Prescribing Guidelines | Opioid resources | North East North Cumbria ICS Formulary
Wound Formulary | PGDs | Shared Care Protocols | Practice Resources
North Cumbria Opioid Prescribing Resources
APC-position-statement-non-palliative-care-use-of-opiates
Patient stories
One patient story:
Patient was on Morphine 120mg total daily dose and had repeated admissions with type 2 respiratory failure. On ITU and almost died.
He has followed the printed reducing regimen perfectly and now down to 15mg MST twice daily. He said ‘I can breathe again‘. He has started coming up to the surgery for leg dressings now once weekly, previously district nurses were going in to the house 2-3 times per week to do it. He is continuing to reduce and aiming to stop all together.
The patient is happy for his story to be shared anonymously with other doctors and patients “because if it helps just one person…”
He said he is a different person to the one he was before he almost died in ITU.
Patient leaflets and resources
Explaining Pain Patient Leaflet - North Cumbria CCG (1007 downloads ) Living Well with pain - Ten Footsteps leaflet (902 downloads )Oxford, Reducing and stopping Opioids Information for patients
Brainman – understanding pain, Brainman stops his Opioids
Brainman – understanding pain in less than five minutes
Take the temperature of your Opioid painkillers
Pregabalin reduction patient leaflet
Patient letters
Patient medicine decision questionnaire
Flippin Pain letter for Gabapentinoid reduction
Flippin Pain letter for Opioid reduction
Opioid and Gabapentinoid letters
Patient letter - general info / intervention over 12 months (888 downloads )Opioid appointment with options for invite
Patient letter - start of reduction - patient non-responsive (864 downloads )Pregabalin reduction initial letter
Prescribing Guidelines and Resources
GMMMG Gabapentinoids resource pack
PrescQIPP Neuropathic pain template
Pregabalin Reduction Plan A – 50mg per month reduction, 50mg night time reduction.
Pregabalin Reduction Plan B – 50mg per month reduction, reducing morning and night by 25mgPlan B
Pregabalin Reduction Plan C – 50mg per fortnight reduction, reducing morning and night by 25mg
Pregabalin Reduction Plan D – 50mg per week reduction, reducing morning and night by 25mg
Training
Royal College of GPs (training open for GPs only)
Royal College of GPs Clinical Resources (available to all)
PresQipp (Reducing Opioid Prescibing in Chronic Pain)
Useful websites
Persistent Pain Service in Cumbria
DVLA information on Opioids and driving
Recent MHRA safety alerts
Pregabalin Safety in Pregnant Concerns Letter to patient
Practice Audits
Opioid Prescribing Care Bundle - March 2019 (782 downloads ) Opioid Care Bundle - data collection sheet (733 downloads ) Opioid Care Bundle - PDSA cycle template (746 downloads )Recovery Steps Cumbria
Recovery Steps Cumbria stakeholder letter
Recovery Steps Cumbria - Information Leaflet (383 downloads )