Enquiries and support
Opiate Medication Addiction within the UK
Opiate pain
killers principally Codeine are used by 1 in 10 adults in the UK and whilst
they are effective at reducing pain in the short term, it is highly likely that
when used overtime patients will ask to have their dosage increased with the
potential of eventually transitioning to stronger options. This escalation in dosage
and strength of medication increases the level of impairment and hence risk to
fellow employees, customers or the wider public. Reliance on pain medication
coupled with a lack of adequate management procedures can create significant
risk and legal implications for employers and for company managers personally.
The National Institute for Health and
Care Excellence (NICE) have recently written a consultation draft regarding
‘Chronic pain in over 16s: assessment and management’ [1]. The guideline, which
has been drafted by an expert committee, recommends that Health Professionals
should not offer opioids, ‘by any route’ to anyone over the
age of 16 to manage chronic primary pain. It also recommends that if any
individual with chronic primary pain is currently taking opioids, it is the
responsibility of the Health Professional to explain the risks of
continuing.
In simple terms, ‘Opioids’ is the
overarching name for any illegal drug or medicine that is derived from the
opium poppy or chemically derived to be of a similar structure with similar
effects on the body. Opioids are frequently used as prescription medicines, due
to their chemical properties which can relax the body and relieve pain. These
properties are a depression of the Central Nervous System causing both a
complete slowing of the brain and bodily functions, specifically effecting an
individual’s breathing, reaction times and the ability to perform simple tasks.
However, opioids can also make individuals feel ‘high’ and euphoric, hence the
reason why they are used for non-medical reasons, a well-known example of this
is Heroin.
Opioids are used in very different
ways, for instance, drug addicts use Heroin, hospitals use Morphine based
medicines, doctors prescribe mainly Codeines and pharmacists sell branded
medicines with low level Codeine mixed with pain killers such as Paracetamol
e.g. Co-codamol. However, taking opioids can be extremely dangerous as they are
highly addictive, and overdoses and death are common. To put this in
perspective ‘in 2018, opioids were mentioned or implicated in around 80% of
drug-related deaths registered in each of the countries of the UK, with the
highest proportion in Scotland (86%)’ [2].
This figure is shocking, and it gives
an insight into why NICE are recommending that opioids are not prescribed as
pain relief anymore. Their research suggests that there is a lack of evidence
for effectiveness of opioids, as well as evidence demonstrating long-term harm,
most specifically a risk of dependence on the drug. It is also suggested that
short-term use of prescription opioids can be harmful for an individual, as
they can be the gateway drugs for stronger prescription opioid medication or
worse, heroin.
This raises a serious question, why are GP’s are prescribing opioids as a pain relief medication? Professor Martin Marshall, Chair of the Royal College of GPs said ‘GPs and our teams are aware that prescribing pain medication to patients comes with risks, including addiction, and this is something we will discuss with them when developing a treatment plan – and as part of subsequent medication reviews’ [3]. Yet, research suggests that opiate pain killers are ineffective when combatting pain after the first few days/weeks of use, as the body grows accustomed to the medication and the pain returns. Marshall goes on to say, ‘most patients in pain do not want to take medication long-term, and GPs do not want this either, but sometimes medication has been the only thing that brings relief’ [4]. Effectively, causing the start of a downward spiral, as the individual relies on stronger drugs to ease the pain, which then creates a dependency on this feeling of relief.
So how does
this effect the UK workforce?
The majority of individuals understand
that Heroin is highly addictive and unbelievably difficult to stop taking but
what they do not seem to appreciate is medicinal opioids can create a tolerance
level, leading to a need for stronger medication to numb the same level of
pain. The bottom and appalling line is that 10% of the UK population are
taking pain killers and most of these are opiates! With this increasing
level of opiate in the body, the person is unable to perform or function
correctly. They will be impaired, and this will restrict their ability to make
imperative decisions correctly or quickly. This will have an adverse effect on
their role, more specifically, they will be unable to function safely whilst
driving or operating machinery and they will be more likely to have a serious
accident, potentially causing personal injury, third party injury or death.
Codeine medications now specifically state ‘do not drive or operate machinery’
on their fact sheet. Any employee who is under the impairment of drugs becomes
a liability to the company.
It is easy to assume your workforce is
not affected but take into consideration that if 10% of society are using
opiate medication, it is very likely that 10% of your employees also fall under
this category. Managing drug use in the workplace can be perceived as a complex
and uncomfortable problem but DrugWipe can help. Our DrugWipe Dual can detect
the main opiate medications used within the UK within five minutes.
If your employee gives an opiate
non-negative on the DrugWipe, it is important that a confirmation urine sample
is arranged within two hours with a fully accredited laboratory. Please give us
a call and we will be able to organise this for you. The laboratory will
analyse the sample and highlight the medication involved as well as indicate
the levels present at the time of sample. This will then indicate if the
medication has been used correctly for therapeutic reasons, or, if an excessive
level is present it could potentially demonstrate addiction, which will significantly
increase the impairment and hence the risk for you and your company. When you
have received the result from the lab you are then able to discuss with and
potentially assist the employee in their challenge to reduce or stop their
addiction by seeking the help they need.
D.tec are here to support your business
with any challenges you are currently facing. We offer fully confidential; 24/7
support and we also provide a range of training courses to suit individual
business needs. Unfortunately, this problem is not going away so give us a call
today and let us know how we can assist you.
[1] - https://www.nice.org.uk/guidance/GID-NG10069/documents/draft-guideline