Optimising non-opioid medicines

Although willing to consider reducing ineffective opioids, patients often expect to be offered an alternative medicine for their pain and it makes sense to review the effects of their current non-opioid pain medicines whilst reviewing opioids.

Reviewing non-opioid pain medicines alongside opioids provides an opportunity to:

However, for the majority of patients with persistent pain, it is unlikely that there will be a safe and effective alternative non-opioid analgesic you can offer.

Key considerations regarding non-opioid analgesics for persistent pain are summarised below. More detail and links to relevant NICE Guidance are included in the training manual (Section 3.1 Medicines Management).

*NICE CG177 Osteoarthritis: care and management
*NICE CG177 Osteoarthritis: care and management
NICE Guideline 59: LBP & Sciatica in over-16’s
*NICE CG 173: Neuropathic Pain in Adults **NICE draft guideline: Chronic Pain in over-16’s: Assessment & Management
* Friedman 2017 ** NICE Guideline 59: LBP & Sciatica in over-16’s.
***NICE draft guideline: Chronic pain in over 16s: assessment and management
NICE Guideline 144 Cannabis-based medicinal products