Trial to start aimed at improving the lives of long-term painkiller users

The University of Warwick has announced the commencement of a trial that is aiming to improve long-term painkiller users’ lives and reduce their dependency on the drugs.

Researchers from the University of Warwick’s Medical School and The James Cook University Hospital, Middlesbrough, have developed a support programme that they hope will help people with long-term pain reduce their dependency on strong pain killers (opioids) and improve their quality of life.

“Evidence suggests that opioids are only effective in the short term and patients take them long-term then need to manage a range of side effects and can suffer devastating withdrawal symptoms,” revealed Dr Harbinder Sandhu associate professor, Warwick Medical School, one of the trial leaders. “However, the UK reports indicate that between 2000–2010 prescriptions of opioids for non-cancer pain increased by 466% and in 2015 there were 16 million opioid prescriptions costing over £200 million.”

The trial will compare two treatments — the existing GP care in addition to a self-hep booklet and relaxation CD, or GP care plus a specifically designed group and one-to-one support programme (developed at Warwick Medical School with input from the collaborative study team). Participants will be randomised to receive one of the treatment regimens and both groups will be required to keep a diary for four months, which will provide information about quality-of-life and withdrawal symptoms.

Sandhu and her team will measure the everyday functioning and opioid use of the 468 volunteers taking part in the study called I-WOTCH (Improving the Wellbeing of People with Opioid Treated Chronic Pain). The intervention is targeting patients using strong pain killers up to and including Tramadol for the treatment of persistent non-cancer pain which account for 95% of strong opioids prescribed in the UK within primary care.

“Structured, group-based, psycho-educational self-management interventions help people to better manage their daily lives with a long-term condition, including persistent pain, but few of these have specifically targeted patients considering opioid withdrawal,” Sandhu added. “We hope that the results of our study will be used to help patients with long-term pain in the future.”

The other trial lead, Professor Sam Eldabe, consultant in pain medicine, The James Cook University Hospital commented: “Our clinical experience of helping people who wished to come off strong painkillers is that the great majority feel much better in themselves, are better able to interact with their families, become more outgoing and active and perhaps surprisingly complain of no more pain than when they were taking the pain killers.”

The intervention will run in in three locations: North East England; North East London; and the West Midlands. The 468 participants will be recruited from around 100 general practices, and from community pain/musculoskeletal services across the three locations.