Opioid Medication Review Opioid Medication Review First Name * Surname * Date of Birth Name of Usual GP Painkiller(s) currently taking (please select) Co-dydramol Dihydrocodeine Tramadol Oxycodone Other (please state below) Please state other painkiller(s) you are taking How long have you been taking painkiller(s) Do you take anything else for your pain? How effective are they? Please select from the options 0 = having no effect, to 10 making you pain free) 0 – no effect 1 2 3 4 5 6 7 8 9 10 – completely pain free How many painkillers do you take and how often? What is the reason for taking painkillers? Research shows that taking painkillers in the long term, can cause: Side effects: including drowsiness, nausea, constipation, weight gain, reduced libido, poor concentration & mood problems. Addiction: The effect of the painkillers is less, but trying to stop taking them causes unpleasant withdrawal side effects. Interactions: with other medication, which can make side effects worse. Worsening pain: your brain becomes more sensitive to pain over time. Are you interested in reducing your painkiller(s)? Yes No Useful Resources Lothian Chronic Pain Service The great opioid side effect lottery If you feel that your pain medication needs further review please book a routine appointment as usual to discuss. Submit If you are human, leave this field blank.
