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For a full transcript of this programme, please click here.
This edition is funded by Pain Concern’s donors and friends, assisted by an educational grant from Grünenthal.
The International Association for the Study of Pain (IASP), formed in 1973, is the leading forum of scientists, clinicians, healthcare providers and policy makers supporting and promoting the study of pain and using that knowledge to improve pain relief worldwide.
Each year IASP focuses on a different aspect of pain that has global relevance. In 2017, IASP focused on pain after surgery, and joint pain was the focus of 2016. In this programme, Paul Evans speaks to Dr Paul Wilkinson, lead of the IASP force of the 2018 Global Year of Excellence in Pain Education.
IASP hopes to advance the understanding of pain in the areas of government, professional and research education and ultimately create strategy to communicate the gaps in pain education globally.
Paul also speaks to clinical psychologist Dr Nicholas Ambler, patient trainer Lisa Parry and assistant psychologist Sareeta Vyas at the Bristol Pain Management Programme to find out if there is a correlation between investment in pain management research and development and patient benefit.
Monday 23rd October 2017
Government moves to reclassify pain medications pregabalin and gabapentin create fear and anxiety for people living with long-term pain
Health charity Pain Concern is warning that moves to restrict prescribed painkillers pregabalin and gabapentin over their association with rising death rates and mis-use would have a serious impact on people who depend on the medication for relief from long-term pain.
Home Office proposals to reclassify both gabapentin and pregabalin – commonly used to treat neuropathic or nerve pain – as class ‘C’ substances, will make access to them more difficult. Publicity surrounding the proposal has also created fear and anxiety and left people who depend on gabapentin or pregabalin for pain relief, questioning the safety of the two medicines which, if used responsibly and with the right combination of support, can change the lives of people who have previously struggled to manage pain symptoms.
Heather Wallace, Chair of Pain Concern – a UK charity based in Scotland – acknowledges the rise in the number of deaths associated with pregabalin and gabapentin but says the circumstances around the alarming statistics haven’t been properly examined. ‘We have known for a long time that these medicines have been over-prescribed, but the people who find them beneficial for pain relief, haven’t misused them and feel they are being punished for something they haven’t done. In many cases it is difficult to find the right combination of pain relief, and we know from our helpline that people have been left fearful and confused by this proposal and all the publicity it has generated. It’s premature and risks harming people who are using these medicines because there is nothing else for them that works’.
Pain specialist Dr Pamela Bell believes that open and informed discussion between people living with pain and their GP about the benefits versus the risks of potential treatment, including the risks of dependency, addiction and interactions with other drugs, is vital. ‘We know many people who benefit from these medicines when they are appropriately prescribed and we share their concerns at moves to reclassify pregabalin and gabapentin. Many people tell us it has taken years for them to find the right combination of medication, physiotherapy and support that allows them a better quality of life and it will prove more difficult to access pregabalin and gabapentin when they are reclassified as controlled drugs’.
Pain Concern works to empower people living with long term pain to be proactive in managing their condition and has in response to the demand for trustworthy and reliable information on pain medication has produced three information leaflets on: gabapentin and pregabalin; amitriptyline and opioids. Written by pain experts, the leaflets provide up-to-date information and facts to help people discuss possible treatments and therapies with their GP or clinic. Leaflets are free of charge from email@example.com or 03001020162.
We at Pain Concern wish to address the recent articles published in Pulse Today titled ‘Pregabalin and gabapentine set to become controlled drugs’ on the 21st September, and the British Medical Journal (BMJ) on the 25th September 2017 titled ‘UK government to reclassify pregabalin and gabapentin after rise in deaths.’
The terms dependence and addiction are used as if interchangeable; they are not. With regards to deaths associated with these drugs it is entirely unclear whether these are due to taking as prescribed, taking at doses higher than prescribed, taken with other (potentially addictive drugs such as opioids) – and therefore, abuse – or taken in increasing doses alone or in combination with recreational drugs and/or alcohol.
We note with concern a rise in the number of deaths associated with the ingestion of pregabin and gabapentin. It is unclear what proportion of these were in people taking these drugs as prescribed or abusing the drugs by taking excessively large doses, or in combination with other prescribed or recreational drugs or alcohol. We support open and informed discussion between patients and their prescribers about the likely benefits of treatment and potential adverse effects, including the risks of dependency, addiction and interactions with other drugs.
We recognise that a significant number of people do not derive benefit from these drugs even when prescribed appropriately for nerve pain, and would encourage them to consult with their GP about alternative ways of controlling their pain. We share the concerns of those who are deriving significant benefit from these drugs: that it will prove more difficult to get them when they are reclassified as Controlled Substances.
Pain Concern is committed to the dissemination of accurate and clinician approved information regarding the treatment of chronic pain directly to the patients themselves. This includes information on the use and misuse of prescription drugs. As such, we feel the need to address this issue in the strongest possible terms.
The British Pain Society has launched a new campaign; PAIN:LESS. Its goal is to raise awareness of how pain affects people in the UK, to raise visibility and to facilitate dialogues for those people who are suffering in silence, and they need your support to accomplish this. If you could donate a small amount to the BPS, it would go towards the valuable work they do year round.
For pain management in older people, there is an excellent self-help guide in our bookstore, Pain Management for Older Adults: A Self-Help Guide, here: http://painconcern.org.uk/resources/bookstore/
With any purchase made through our bookstore, a small amount goes towards Pain Concern itself.
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