New NICE guidelines aim to address patient concerns about the use of opioids in advanced disease.

The UK’s Institute for Clinical Excellence has released new guidelines which aim to standardize the use of opioids in advanced disease pain management.

It is estimated that each year in the UK some 300,000 people are diagnosed with cancer and 900,000 have heart failure. As well as this, thousands live with long-term chronic conditions such as kidney disease and COPD.

Despite the fact that opioids offer the most effective pain control in advanced disease, both patients and doctors seem unwilling to use them.

Often, it seems, patients worry about the side-effects of opioid painkillers, as well as the possibility of becoming addicted. According to Dr Damien Longson, Chair of the Guideline Development Group,  “Because opioids are powerful medicines people worry they can become addicted, particularly if opioids are prescribed over an extended period of time”.

As well as this, many doctors seem unsure about when strong opioids are an effective and appropriate treatment option.

The new guidelines aim to combat both patient and doctor aversion to opioid prescribing.

The guidelines recommend more clear and effective communication with patients, including asking them about their concerns and discussing these with them. Also, NICE recommends that patients be given access to out of hours contacts and frequent reviews of pain control and side effects.

Regular oral sustained-release or immediate-release preparations are recommended for patients beginning strong opioid treatment for chronic disease, with rescue doses of oral immediate-release preparations for breakthrough pain.

Read the full guidelines here: http://www.nice.org.uk/CG140

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