References
Meeting demand for opioid dependency in an Inner London borough
Abstract
This paper is looking at the development of the Benzodiazepine and Opiate Withdrawal Service (BOWS) in the borough in Inner London to implement a model that would treat patients effectively in GP practices. It is to illustrate what can be achieved with experienced nurse prescribers in treating an emerging group of patients in primary care. Often patients are aware of their dependency on opiate medications and do want to reduce and come off their medications. This paper describes the BOWS service and its approach, illustrating what can be possible, in terms of treatment for patients in general practice. It also shows what can be designed in NHS services to address the growing issue of dependency on prescribed drugs and argues that services having experience in addictive behaviours can play a very large role in achieving this.
Evidence collected by Public Health England (PHE) shows an increase in the use of over-the-counter codeine medicines. It is also increasingly recognised by health professionals that opioid medications used to treat pain become less effective over time. Often, doses can be increased to high levels of opioid medication and this often does not work, creating a dependency on opioid medications in the long run, particularly codeine based ones (PHE, 2014; 2019).
From data collected by PHE, 11.5 million adults received at least one prescription, which was for over 36 months in duration. Of those receiving medications for over 36 months were: 5.6 million on opioid pain medicines, 1.4 million on benzodiazepines and a growing number on gabapentiods. These figures illustrate there is significant bulk of prescribing in this area and therefore PHE has encouraged commissioning services to try and address this issue (PHE, 2019).
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