Friday, 25 March 2016

Painkillers. Doctors told they are not safe for patients

Our doctors have been bemoaning the fact that painkillers do much harm to prescribe safely. One doctor wrote honestly about "the vanishing option for chronic pain' in the GP e-magaizine, Pulse, in September last year.

          "... GP options for managing persistent pain in their patients have declined markedly over the past decade, but it seems we may have finally reached crisis point".

NICE, the National Institute for Clinical Excellence, has now confirmed this position, issuing new guidance for the prescription of painkilling drugs. Pulse has reported on this in it article 'NICE dramatically reduces drug options for low back pain', (24 March 2016).

          "The draft guidelines – which now also cover sciatica – said that GPs should offer NSAIDs as first-line for pain relief, and should offer paracetamol only alongside a weak opioid."

Although this is a clear indication that conventional medicine is failing, disastrously, NICE cannot avoid taking a swipe at traditional medicine, this time Acupuncture, saying that GPs "should avoid acupuncture altogether - which ..... is no better than sham treatment".

Instead it recommends exercise, such as stretching, strengthening, aerobics or yoga "to be the first step to help patients manage their condition". Clearly, the drugs cabinet of conventional medicine is becoming increasingly bare!

Yet it is the comments on the Pulse article that is perhaps most interesting. As far as doctors are concerned, the response varies from despair to denial. Yet one feature of GP comments appear to show some misunderstanding of what is actually happening. There is some sense that NICE are making their life difficult for them, that the new guidance is either misguided or incorrect. One comment reminds us that all the painkillers doctors can no longer freely prescribe can be purchased at chemists at a cost far lower than a prescription.

All this misses the essential truth behind the new guidance. NICE have recognised that conventional painkilling drugs are not safe. They are harmful. They are dangerous.

Nowhere can I see significant concern for patient health. Nowhere can I see doctors asking how they can protect patients, or whether they should stop prescribing or recommending painkillers. Nowhere is the question asked - 'if painkillers are too dangerous for doctors to prescribe, why are the still on sale at chemist shops?"

As might be expected, the 'medical fundamentalists' have entered the argument, but they only to focus on the attack on Acupuncture, and do not mention the dangers of conventional painkilling drugs.

  • Andy Lewis appears to think that acupuncture has not been used for for thousands of years (which makes me wonder where he has been for all that time)! His claim is refuted by Tony Gu, who correctly says that "it has a fairly reasonable evidence base"! Yes, indeed it has! An evidence base that stretches back thousands of years!
  • David Colquhoun states that "the results of more than 3000 trials of acupuncture ... have consistently shown that (acupuncture) is indistinguishable from various sorts of sham, yet some people still advocate it".  These trial are, of course, 'randomised controlled tests', and RCTs are the tests that told us initially that painkilling drugs were safe and effective.
  • In another post Colquhoun says he is 'heartened' by the new guidance because "the fact is that none of the treatments works very well and that has led to clutching at straws". So this conventional medical fundamentalist professor is heartened that we are 'clutching at straws' - a dispiriting and defeatist comment indeed.
 At least Colquhoun is correct here. It is a dispiriting time for supporters of conventional medicine, on which society has placed so much trust, and spent enormous resources, during the last 70 years and more. It is dispiriting for patients. And it must be dispiriting for professors, sitting in their university faculties, largely funded by the pharmaceutical industry.

Patients are needing some positive guidance, and this will not come from the conventional medical establishment. It will come from traditional therapies, including acupuncture, osteopathy, chiropractic, homeopathy,  and many others. At least these treatments are not dangerous. And patients will increasingly seek and use these therapies because their doctors have nothing to offer. And they will find that they do work - just as millions of patients throughout the world over centuries have told us!