New warning to powerful painkillers: GPs are told not to prescribe pills for chronic pain with no known cause … and exercise instead, latest guidelines say
- Experts say drug treatments don’t balance benefits and risks
- Research shows that ‘little or no evidence’ painkillers make a difference to quality of life
- New health guidelines say patients should receive exercise programs, psychological therapies, acceptance therapy, and acupuncture instead of drugs
Millions of patients suffering from chronic pain with no known cause should not be prescribed painkillers, new health guidelines say.
NHS watchdog Nice said they should get exercise programs or therapies instead.
In a win for a Daily Mail campaign, it said there is “little or no evidence” that painkillers make a difference to patients’ quality of life, pain or psychological distress.
The NHS watchdog Nice says there is “little to no evidence” that painkillers make a beneficial difference in the lives of pain patients and that their use does not outweigh the risks such as addiction.
But drugs – including benzodiazepines like diazepam or opioids like tramadol and codeine – “can cause harm, including potential addiction.”
Chronic pain, defined as persisting for more than three months, usually involves the diagnosis of a cause.
The guidelines focus on chronic primary pain, where doctors have been unable to find the cause, which is estimated to affect between 1 and 6 percent of the country – up to 3.3 million people.
It suggests that patients should receive exercise programs, psychological therapies, acceptance and commitment therapy, and acupuncture.
Antidepressants can be considered, it added. But patients should not be started on commonly used drugs, including acetaminophen, nonsteroidal anti-inflammatory drugs, benzodiazepines or opioids, they say.
Dr. Paul Chrisp, director of the Center for Guidelines in Nice, said the evidence suggests that drug treatments other than antidepressants are unlikely to provide an adequate balance of benefits and risks.
The watchdog said patients should receive exercise programs, psychological therapies, acceptance and commitment therapy, and acupuncture in lieu of prescription medications.
He added, “People don’t have to worry about us just asking them to stop taking their medications without giving them alternative, safer, and more effective options.”
The Mail has been campaigning for more recognition of the prescription addiction crisis since 2017.
Lucy Ryan, a patient representative on the guideline committee, said, “I’m glad it highlighted the potential risks of some drugs, as I feel people are sometimes unaware of them.”
Nick Kosky, consultant psychiatrist at Dorset NHS Foundation Trust, said GPs and specialists “find chronic pain very difficult to treat.”
He said, “This guideline underscores the importance of proper assessment, careful drug selection, exercise programs, psychological therapies, and acupuncture focus in improving the experience and outcomes of care for people with chronic pain.”