Chronic Pain Patients Condemn ‘Cruel’ Changes in Treatment Guidelines

A woman from Belfast said new treatment guidelines for people with chronic pain are bringing some patients to a “crisis point”.

Julie Bermond is part of a campaign calling for a change to the NICE guidelines for the treatment of chronic pain that were implemented last year.

These guidelines say that people with chronic pain should no longer receive pain relievers, other than antidepressants, as part of their treatment, and that exercise and acceptance therapy should be used instead.

Computer engineer Julie says that while exercise and other forms of therapy are important treatment methods, she believes removing pain relievers from the guidelines will leave some patients with chronic pain “without quality of life.”

Speaking to Belfast Live, Julie said: “I have suffered from chronic pain for years and without pain relief I would not be able to be the functional member of society that I am today, where I have a job and I can pay my rent and taxes without asking for disability assistance.

“There are others who are in a worse situation than me and even with pain relief can still struggle to live normal lives due to the constant pain they find themselves in.

“These new guidelines that were put in place in April of last year took away that relief for many and I have spoken to patients who are in crisis due to the complete withdrawal of their medications in recent months.

“There are people who have been using these drugs for years, many of which can be addictive, and having them withdrawn like this can cause them serious problems and they should not be placed in such a situation.”

Julie says that while she agrees with many of the new NICE guidelines, she thinks they need to rethink the approach to pain relief.

She continued, “The new guidelines offer treatments that may work for people with chronic pain, but for many patients with chronic pain, they should be used in conjunction with some form of pain relief.

“Things like acupuncture are now recommended instead, which in my experience produces no pain relief benefit.

“The loss of pain relief could lead patients to acquire it illegally or use other substances, which can only lead them down a dark path.

“Most chronic pain patients don’t want to be medicated so as not to suffer and be ‘stoned’, because we like to have the use of our healthy minds. We just want to be medicated enough to be able to function and have a life. .

“Many chronic pain patients find these new guidelines cruel and that something urgently needs to be done about them. “

Julie has campaigned alongside chronic pain patients across the UK for the past two years against new NICE guidelines and is urging people to sign a petition against them so the issue can be heard in Parliament.

Julie said: “Thanks to our campaign, we are already seeing that patients have either a drastic reduction in pain medication or that it is completely removed apart from primary chronic pain, which appears to be being used as a comprehensive response.

“Patients can wait years in horrible pain while awaiting a diagnosis and they should be given the opportunity to decide all the options available to them for their pain relief so that they can have a good quality of life. . “

Claire Swain, who started the petition, said: “Since the start of the campaign, we have spoken to chronic pain patients across the UK who are very concerned about what lies ahead.

“Some have already lost their pain relief, while others fear it will happen to them in the future.

“Many think it’s cruel to have that relief taken away because it’s the only thing that can get them through the day.

“The Faculty of Pain Medicine and other organizations have highlighted the risks these new guidelines could pose to patients and we hope we can get enough support to bring this issue to Parliament. “

When the new NICE guidelines were announced, Dr Paul Chrisp, director of the Center for Guidelines at NICE, said: “We want these guidelines to make a positive difference for people with chronic pain, their families and their caregivers.

“He emphasizes that understanding how pain affects a person’s life and those around them and knowing what is important to the person is the first step in developing an effective care and support plan that recognizes and addresses the pain. pain of a person as valid and unique. for them.”

“Pain that lasts longer than 3 months is known as chronic or persistent pain. In the UK, the prevalence of chronic pain is uncertain, but appears to be common, affecting perhaps a third to half of the population. The prevalence of primary chronic pain pain is unknown but is estimated to be between 1 and 6% in England.

“Chronic pain caused by an underlying condition (eg, osteoarthritis, rheumatoid arthritis, ulcerative colitis, endometriosis) is known as chronic secondary pain. When the cause of the pain is not clear, it is called chronic primary pain. Although the NICE guideline covers the assessment and development of a care and support plan for all types of chronic pain, it focuses on the treatment of chronic primary pain. framework of palliative care is not covered by the guideline.

“The guideline emphasizes the need for shared decision-making, putting patients at the center of their care and fostering a collaborative and supportive relationship between patients and healthcare professionals. She emphasizes the importance for healthcare professionals to understand how a person’s life affects their pain and how pain affects their lives, including their work and play, their relationships with family and friends, and the sleep.

“The guideline recommends that a care and support plan be developed based on the effects of pain on daily activities, as well as a person’s preferences, abilities and goals. It also emphasizes the importance of being honest with the person about the uncertainty of the prognosis.

The guideline makes recommendations for treatments that have been shown to be effective in the management of chronic primary pain. These include exercise programs and psychological therapies CBT and Acceptance and Commitment Therapy (ACT) Acupuncture is also recommended as an option.

“People with chronic primary pain should not start with commonly used medications, including paracetamol, nonsteroidal anti-inflammatory drugs, benzodiazepines, or opioids. Indeed, there is little or no evidence that they alter people’s quality of life, pain, or psychological distress, but they can cause harm, including possible addiction.

“The guideline recommends that an antidepressant may be considered in people 18 years of age and older to manage chronic primary pain, after a full discussion of the pros and cons. Indeed, evidence shows that antidepressants can improve quality of life, pain, sleep, and psychological distress, even without a diagnosis of depression.

Dr Chrisp added: “This guideline is very clear in pointing out that, based on the evidence, for most people, drug treatments for chronic primary pain, other than antidepressants, are unlikely to provide an adequate balance of the benefits that are needed. ‘they could bring and the risks associated with them.

“But people shouldn’t worry that we are just asking them to stop taking their medication without giving them alternative, safer and more effective options. First, people taking medications to treat their chronic primary pain that are not recommended in the guideline should ask their doctor to review their prescription as part of shared decision making. This could involve agreeing on a plan to continue taking their drugs if they provide benefit at a safe dose and little harm, or support for them to reduce and stop the drug if possible. When making shared decisions about whether to quit, it is important that all issues associated with quitting are discussed and properly addressed.

If you would like to sign the campaign petition, please follow this link.

About Antoine L. Cassell

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