Opioid Management

The use and misuse of opioids have reached epidemic proportions in the western world.  Most people start taking these medications for poorly controlled pain and unfortunately become tolerant and dependent on them.  This not only results in managing the pain difficult and complicated, but also negatively impact on many aspects of life.  Most patients who want to come off these medications and get better pain management would be managed within the remit of the pain clinic.  There is a small group of patients who have a substance misuse problem and managing chronic pain in such patients is a challenging problem for some clinicians; we work alongside specialists in addiction medicine to give the best possible care for such patients.

Symptoms of Medication issues

• Pain not well controlled despite taking prescribed medications
• Pain between medication doses
• Doses that used to work for pain is not sufficient
• Increasing dose or adding new medications
• Increasing frequency of dosing
• Abdominal pain and uncontrolled sweating
• Frequent hospital visits
• Reliance of injectable pain-killers
• Previous history of substance misuse
• History of alcohol dependence

How are Medication issues Treated

The priority is to establish a good pain management plan which can be sustained over a period of time without any major side-effects.

• Optimising medications
  • Down-titration
  • Substitution therapy
• Alternative analgesics
• Interventional management
• Support to establish self-management
• Access to specialist services for substance misuse if indicated

Success rate and Recovery

Our approach is to separate out the complexities into three main categories – issues of pain, issues with medications and other complicating factors.  We would address these specifically and bring them together in discussion with the patient as part of a bespoke management plan that could be used in the long term.  We work alongside other specialists to help and address these issues professionally, yet with compassion and non-judgemental approach.  We have years of experience in dealing with complex opioid and related medication issues and have successfully treated many patients.

What Treatments are Available?

• Personalised treatment plan
• Opioid substitution therapy
• Rapid detoxification if indicated
• Interventional management of pain
• Pharmacotherapy
• Ongoing support
• Support of addiction specialist if required