According to new guidelines issued by the National Institute for the Advancement of Clinical Medicine (UKU), doctors should be more active in using morphine and other strong opioids, the only way to relieve pain in patients with advanced cancer or other serious illnesses.
As noted by the NIUKM, at present many of these patients receive insufficient anesthesia.
In addition, the recommendations call for doctors to pay more attention to discussing the needs of patients, namely - the issues of addiction, side effects, fear that such treatment means the last weeks of life.
The recommendations consider 5 opioids: morphine, diamorphine (heroin), buprenorphine, fentanyl and oxycodone. They are obtained from natural poppy or synthetically.
"Misunderstanding and misunderstanding" surrounded these drugs for decades, which led to erroneous "prescribing of too low doses and the assumption of pain that can be avoided or, conversely, an overdose and severe side effects," the recommendations of NIUKM. The story of Dr. Harold Shipman, who killed his patients with diamorphine, also left a mark - after that many doctors began to be wary of the appointment of strong opioids.
The purpose of issuing these recommendations, according to the NIUKM, is both improving anesthesia and improving the safety of patients.
"Almost half of patients with advanced cancer suffer from inadequate pain medication, mainly because doctors are reluctant to prescribe strong opioids," said Mike Bennett, professor of palliative medicine at the University of Leeds. "The same applies to other conditions, for example, to late stages of heart failure or neurological diseases," he adds..
In the British Medical Journal, which published a shortened version of the recommendations of the NIUKM, prof.. Bennett notes that it is very important to take into account the anxiety of patients, explaining to them that addiction is very rare, and with side effects, in particular with constipation, it is possible to cope with the prescription of appropriate medications.
"Patients may experience because of possible addiction, especially if opioids are prescribed over time," comments Dr Damien Longson, chairman of the NIACM Working Group on the development of recommendations. "In these recommendations, a special place is given to the quality of communication between the doctor and the patient, which serves as a key to getting patients accurate and timely responses to issues of concern to them".
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