Opioid Prescribing- June 2013

Listed below is the high level evidence on Opioid Prescribing [Safe Prescribing] produced by NICE, SIGN and NHS based organisations. Also included are the European Society guidelines where available. This list is produced and maintained by HEFT Library Services to support VITAL for Doctors core skills programme developed in the Trust.


HEFT Local Policies

Palliative Care Guidelines for the Use of Drugs in Symptom Control

West Midlands Palliative Care Physicians-Alison Harrison. Date: 1st July 2012. Next Review Date: 2nd April 2015.


NICE Guidelines and Pathways

Opioids in Palliative Care

NICE, May 2012

Opioids in Palliative Care-NICE Pathways

NICE, May 2012

Drug Misuse: Opioid Detoxification

NICE, July 2007


Map of Medicine

Search for Opioids

Use HEFT Athens ID to login to Map of Medicine.


Other National (includes Professional Bodies/Associations) and non-UK Guidelines (with EU)

Guidance for the use of substitute prescribing in the treatment of opioid dependence in primary care

Royal College of General Practitioners, January 2011. Next Review Date: 2013

Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC.

European Palliative Care Research Collaborative, Feb 2012

General Palliative Care Guidelines for the Management of Pain at the End of Life in Adult Patients

Guidelines Audit and Implementation Network (GAIN), 2011.

Opioids for Persistent Pain: Good Practice

British Pain Society, January 2010.

Control of pain in adults with cancer

SIGN, November 2008

Reducing dosing errors with opioid medicines

NPSA, 2008

Drug Misuse and Dependence: UK Guidelines on Clinical Management

Department of Health (England) and devolved administrations, 2007


Systematic Reviews – Cochrane Library

Methadone for chronic non-cancer pain in adults

Simon Haroutiunian1,  Ewan D McNicol2,*,  Arthur G Lipman3 Editorial Group: Cochrane Pain, Palliative and Supportive Care Group Published Online: 14 NOV 2012 Assessed as up-to-date: 5 APR 2012

Long-term opioid management for chronic non-cancer pain

Meredith Noble1,*,  Jonathan R Treadwell1,  Stephen J Tregear2,  Vivian H Coates1,  Philip J Wiffen3,  Clarisse Akafomo1,  Karen M SchoellesEditorial Group: Cochrane Pain, Palliative and Supportive Care Group  Published Online: 20 JAN 2010 Assessed as up-to-date: 18 MAY 2009

Opioids for neonates receiving mechanical ventilation

Roberto Bellù1,*,  Koert A de Waal2,  Rinaldo Zanini3  Editorial Group: Cochrane Neonatal Group Published Online: 8 OCT 2008 Assessed as up-to-date: 31 AUG 2007

Methadone for cancer pain

Alexander B Nicholson* Editorial Group: Cochrane Pain, Palliative and Supportive Care Group Published Online: 8 OCT 2008 Assessed as up-to-date: 13 AUG 2007



NHS Evidence

Opioid Dependence

Clinical Knowledge Summaries, February 2008

Caraceni A, Pigni A, Brunelli C. 2011. 'Is oral morphine still the first choice opioid for moderate to severe cancer pain? A systematic review within the European Palliative Care Research Collaborative guidelines project.', Palliative Medicine, 25(5), 402-9.  

  • Abstract: The aim of this systematic review was to evaluate the evidence that oral morphine can be recommended as the first choice opioid in the treatment of moderate to severe cancer pain in updating the European Association for Palliative Care opioid recommendations. A systematic literature review was performed to update the 2007 Cochrane review 'Oral morphine for cancer pain'. The literature search was conducted on MedLine, EMBASE and Cochrane Central Register of Controlled Trials databases. The search strategy, limited in time (from 1 July 2006 to 31 October 2009), was aimed to be as extensive as possible using both text words and MeSH/EMTREE terms; a hand search of the reference lists of identified papers was also performed. Randomized clinical trials, containing data on efficacy and/or side effects of morphine, were identified. Among the papers retrieved from the cited databases and the Cochrane review, 17 eligible studies, for a total of 2053 patients, and a meta-analysis were selected. These studies do not add significant information to the previous Cochrane review confirming the limitation of efficacy and tolerability data on opioid-naive and non-selected populations of cancer patients treated with morphine and suggesting that oral morphine, oxycodone and hydromorphone have similar efficacy and toxicity in this patient population.
  • Full Text: Available from EBSCOhost in Palliative Medicine

Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation

Author(s): M Connock, A Juarez-Garcia, S Jowett, E Frew, Z Liu, RJ Taylor, A Fry-Smith, E Day, N Lintzeris, T Roberts, A Burls and RS Taylor

Health Technology Assessment 2007; Vol. 11: No. 9


Further information:

The following sources have been searched for evidence published in the previous 12 months: HEFT Policies, NICE, SIGN, Cochrane Library, Department of Health, National Patient Safety Agency and NHS Evidence.

Please contact [email protected] for any further information.

For more information on how to make the most use of the HEFT Library Services, visit www.heftlibrary.nhs.uk. Visit NHS Evidence www.evidence.nhs.uk to access your guidelines, Cochrane systematic reviews, journals and databases.