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Around eight million people in the UK live with chronic pain, where symptoms persist for longer than three months.
Since then, she has warned persistently of the health risks of so-called ‘open-ended dose escalation.
In 2015, she caused outrage among fellow pain specialists by insisting that ‘reducing pain intensity should not be the goal of doctors who treat chronic pain’ because chronic pain causes changes in the brain that mean painkillers won’t work.
A further cause for concern is the growing evidence that people who are most susceptible to chronic pain are also most at risk of opioid addiction. Yet the NHS remains largely oblivious to what is now a clear and present danger.
We know that people with chronic pain are at a greater risk of running into problems with dependency, yet there’s often very little training for GPs to raise awareness of these issues,’ says Roger Knaggs, an associate professor in clinical pharmacy practice at the University of Nottingham.
This is despite ‘substantial evidence showing that opioids cause real harm to the vast majority of chronic pain sufferers while offering no benefit,’ says Professor Knaggs, who is also honorary secretary of the British Pain Society.
We’re brought up to believe that if you are sore, your GP will give you a pill for it and that it will work. My doctor seemed to believe that as much as I did,’ recalls Amanda.The practice is for people to be discharged as early as possible, often while they are still suffering post-surgical pain,’ explains Professor Knaggs. ‘So they are sent home with opioids, often oral morphine. ‘Yet the patient’s discharge letter may not mention that this is for short-term use, and GPs may provide repeat prescriptions until it becomes difficult for patients to stop.’
There are now services for people with chronic pain, such as NHS Pain Management Programmes, run by multi-disciplinary teams including psychologists and physiotherapists, that aim to help them come to terms with it.The fact is chronic pain is a lifestyle issue not a medical issue,’ adds Professor Ballantyne.
‘We know that acupuncture, yoga, tai chi and walking can relieve chronic pain by boosting the body’s natural opioid system. It’s a lesson we need to learn, though it might take generations to be widely accepted,’ she says.