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Airing Pain 54: Opioids, Memories and Prison Healthcare

Delv­ing into the issues sur­round­ing opi­oids and health­care with­in pris­ons and inves­ti­gat­ing the rela­tion­ship between mem­o­ry and pain

This edi­tion has been sup­port­ed by a grant from the Scot­tish Government.

Paul Evans talks to Dr Cathy Stan­nard, a Con­sul­tant in Pain Med­i­cine at Fren­chay Hos­pi­tal in Bris­tol, who out­lines the use and mis­use of opi­oids in chron­ic pain man­age­ment. She points out that whilst opi­oids are a use­ful anal­gesic for some peo­ple, they can have a detri­men­tal effect on oth­ers due to their strong side effects. She empha­sis­es the need for health­care pro­fes­sion­als to be aware of how to use opi­oids effec­tive­ly as a pain man­age­ment resource.

Paul also meets Dr Rajesh Munglani, a Con­sul­tant in Pain Med­i­cine in Cam­bridge, who has car­ried out research into the rela­tion­ship between pain and mem­o­ry. He describes chron­ic pain as a cir­cuit that can be trig­gered by seem­ing­ly small events or mem­o­ries and high­lights the impor­tance of con­text and mem­o­ries on pain. He explains that med­ical or psy­cho­log­i­cal inter­ven­tion is need­ed to dis­rupt the cir­cuit of pain.

Then Paul speaks to Dr Cathy Stan­nard and Dr Ian Brew, a prison GP, about health­care with­in pris­ons. Stan­nard reveals some prob­lems in this area, say­ing that some med­i­cines are a trad­able com­mod­i­ty in pris­ons and that often pris­on­ers’ account of pain are treat­ed with mis­trust. She reports that the sit­u­a­tion is improv­ing, as the health­care needs assess­ment that pris­on­ers receive when they arrive in prison now includes a sec­tion on pain, along­side the orig­i­nal sec­tions on sub­stance mis­use and psy­chi­atric dis­or­ders. Dr Ian Brew empha­sis­es that pris­on­ers deserve to receive equal health­care to those out­side of prison and says evi­dence sug­gests that good health­care, along­side oth­er reha­bil­i­ta­tion ini­tia­tives in pris­ons, can reduce the rate of re-offending.

Issues cov­ered in this pro­gramme include: Opi­oids, side effects, edu­cat­ing health pro­fes­sion­als, prison, pain mem­o­ry, psy­chol­o­gy, drug overuse, drug mis­use, dosage, over-pre­scrip­tion, under-pre­scrip­tion, trig­gers, sen­so­ry mem­o­ry, asso­ci­a­tions, ampu­ta­tion, phan­tom limb pain, neu­ro­path­ic pain, med­ical research, psy­chi­atric dis­or­der, men­tal health, con­fi­dence and self-esteem.


  • Dr Cathy Stan­nard, Con­sul­tant in Pain Med­i­cine at Fren­chay Hos­pi­tal in Bris­tol and chair of con­sen­sus group and edi­tor of British Pain Society’s Guide­lines on Opi­oids for Per­sis­tent Pain: Good Practice
  • Dr Rajesh Munglani, Con­sul­tant in Pain Med­i­cine in Cam­bridge and a lec­tur­er in the Uni­ver­si­ty of Cam­bridge research­ing mech­a­nisms of chron­ic pain
  • Dr Iain Brew, GP work­ing in prisons.


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