Opioid analgesic dependence: where do we go from here?

Long-term benzodiazepine and Z-drugs use in England: a survey of general practice

“…Quinlan and colleagues, in a recent editorial in the British Journal of General Practice, drew attention to rising opioid dependency, and the lack of both dedicated withdrawal support and essential data on the scale of the problem regarding all dependencyforming medications. 16 Additionally, Alderson has more recently argued that GPs should stop prescribing opioid medication except for palliative care, owing to their serious adverse and dependency-forming effects. 17 Although this study finally fills this data gap, at least with respect to BZDs, its methodology could also be applied to determine the scale of long-term use, and thus dependency, on medications such as opioids and gabapentinoids, a study the authors are now proposing to undertake.…”

Hopes and fears before opioid tapering: a quantitative and qualitative study of patients with chronic pain and long-term opioids

“…Opioid tapering in patients with chronic pain needs to be a collaborative process, with mental health support to address the co-factors of pain for which opioids have provided a chemical crutch. 7 The iatrogenic disaster of inappropriate prescribing of opioids for chronic pain should not now be compounded by iatrogenic mishandling of their cessation.…”

“…6 This ‘complex persistent dependence’, 6 existing between simple dependence and addiction, can lead to worsened pain, function and psychopathology during opioid tapering, such that many patients need considerable mental health support to achieve material and sustained opioid reduction. 7 Equally, these patients are not well served in traditional addiction services where issues of social deprivation, homelessness and criminality are prevalent, 8 and alleviation of withdrawal is the primary driver of opioid use rather than relief of pain.…”

Bad Medicine: The medical untouchables

“…A petition was recently sent to the Scottish Parliament to highlight the harm caused by prescription drugs 1 -a topic I have been droning on about for decades. With a tripling of the use of antidepressants and painkillers in a decade, which are causing widespread dependence and addiction, 2,3 this is a huge public health issue but no one seems to care. The great and good are just desperate political wannabes, busy posturing and having completely lost sight of their real job as doctors.…”