PARACETAMOL CAN DO MORE HARM THAN GOOD AND SHOULDN’T BE PRESCRIBED FOR CHRONIC PAIN, OFFICIALS SAY by HENRY HOLLOWAY

PAINKILLERS such as paracetamol, ibuprofen, and aspirin can do more harm than good for chronic pain, health officials have said.

New draft guidance from the National Institute for Health and Care Excellence (Nice) urged doctors not to prescribe the drugs to people suffering the condition.

Nice said there was “little or no evidence” the commonly used drugs made any difference to patient’s health, quality of life, pain or psychological distress.

And the new guidance, published on Monday, said there was evidence they can cause harm – such as addiction.

Chronic pain is a condition which cannot be accounted for by another diagnosis or as a symptom of an underlying condition.

It can lead to depression and disability – with the pain being felt in the muscles and skeleton, or even all over the body.

Nice said an estimated third to half of the population may be affected by chronic pain.

Meanwhile, almost half of people with the condition have a diagnosis of depression and two-thirds are unable to work because of it.

The draft guidance said that paracetamol, drugs such as aspirin and ibuprofen, benzodiazepines or opioids should not be offered as there is no proof they help.

Nick Kosky, chairman of the guidance committee, said GPs can often find it “challenging” to manage the condition.

Dr Kosky, said there is a “mismatch” between patient expectations and treatment which can lead to tensions between people needing care and doctors.

He said this can then lead to doctors prescribing ineffective or potentially harmful drugs to patients.

Dr Kosky, the consultant psychiatrist at Dorset HealthCare NHS University Foundation Trust, said: “This mismatch between patient expectations and treatment outcomes can affect the relationship between healthcare professionals and patients, a possible consequence of which is the prescribing of ineffective but harmful drugs.

“This guideline, by fostering a clearer understanding of the evidence for the effectiveness of chronic pain treatments, will help to improve the confidence of healthcare professionals in their conversations with patients.

“In doing so it will help them better manage both their own and their patients’ expectations.”

The draft guidance – which is under consultation until August 14 – recommends that some antidepressants can be considered for people with chronic primary pain.

It also said that antiepileptic drugs including gabapentinoids, local anaesthetics, ketamine, corticosteroids and antipsychotics should not be offered to sufferers.

The guidelines again say there is little to no evidence they work and could cause harm.

Nice guidence recommends that GPs explain the “risk of continuing” to any patients already routinely taking painkillers.

It urges GPs to develop a unique care plan with chronic pain patients and develop a “collaborative, supportive relationship”.

Paul Chrisp, director of the centre for guidelines at Nice, said: “When many treatments are ineffective or not well tolerated, it is important to get an understanding of how pain is affecting a person’s life and those around them because knowing what is important to the person is the first step in developing an effective care plan.

“Importantly the draft guideline also acknowledges the need for further research across the range of possible treatment options, reflecting both the lack of evidence in this area and the need to provide further choice for people with the condition.”

Last year, Health Secretary Matt Hancock said he was “incredibly concerned” by the rising trend of doctors prescribing pain pills, sleeping tablets and anti-depressant.

Figures should about 13 per cent of adults, one in eight, were given potentially addictive opioid painkillers.

The stats revealed some 11.5million patients had been prescribed with pills in the previous year – more than one in four Brits.

Mr Hancock said: “The disturbing findings, especially that one in eight adults are taking super-strength, addictive opioid painkillers, proves to me that we are in the grip of an over-medication crisis.”

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