Overworked GPs are handing out opioid painkillers because they are too busy to help patients properly manage pain, experts have warned as the Government announced a multi-million project to tackle over-prescribing.
A new study found family doctors are signing repeat prescriptions of potentially addictive drugs such as tramadol and codeine rather than ordering pain counselling and encouraging behaviour change.
The findings showed that GPs working in poorer areas were more likely to prescribe opioids than those working in more affluent areas.
They come amid a steady overall rise in the use of the drugs, raising fears that the crisis of opioid overuse in the US is spreading to Britain.
Approximately eight million adults in the UK suffer from moderate or severe persistent pain, mostly emanating from the lower back.
While opioids are recommended for short-term acute pain and for those suffering from cancer, they tend to become less effective over time, meaning patients need to up their dose to get the same relief. The use of morphine-like painkillers went up by a third 1998 and 2016.
Best medical practice should involve a specialist pain consultant with help from physiotherapists and a psychologist. But Dr Li-Chia Chen, who co-authored the new study at Manchester University, said overstretched GPs were instead being pressured into relying on strong medication.
“Chronic pain is difficult to manage and unfortunately, because their workload pressures are so stringent, GPs have limited capacity to counsel patients with persistent pain,” she said.
“This might explain why drug therapy is the main way GPs manage pain.”
Last night Keele University announced it had been awarded £2.4 million from the National Institute for Health Research to investigate ways to curb the long-term use of opioids.
People with persistent pain who take long-term opioids tend to have a worse quality of life than those who do not and are more likely to suffer bone fractures, addiction and overdose, especially at high doses, the University said.
Published in the International Journal of Drug Policy, the new study found links between prescribing rates and high levels of smoking, depression and obesity.
Dr Chen said: “There’s no guarantee that long-term use of opioid analgesics can resolve chronic pain. “Indeed the risk of opioids’ side-effects such as dependency, respiratory depression and immunosuppression may sometimes outweigh the potential benefits.”
Last year research by University College London found that Tramadol had been implicated in a rising number of deaths due to misuse. In England the drug was found to be responsible for 132 deaths in 2010, but 240 in 2014.
The paper prompted calls for a national database of people taking higher doses of opioids to help get a grip on the problem.
Professor Christian Mallen, who will lead the Government-funded project at Keele University, said: “Prescriptions for opioid medication continue to dramatically rise, despite limited evidence supporting their use for many painful conditions.
“By proactively addressing this problem and making better use of the highly skilled primary healthcare team, I hope we can rapidly improve outcomes for patients who too often suffer in silence.”
GPs are already under pressure to cut the amount of antibiotics they prescribe due to the rise of drug-resistant superbugs, however some progress has been made indicating that interventions such as fines, centrally-imposed targets and local dashboards so surgeries can compare performance are effective.