Options for the treatment of Chronic Pain: Part Five: The Opioid Crisis

Professor Lesley Colvin, from the University of Dundee was quoted in a recent report

“Most people are aware of the opioid epidemic in the States, where there's been a huge increase in strong opioids prescribed for the management of chronic pain,”

“One of the things we're trying to do is find out why that's happened. There's no doubt that one of the contributors has been people having surgery. They need strong painkillers afterwards and those painkillers are sometimes not stopped when they should be.”

“People carry on, sometimes with chronic pain, but they carry on with bigger doses of opioids so they end up with the problems of the side effects, misuse problems, tolerance and opioid-induced hyperalgesia.”

Opioid v non-opioid test data

Data taken from one hospital in the United States compared to a Dutch hospital found that 77% of patients undergoing a hip repair were prescribed opioids post-surgery compared to 0% of patients in the Netherlands.

Further 82% of US patients received opioids after an ankle fracture repair, compared with just 6% of Dutch patients.  Interestingly, the levels of patient satisfaction with pain management were similar in all cases reviewed comparing the two approaches.

What do we know about the opioid crisis?
  • Roughly 21 to 29% of patients prescribed opioids for chronic pain misuse them.
  • Between 8 and 12% develop an opioid use disorder.
  • An estimated 4 to 6% who misuse prescription opioids transition to heroin.
  • About 80% percent of people who use heroin first misused prescription opioids.

Clearly the wide usage and routine prescribing of opioids has potential to cause problems as well as help fix them. 

Are opioids being given out too readily?

One client of ours was involved in a road traffic accident, as a consequence of which she developed chronic pain in 2015.  Prior to the accident, this patient in her mid-30s had received just 18 prescriptions in her lifetime (2 per annum approximately on average) for what one might describe as routine health issues.

In the three years that followed the accident, she received 79 prescriptions for opioid-based medication, approximately 2 per month.

She was seen by multiple GPs at her local practice.  She was never once referred on the NHS onto a pain management programme, despite various requests being made. Further this client claims to have been told by GPs that the pain was “in her head” on numerous occasions, yet the prescriptions to tackle pain manifested from an organic cause continued to be prescribed.

The BBC recently reported that some 24 million opioid drugs were prescribed last year, up 10 million in a decade, and that means the UK has the third-fastest use of opioids in the world.

Meanwhile for the first time since 1999 preliminary data coming out of the US in July 2019 suggests that deaths from overdose in the US have fallen for the first time, which suggests perhaps a change in thinking is starting to take effect, we shall see.

With increasing pressure on NHS GPs to meet the demand of a growing population and so less time to follow up on appointments and or to do the necessary reading before appointments, is it possible that people are being led into a pattern of addiction where alternative treatments might have proved as or more effective?

So what needs to be done?

In the US and Canada there is said to be an “opioid epidemic”. The Organisation for Economic Co-operation and Development OECD has published a report which describes the opioid crisis as “a complex public health issue that requires a comprehensive approach across all sectors, including health, social services, and law enforcement.”

Clearly this is a problem that cannot be dismissed and there needs to be a policy change to ensure patients and health care professionals have a greater depth of knowledge, ensuring more information is provided while providing access to alternative pain management.

It is perhaps no surprise that the rise in the recreational use of prescription drugs to Heroin are on the rise in more socially deprived areas of northern England.  Employment and housing also need to be addressed to help prevent substance misuse in general.

Raising awareness of the situation is just one-way individuals can help fight the war on opioids.

At Goughs we meet victims of chronic pain regularly and through careful management with the use of the best experts, we can gain access to a multi-disciplinary treatment in order to allow our clients all of the options.

If you have any questions or feel that you may be experiencing chronic pain as a result of an accident or injury please do get in touch.

Our specialist chronic pain lawyers are highly experienced and can help you understand your condition and will always seek the opinion-leading barristers to reinforce your claim.

This approach allows us to build a strong case, ensuring that you feel safe in the knowledge that we are in the best possible position to try to secure the compensation that will assist you for the rest of your life.

We encourage you to take advantage of our free initial consultation and we will come to see you at home, at work or anywhere in England and Wales to discuss your claim on a no win no fee basis.

We take the time to really understand what you are going through and will explain exactly how we can help.

We listen, we advise, we are here for you.