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Back in the Spotlight: BBC Panorama’s “Hooked on Painkillers”

“When it comes to opioids the dangers of physical dependance are well known. So why are doctors now handing out more than 22 millons presciption a year?”

Declan Lawn in Panorama’s “Hooked on Painkillers”

Did you happen to watch BBC Panorama​ last night? In their latest episode BBC reporter Declan Lawn met with chronic pain patients and also GPs and specialists in a well-balanced discussion over the rise of prescription painkiller usage by patients dealing with long term pain.

Amongst others, Dr Cathy Stannard (Consultant in Pain Medicine at Frenchay Hospital in Bristol) and Dr Martin Johnson (Royal College of GPs) spoke candidly about the research into the growingly controversial area. Bringing Opioids and chronic pain back in to the media spotlight, this programme follows only 6 weeks after the launch of the Opioid Painkiller Addiction Awareness Day (OPAAD) on the 22nd September, and highlights the need for further research into the area itself; so that everyone is made aware of the difference between effective and non-effective Opioid referral.

“One of the things is we have to be aware of is when to say no and when to try and bring in other resources. We are not saying no enough at the moment because GPs like to help their patients.”

Dr Martin Johnson

Both Cathy and Martin have been involved in multiple Airing Pain programmes since 2010; including the discussion over the difference between Opioid addiction and dependency.

Know the Difference (Dr Stannard, AP21 – 2011)

  • Dependence: you have been on the drug for a long time; you can’t stop it suddenly because you will feel quite unwell with withdrawal effects. And what that means is that we would take somebody off opioid drugs very slowly, to avoid withdrawal effects and dependence is a normal expected effect for anybody taking this class of drugs.
  • Addiction: much more of a behavioural thing, which is to do with the way that patients take drugs and the features of addiction are craving, continued use despite harm, behaviours focused towards drug seeking and inability to control drug use.

You can listen to all of the podcasts that both Martin and Cathy have been involved in by simply typing in their names in our search bar. Alternatively, click the links below for our programme’s focussing on Opioids.

In Airing Pain Programme 21: Opioids and managing pain in remote areas

Paul Evans talks to Jackie Milburn, Dr John Macleod and also Dr Cathy Stannard, outlining the use and misuse of opioids in chronic pain management. Dr Stannard 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.

In Airing Pain Programme 54: Opioids, memories and prison healthcare

Paul speaks to Dr Cathy Stannard, Dr Rajesh Munglani and Dr Ian Brew 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.

My view is that opioids probably are currently over-prescribed. I think there is a poor recognition with opioid drugs that they may not always be effective for persistent pain and there is a strange way that these drugs are prescribed compared to other drugs. Many patients will have the experience that they will go to their doctor and they will be given an opioid drug and if it doesn’t work, they will be given a bigger dose and a bigger dose and actually one of the things we are trying to encourage in terms of guiding prescribers is to think of opioids like any other painkiller and if it’s going to work, it will work in a sensible dose and once a prescriber has to start escalating a dose, to get an effect, one should start wondering whether that really is the most effective tool for treating that particular pain.”

Dr Cathy Stannard

Pain Concern’s helpline is also listed on the Panorama “Information and Support” page for the episode and we’re here to help you manage your pain. Please also consider reading our leaflets on managing medications and watching our self-management videos.

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Doreen Wiltshire

I watched the Panorama programme with interest. I am currently using 5mcg bu-trans patches with one 50mg Tramadol (rarely) PRN for breakthrough pain. I have tried several times to stop using the patches as, since I had spinal fusion surgery 2 years ago, my pain is much less and I feel I could cope now with Paracetamol PRN and maybe the odd tramadol if the pain is more severe (eg. after a long walk or strenuous cleaning/gardening) As soon as the patch is more than 3 days past its usual 7 day use I start to feel like I have flu. My muscles ache all over and I become very shaky and distressed to the point of tears. I have approached my GP who says to continue with the patches as my chronic back pain will return??? Problem is I am SO lethargic that I feel I am sleeping my life away and I am quite sure the patches are to blame. Who do I turn to?

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Many thanks for your comment. You might find it helpful to call our helpline: 0300 123 0789 (usually available 10am-4pm, weekdays).
Best wishes from Pain Concern

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My husband suffered a head injury in 2010 and was knocked unconscious for two hours with a large gash on the back of his head which needed stapling up in hospital and admittance for 4 days for observation and drips as he lost a great deal of blood.
There is no test in this country for blood brain barrier damage, although there is in the States and Germany! After this event, my husband’s GP continued his repeat prescriptions for Co-codamol for the next 15 months and after about 7 or 8 months, I noticed a problem occurring with my husband’s skills deteriorating, which lead to stress and a sudden stroke which ruined his life.
He was also given a medicine with Aspartame in it as a sweetener which further brain damaged him and he is now in a care home, confined in a wheel chair and unable to look after himself or put a sentence together.
He was sensitive to the opiate drug and addicted – looking back and I have written a 3 page report called ‘What a Way to Learn’ as I have discovered that humans have neural tissue in the head, the heart and the gut and they all work together, so if one area is affected by damaging chemicals, then it can affect the other neural areas. Also 90% of Seratonin is made in the small intestine – none of this is taught to doctors and my husband was suicidal before he was admitted to his care home.( I researched Dignitas and he wanted to go Switzerland.) His mood has improved now he is being well looked after by trained professional carers, but he is unable to complete a sentence and his life has been changed for ever.
I am certain that if he had not been prescribed a strong opiate pain killer immediately after his head injury, (which the drug company web site lists as a warning – not to do so….) then he would have continued with his life and superb skills as a bobbin lace maker, brilliant driver and National Trust Volunteer.
In 2013, we found out that he also had jawbone infections from toxic dentistry which was carried out 20 years ago (root filled tooth and badly extracted wisdom teeth) and the cavitations in his jaw were never picked up by his dentist and allopathic doctors are not taught about the dental connection to health. This is very important information which is why your vet will treat your companion animal better than you if you visit your GP, as they are trained to link dental health with illness and disease etc. Check out Drs. Munro-Hall who are holistic, mercury free dentists in Bedford who own a specialised ultra-sound scanner which is able to reveal jawbone cavitations, but take out dental insurance first….

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