Reproduced from Quality Prescribing for Chronic Pain – A guide for improvement
The Scottish Government, in collaboration with NHS Scotland, has produced a guide on the Management of Chronic Pain which includes both pharmaceutical and non-pharmaceutical interventions in the management of chronic pain. The prescribing for people with chronic pain is clearly defined in SIGN 136. NICE have also produced a number of guidelines on management of chronic pain. However, clinicians in NHS Scotland should refer to SIGN in the first instance which remains the only comprehensive evidence based guideline for managing chronic pain in the non-specialist setting.
1 in 5 people in Europe suffer from chronic pain which is comparable to the proportion of the population suffering heart disease, diabetes and major depression combined. 1 in 20 people in Scotland suffer severe, disabling chronic pain.24 Prescribing for chronic pain increased by 66% over the ten years from 2006
There are a number of key principles which should be considered as part of the management of chronic pain:
There is increasing evidence that many analgesics, including opioids, gabapentin and pregabalin, have the potential for harm and abuse. Cases of dependency have been described and there are reports of an increasing street value risk of drug misuse.26 27 28 There are a number of pharmacological therapies available for the management of chronic pain.