Toolkit to tackle potentially deadly opioid over prescription to be rolled out across parts of England

Leicester researchers are working with NHS partners in the East of England to lead the way in delivering the NHS’ goal of halving the amount of opioids prescribed for non-cancer pain by 2024.

Opioids, like morphine and fentanyl, can be effective for short-term management of severe pain. However, they are highly addictive which makes stopping difficult, yet long-term use is ineffective and impairs quality of life.

Debi Bhattacharya, Professor of Behavioural Medicine at the University of Leicester, led an NIHR-funded study alongside colleagues from the University of East Anglia to develop the Opioid Toolkit that provides the six things that healthcare organisations should do to enable healthcare teams to follow the guidelines for safely reducing opioid prescribing for non-cancer pain.

Their findings are published today (Friday) in the British Journal of Clinical Pharmacology. Professor Bhattacharya said:

“NHS teams across all sectors must work together if they are to successfully support patients to manage the challenge of reducing opioid use.

“Whilst it is the primary care team that prescribe long-term opioids, hospitals have a responsibility to manage the expectations of people when they are prescribed opioids for non-cancer pain.

“The whole NHS needs to balance the amount of work expected from GP practice staff to tackle opioid overprescribing, with the amount of psychological and physical help available to support patients with complex needs.”

In April 2022, the NHS launched their commission for organisations to work together to tackle opioid over prescribing; the Opioid Toolkit provides a theory and evidence-based approach to implementing this NHS commission.

Most regions in England have some of the six Opioid Toolkit components already in place but none have all six. Each region needs to find out which of the six components they are missing and then work with senior NHS staff and patients in their area to establish how they can best introduce the missing components.

Professor Bhattacharya and her team are working with the Eastern Academic Health Science Network and Patient Safety Collaborative to roll out the Opioid Toolkit across the East of England. Sophie Castle-Clarke, of the Eastern Academic Health Science Network, added:

“We are pleased to be partnering with the NIHR ARC East of England and Norfolk and Waveney ICS to support implementation of a pilot to evaluate this toolkit across Norfolk and Waveney. We hope it will provide important insights about how to support the safe tapering of opioid use.”

Dr Andrew Douglass, who leads the initiative to tackle opioid use for non-cancer pain for the Norfolk and Waveney area, added:

“Having the research evidence of the opioid toolkit has helped us to bring together senior colleagues from the region including the local hospitals, mental health trust and our GP surgeries. It is an exciting opportunity to lead on improving patient safety in opioid prescribing.”

‘A review of trial and real-world data applying elements of a realist approach to identify behavioural mechanisms supporting practitioners to taper opioids’ is published in British Journal of Clinical Pharmacology.

This study was supported by the National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) East of England.