Painkillers Don’t Exist is a campaign by NHS Sunderland CCG to tackle the growing problem of painkiller addiction. The city has been dubbed the ‘Painkiller Capital’ of the UK, and the CCG aims to face the issue head on by raising awareness with the campaign and working with GPs and pharmacists to provide a range of physical and digital support tools to increase their confidence in suggesting alternative long-term pain management plans.
It was a brave move, but a necessary one if we are to drive behaviour change and make a real difference. As patients become increasingly aware of the dangers associated with long-term opioid dependency it means GPs are able to initiate difficult conversations, with increased likelihood of a successful outcome, i.e. working together to identify alternative methods of pain management while reducing opioid intake.
If patients are to experience positive outcomes, it is essential they are an active participant in those decisions. But managing expectations is essential. There is no quick fix to persistent pain – a term preferred over chronic pain, which implies it is incurable. Many patients might have been taking pain medication for several years, so it is unrealistic to expect the need for pain medication to simply cease.
Our best results so far have been in reducing doses for people taking the really problematic high dose opioids, rather than necessarily getting people off them altogether. The journey with each individual patient may take months, so there needs to be support from commissioners.
The recent draft guidelines around painkiller prescriptions announced by NICE, go a long way to support GPs and nurse practitioners. Suggested guidelines such as these, alongside the CCGs position statement highlighting the difficulty in prescribing such powerful medication, means health professionals are not seen as the ‘baddies’. Instead, they partner with the patient to find a better, long-term pain management option.
It’s essential we change the narrative and educate people about how the body responds to long-term pain, and the best ways to help individuals take back control and learn to effectively manage that pain without the need for constant medication. As awareness and education develop, it means understanding the difference between acute and persistent pain will enable informed conversations between medical professionals and their patients.
NHS County Durham CCG joined the campaign at the beginning of the year and is hoping to emulate Sunderland’s success that has seen a drop of 30% in opioid painkiller prescriptions in just nine months. No longer the painkiller capital, it is now in the bottom quarter of prescribing CCGs in the UK.No quick fix, but the cure is working.
Ewan Maule, Head of Medicines Optimisation, Sunderland CCG