NICE and pain management
Discussion
BBC story:
http://www.bbc.co.uk/news/health-18166176
Perhaps not the usual NP and E story, but this really is a hugely important story for so many people.
The really sad legacy of Shipman, the fear of death and fear of drugs is the chronic pain so many people suffer and continue to suffer.
I can understand the fear that people have over taking Opiates, I can understand that some are terrified that it signals the last stages of life. but what I really struggle to understand is the often at times reluctance of those practicing medicine to want to refer those they cannot treat to specialists in pain management. Knowing several in the Palliative 'business' and hearing the exhasperation in their voices when they talk about seeing patients who have suffered for months or years without adequate pain intevention, just makes me wonder where the real ingrained fear within medicine comes from.
The Shipman legacy must surely be more than watching and knowing that so many suffer in abject misery. Quality of life... what quality of life. There is none.
http://www.bbc.co.uk/news/health-18166176
Perhaps not the usual NP and E story, but this really is a hugely important story for so many people.
The really sad legacy of Shipman, the fear of death and fear of drugs is the chronic pain so many people suffer and continue to suffer.
I can understand the fear that people have over taking Opiates, I can understand that some are terrified that it signals the last stages of life. but what I really struggle to understand is the often at times reluctance of those practicing medicine to want to refer those they cannot treat to specialists in pain management. Knowing several in the Palliative 'business' and hearing the exhasperation in their voices when they talk about seeing patients who have suffered for months or years without adequate pain intevention, just makes me wonder where the real ingrained fear within medicine comes from.
The Shipman legacy must surely be more than watching and knowing that so many suffer in abject misery. Quality of life... what quality of life. There is none.
I'm glad to hear it because there's a lot of people that should get an improved quality of life from this.
It took my GP 18 months to realise that i really needed to go on fentanyl patches but he still has trouble prescribing oxycodone for breakthrough pain which is really hand in hand. The issue he has always had is the fact that i am technically addicted to fentanly and he doesn't want to add oxycodone to it fortunately my specialist is getting involved but had he not then my gp would still be trying to argue with me that dihydrocodeine is enough and the fact i can't work on it is just too bad.
But then on the flipside, you only have to look at the amount of PCTs that don't follow NICE guidelines and i feel this will be taken up very slowly and in very few places because there are so many doctors that are afraid of opiates and constantly get reminded that it's their licence which leads them into the view that their licence is worth more than keeping a few patients happy with the risk of one becoming an abuser.
It took my GP 18 months to realise that i really needed to go on fentanyl patches but he still has trouble prescribing oxycodone for breakthrough pain which is really hand in hand. The issue he has always had is the fact that i am technically addicted to fentanly and he doesn't want to add oxycodone to it fortunately my specialist is getting involved but had he not then my gp would still be trying to argue with me that dihydrocodeine is enough and the fact i can't work on it is just too bad.
But then on the flipside, you only have to look at the amount of PCTs that don't follow NICE guidelines and i feel this will be taken up very slowly and in very few places because there are so many doctors that are afraid of opiates and constantly get reminded that it's their licence which leads them into the view that their licence is worth more than keeping a few patients happy with the risk of one becoming an abuser.
Silent1 said:
I'm glad to hear it because there's a lot of people that should get an improved quality of life from this.
It took my GP 18 months to realise that i really needed to go on fentanyl patches but he still has trouble prescribing oxycodone for breakthrough pain which is really hand in hand. The issue he has always had is the fact that i am technically addicted to fentanly and he doesn't want to add oxycodone to it fortunately my specialist is getting involved but had he not then my gp would still be trying to argue with me that dihydrocodeine is enough and the fact i can't work on it is just too bad.
But then on the flipside, you only have to look at the amount of PCTs that don't follow NICE guidelines and i feel this will be taken up very slowly and in very few places because there are so many doctors that are afraid of opiates and constantly get reminded that it's their licence which leads them into the view that their licence is worth more than keeping a few patients happy with the risk of one becoming an abuser.
The fear of addiction is one part of the equation... It's very sad that the fear and misunderstanding over Opiates stops a great many getting the help they need. But the flip side is also that there is a general public misconception over the fear of addiction, made worse by lurid stories.It took my GP 18 months to realise that i really needed to go on fentanyl patches but he still has trouble prescribing oxycodone for breakthrough pain which is really hand in hand. The issue he has always had is the fact that i am technically addicted to fentanly and he doesn't want to add oxycodone to it fortunately my specialist is getting involved but had he not then my gp would still be trying to argue with me that dihydrocodeine is enough and the fact i can't work on it is just too bad.
But then on the flipside, you only have to look at the amount of PCTs that don't follow NICE guidelines and i feel this will be taken up very slowly and in very few places because there are so many doctors that are afraid of opiates and constantly get reminded that it's their licence which leads them into the view that their licence is worth more than keeping a few patients happy with the risk of one becoming an abuser.
drivin_me_nuts said:
The fear of addiction is one part of the equation... It's very sad that the fear and misunderstanding over Opiates stops a great many getting the help they need. But the flip side is also that there is a general public misconception over the fear of addiction, made worse by lurid stories.
definitely, not helped by the Daily SoovyEven worse in the US, there the DEA is constantly going after doctors for "over prescribing" and similar crap.
Strange they're doing this while now they won't sell you co-codamol for more than 3 days use, you could take enough of those tablets to kill you with the paracetamol and you would hardly notice the codeine (from an abuse point of view)
p.s. s1 sitrep coming soon...
Strange they're doing this while now they won't sell you co-codamol for more than 3 days use, you could take enough of those tablets to kill you with the paracetamol and you would hardly notice the codeine (from an abuse point of view)
p.s. s1 sitrep coming soon...
Yup, try the US on for size. My OH has degenerative spinal disc disease and suffers constant pain that even strong stuff doesn't take the edge off on a good day. Instead of the multitude of docs she's got using their brains and prescribing what's right, they'll stick her on the lowest dose to start with, even knowing full well it won't do a thing - they gave her weak paracetamol to take after having vertebrae fused in her neck, even though she couldn't take her usual painkillers for her lower spine for 6 months after the op. This, combined with a shower of shat health insurance provider make the stuff we get in the UK a dream by comparison.
I've had no problem getting seriously strong painkillers for my various ailments on repeat in the UK, yet someone desperately in need of the same stuff with a bells and whistles level of insurance coverage over there with a far worse condition than mine might as well try asking for heroin from our experience. They're terrified to prescribe anything effective, so the quality of life of the patient becomes almost irrelevant.
I've had no problem getting seriously strong painkillers for my various ailments on repeat in the UK, yet someone desperately in need of the same stuff with a bells and whistles level of insurance coverage over there with a far worse condition than mine might as well try asking for heroin from our experience. They're terrified to prescribe anything effective, so the quality of life of the patient becomes almost irrelevant.
Edited by Stu R on Saturday 26th May 04:56
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