MHRA advice on opioid dependence and addiction
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MHRA advice on opioid dependence and addiction The UK Medicines and Healthcare products Regulatory Agency (MHRA) has published new recommendations on the use of opioid analgesics following a review of the risks of opioid dependence and addiction in patients receiving long-term treatment for non-cancer pain. Healthcare professionals are advised to discuss the risks of tolerance, dependence and addiction with patients before long-term (>3 months) opioid treatment is initiated, and agree upon a treatment strategy and a plan for the end of treatment. They should also explain the signs, symptoms and risks of potentially fatal overdose, and provide regular monitoring and support, particularly in patients with a history of substance use disorder or mental health disorder, and should be aware of the possibility of hyperalgesia. Suspected dependence, addiction or other adverse reactions should be reported to the MHRA. The national review of the risks and benefits of opioid analgesics covered all opioids authorised for use in the UK: alfentanil, buprenorphine, codeine, diamorphine, dihydrocodeine, dipipanone, fentanyl, hyrdromorphone, meptazinol, methadone, morphine, opium, oxycodone, papaveretum, pentazocine, pethidine, remifentanil, tapentadol and tramadol. It resulted in recommendations by the Commission on Human Medicines (CHM) to improve information for prescribers and patients; the CHM recommended that packaging of all opioids should carry the following warnings: "Can cause addiction" and "Contains opioids," and product information should include further information on the risks of tolerance, dependence, addiction, and withdrawal reactions. Extra vigilance is required during pregnancy to prevent neonatal abstinence syndrome in neonates. The MHRA has developed an opioids safety information leaflet with advice on the risks of dependence and addiction for patients and their families or carers. MHRA. Opioids: risk of dependence and addiction. Drug Safety Update 14: 2-4, No. 2, Sep 2020. Available from: URL: https://assets.publishing.service.gov.uk/government/ 803506200 uploads/system/uploads/attachment_data/file/920770/Sept-2020-DSU-PDF.pdf
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Reactions 10 Oct 2020 No. 1825
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