Opioids, Benzodiazepines and Z-drugs

Opioids are effective painkillers for patients experiencing a recent onset of (acute) pain and for pain control at the end of life. However, there is little evidence of benefit in the long term.

In fact, opioids are proven to be associated with multiple negative side effects, including addiction, hyperalgesia (feeling of excessive pain in response to normal stimulus), reduced ability to fight infection and weight gain.

Despite this, opioid prescribing has more than doubled in the last 25 years and has become an epidemic in the UK. This has been recognised at a government level and steps are now being taken to try to turn the tide. The Medicines and Healthcare products Regulatory Agency will now ensure that packs of opioid medication carry clear warnings about the risks of addiction and dependency. Guidance from NICE is clear that opioids are not indicated for chronic pain and the Royal College of Anaesthetists (pain specialists) have been clear about the harm associated with them.

In addition to this, there is a significant risk of severe illness and death with high doses of opioids or when these are taken alongside strong sedatives such as benzodiazepines and z-drugs (zopiclone and zolpidem).

Its our job as GPs to try to provide the best possible care for our patients, and this means doing our part to address the high burden posed by these medications. We hope that our patients will be interested in discussing this further and coming together with a joint plan.

Please find below link to a helpful 5 minute  video about chronic pain and an information leaflet:

Understanding Pain in less than 5 minutes, and what to do about it!

https://healthinnovationmanchester.com/wp-content/uploads/2024/03/PIL-Final.pdf