- Indication
- Pain - review letter
- RAG rating
- n/a
- Document type
- Primary Care prescribing resource
- Place
- Hertfordshire and West Essex ICB
- Output type
- Pharmacy / Prescribing
- Document
- Download
Opioid
Sample Letter Inviting Patients for Review
Dear Patient
We are currently undertaking a review of prescriptions for
medications collectively known as opioids, which are prescribed to patients
within our practice.
An opioid (sometimes called an opiate) is a strong
painkiller, such as morphine, oxycodone, fentanyl, buprenorphine, tramadol,
codeine and dihydrocodeine.
New national guidance (1) requires that all
patients prescribed high dose opioid painkillers for long term pain must be
reviewed to ensure that their treatment is effective and appropriate.
This review is needed because although opioids are very
effective at treating short-term pain and end of life pain, there is little
evidence that they are helpful for managing long-term pain. However, some
people may obtain good long-term pain relief with opioids if the dose can be
kept low and they are only used occasionally. It is difficult to identify these
people at the start of treatment.
There are some risks associated with long-term opioid use –
opioids can:
- sometimes make pain worse
- cause side effects to the intestines and the stomach
- make the body feel addicted to, or dependent on them so if you miss a dose you feel a bit jittery and anxious
- increase the risk of falls
- increase the risk of overdose and death, especially if too much medication is inadvertently taken with alcohol, pregabalin, gabapentin or benzodiazepines like diazepam.
We are now writing to all patients, who from our records,
have received a number of opioid prescriptions above a specific dose for at
least three months.
The practice will contact you to make an appointment to
review your medication.
At this appointment we will carry out a full assessment of
your pain issues and a medication review. We will be able to discuss the benefits
and risks associated with the medications prescribed for your long-term pain
and explore if there are any alternative treatment options to help you manage
your pain effectively.
Please don’t change your medication until you have spoken to
somebody from the team who will guide you through adjusting the dosage, if this
is appropriate.
In the meantime, we enclose
leaflets on managing long term pain – ‘Ten Footsteps - Your Journey to Living
Well with Pain’ and ‘Driving and Pain -information for patients’ (2,3). We hope
you will find these helpful.
Yours sincerely
Dr
1 NHS
England and NHS Improvement South West » Opioid prescribing for chronic pain
2 Ten Footsteps to
Living Well with Pain
- Version number
- 1.0
- Developed by
- HWE ICB PMOT
- Approved by
- HWE APC
- Date approved / updated
- July 2022
- Review date
- This HWE APC document is based upon the information available at the time of publication. This document will be reviewed upon request in light of new information becoming available.
- Superseded version
- n/a