• AUDIT
• BASIC SCIENCES

Strong opioids are under attack again and pharmacists need to be aware of the issues in order to balance regulatory concerns with meeting the needs of patients in severe pain. The main pressures are coming from the USA but there are increasing clinical concerns in Europe as well.

The US situation has become very political with President Obama making statements such as: “Four out of five heroin users started out by misusing prescription opioids” and “120 Americans die every day from drug overdoses—most involving legal prescription drugs” Of course these are only half truths. The reality is that heroin use has been a problem in the US for decades. On the other hand there is no doubt that prescription opioids have been diverted by patients and family members.

The International Narcotics Board1 states: “The primary objective of the 1961 and 1971 Conventions is to ensure the availability of controlled drugs for medical and scientific purposes and to prevent the non-medical use of those drugs.”

Few hospital pharmacists have a role in misuse …

Correspondence to Professor Phil Wiffen, Pain Research Unit, Churchill Hospital, Old Rd, Oxford OX3 7LE, UK; phil.wiffen{at}ndcn.ox.ac.uk