NICE releases new pain relief guidelines
Many patients with advanced cancer and other debilitating conditions are being "under-treated" for their pain, the guidance from NICE says.
NICE - the National Institute for Clinical Excellence - wants doctors in England and Wales to make more use of morphine and other strong opioids - the only adequate pain relief source for many patients.The guideline recommends doctors discuss patients' concerns (which may include addiction, tolerance, side-effects and fears that treatment implies the final stage of life) and deals with five opioids: morphine, diamorphine (heroin), buprenorphine, fentanyl and oxycodone. The aim is to improve both pain management and patient safety.
NICE says "misinterpretations and misunderstanding" have surrounded the use of strong opioids for decades, which has resulted in errors "causing under-dosing and avoidable pain, or overdosing and distressing adverse effects".
Mike Bennett, St Gemma's professor of palliative medicine at the University of Leeds, said: "Almost half of patients with advanced cancer are under-treated for their pain, largely because clinicians are reluctant to use strong opioids." In a summary of the guidance in the British Medical Journal, he said doctors should address patients' concerns and reassure them that addiction is "very rare".
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