of all NSAIs? BTW, weren't NSAIs regarded as a poison not so long ago? GI bleeding, renal impairment etc. And yet NICE IIRC tells us
    that Paracetamol doesn't work for pain!
    I've known lots of people- the overwhelming majority, in fact, who used things like Codeine or even MST for chronic unresponsive MSK pain in a quite responsible manner. Some were even able to continue to work.
    So let's do the usual thing that we do nowadays; let a minority (I'd even dare to say often an irresponsible minority) override the needs of a responsible majority.

    Watch the suicide rate rise from people with uncontrolled pain: early on in my career I saw two who died this way when we were told, "You can't given anything stronger than codeine or they will become addicts."

    At least Dr Stokes-Lampard isn't falling into the usual RCGP self-flagellatory trap of saying "GPs should be doing more". Well done to her.

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  • What you describe is a drug dependence problem rather than a pain problem. I hope you can get help with this.

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  • controlled drugs are controlled cause they are dangerous when abused. if you don't prescribe them then they cant be abused unless obtained illegally. currently weaning 3 patients off controlled drugs that was used for pain management and not working but were not stopped. if a drug is not working take people off them. pain is a subjective response with considerable emotional and psychological overlay. morphine based drugs just help you to ignore the pain - so why not just ignore the pain - there is plenty of evidence that other non drug techniques do exactly this - exercise, meditation, mindfulness, distraction techniques, CBT, acupuncture, placebo effect etc. phantom limb pain can be treated with various psychological techniques - tells you a lot about chronic pain. having a chronic sports injury since teenage years I have done a lot of research on this and rarely use painkillers for it. you really don't need controlled drugs for pain, you just think you do.

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  • Anonymouse3 is this fake news or evidence based? Your comments about Quetiapine are just not true.

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  • "I have done a lot of research on this and rarely use painkillers for it. you really don't need controlled drugs for pain, you just think you do"

    wow. just wow. are you in the right job?

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  • @ d in vadar
    What a ridiculous attitude. Because there are other ways of helping chronic pain sufferers, then using drugs is bad, wrong and now useless?
    I found a smile forming when I read this part - 'having a chronic sports injury since teenage years I have done a lot of research on this and rarely use painkillers for it'
    So, hang on, you cannot simply IGNORE the pain every time and admit there are times when even you, our resident superhero, lowers himself to the use of a drug for assistance in managing a chronic pain.
    That might just make you a pathetic hypocrite you know.
    You are in the wrong job, no doubt in this mind.

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