Prescribing drugs of dependence in general practice

Part C1 - Opioids

Introduction

Last revised: 19 Jun 2020

This guide aims to help general practitioners (GPs) prescribe opioids appropriately in the general practice context. It is designed to discourage inappropriate use and reduce harms by providing GPs with guidance and practical advice regarding opioid therapy. It is complemented by Part C2: The role of opioids in pain management and aligns with Prescribing drugs of dependence in general practice, Part A: Clinical governance framework.

This document provides an overview of clinical standards for opioid use in general practice.
 

The guide covers:

  • the evidence base for opioid prescribing
  • opioid pharmacology
  • common concerns regarding opioid prescribing
  • the place for opioids (and other interventions) in general practice
  • clinical governance strategies that support accountable prescribing of opioids within general practice.

Implementing principles from this guide should facilitate improved patient care and reduce the risk of GPs being involved in an adverse event associated with prescribing opioids.

Wording of key principles and recommendations

Within the key principles and recommendations, the term ‘should’ refers to a recommended action, ‘must’ refers to an obligation, ‘must not’ to a prohibition, and ‘may’ refers to a discretionary action.

This guide is a reference for opioid prescribing and forms part of an RACGP series for guidance on drugs of dependence. Freely available on the RACGP website, the series includes: Prescribing drugs of dependence in general practice, Part A: Clinical governance framework

This document provides general practices with a framework to ensure accountable prescribing of drugs of dependence in general practice. It provides information on national and state laws and a range of strategies (with templates) for use at the practice level. 

Prescribing drugs of dependence in general practice, Part B: Benzodiazepines

Part C2 is a companion to Part C1. However, unlike this guide, Part C2 provides broader guidance on pain management. 

Recommendations should be considered and implemented based on individual conditions and circumstances.

As this is primarily a clinical governance document, the RACGP performed systematic searches on PubMed and Medline for national and international governance documents regarding opioids in primary care. We also reviewed government publications (including drug utilisation data), coroners’ proceedings and state health laws and regulations. Further, we sought advice from a range of experts.

All conflicts of interest were managed according to RACGP policies.

The Expert Committee members wish to disclose they have no financial conflicts of interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters.

Two consultation periods involved broad stakeholder (including consumer organisations) input to the guidelines. A list of all consultation bodies is found in the introductory pages.

This guide is available on the RACGP website. It contains infrastructure for feedback, and a section for detailing/ logging updates and corrections.

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