Opioid aware

Question 1

long-term opioid use

Answer 1

opioid is good analgesia for acute pain/end of life pain but there is little evidence that they are helpful for long term.

risk of harm increases if oral morphine >120mg/day

Question 2

legality of opioid

Answer 2

management of controlled drugs, including opioid, is governed by 2 key sets of legislation the Misuse of Drugs Act 1971 and The Control Drugs Regulation 2013. Prevent the misuse by imposing restriction of their possession, supply, manufacture, import and export.

Question 3

Dose equivalents and chainng opioids

Answer 3

can be considered if a patient obtains pain relief with one opioid but suffering adverse side effects.

100mg codeine= 10mg oral morphine

100mg dihydrocodeine= 10mg oral morhine

2mg hydromorphone = 10mg oral morphine

oxycodone 6.6mg= 10mg oral morphine

tramadol 100mg = 10mg oral morphine

Question 4

what are the main drugs used for opioid dependence (heroin, morphine, oxycodone)

Answer 4

methadone (mu opioid agonist)
buprenorphine (partial agonist)

(+ naloxone?)

Question 5

behavioural approaches

Answer 5

1. releaxation training (stress- reduce tension levels physically and mentally by activating the parasympathetic nervous system)
2. diamphragmatic breathing
3. progressive muscle relaxation (PMR)
4. autogenic training (repeats a phrase in conjunction with a visualisation to induce a state of relaxation)
5. visualization/guided imagery. uses senses

Question 6

non pharmacological

Answer 6

biofeedback- learn to recognise areas of tension in body and to relax those areas.

behavioural approaches

CBT- utilise psychological principles to effect adaptive change in behaviour, congitions, evaluations and emotions

acceptance-based approaches: importantce of facilitating clients progress towards attaining a more valued and fulfilling life.

expectations

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218789/