COVID-19 restrictions to remain in place at The Walton Centre

Restrictions remain in place across the NHS in relation to the COVID-19 pandemic. The safety measures in place over the 18 months therefore remain in place at The Walton Centre - and in our other clinic settings within the community – until further notice.

Due to the increased transmission risk posed by the Omicron variant, visiting has been suspended within The Walton Centre except for exceptional circumstances.

Reducing and switching opioid drugs

What is an opioid?

Opioids are strong pain medications. Some of the more common opioid medications are:

  • Morphine Sulphate (MST, Oramorph)
  • Oxycodone (Oycontin, Oxynorm)
  • Buprenorphine (Butrans)
  • Tapentadol (Palexia)
  • Fentanyl
  • Methadone (Physeptone)

Strong opioids are available in tablets and capsules, liquid, skin patches, nasal sprays or injections.

I am taking a strong opioid drug, but my pain is not improved!

Unfortunately there are no medications available that will completely eliminate pain. Some patients who have chronic pain (pain that lasts longer than six months) find them useful. However, they are not always helpful for everyone with chronic pain. It is important to be realistic about how much benefit opioids can be to your pain management. If you find an opioid is helpful for you, then you can expect around a 30% reduction in your pain.

Have I become addicted to an opioid drug?

Addiction is a need to repeatedly take a drug for the feeling of pleasure and well-being it gives, even though it is causing harm. This is very different from taking a medicine which helps your pain and allows you to have a more active life. However, your body can develop a physical dependency on opioid drugs and therefore you may find your body will tell you when you are getting near to your next dose. Some people can experience agitation, hot sweats or shaking if a dose of their opioid drug is missed or very late. These are all signs that your body has become very accustom to the drug.

Opioid safety

Using high doses of opioids is not safe. Opioid drugs at high doses can suppress breathing. The following early warning signs can often be observed (If you notice any of these side effects you should seek medical advice):

  • Pin point pupils
  • Agitation and restlessness
  • Confusion
  • Hallucinations
  • Muscle jerking
  • Nightmares

My opioid does not work despite increasing the dose!

Over time you may find the drug is no longer as effective as it used to be, therefore you might find that the dose has greatly increased. Despite this increase, some people still do not feel that their pain has been improved. This is known as drug tolerance. In some instances people may experience more side effects from the opioids, than benefit from it. Sometimes high doses of opioids, used over a long time, can cause an increase in pain. This is known as opioid induced hyperalgesia. Your doctor will advise you if they think that this applies to you. You may be asked to begin reducing your opioids.

Changing over to a different opioid drug

If you are on a high dose of an opioid your Specialist Pain Nurse will assist you to gradually reduce the dose down to safer level. In some instances this may enable a switch to a different opioid drug. Once the opioid has been reduced (or even stopped) many people report that their pain does not change all that much.


During this reduction or transition you may feel that your pain has increased or that you were better off before the change. In this case it is important to remember why we are asking you to make these changes. Your doctor or nurse has requested you reduce your opioid drug for the following reason(s):
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If you require any further advice or support whilst making changes to your pain medication please contact your pain nurse on 0151 556 3686:

  • Alison Cox (Advanced Nurse Practitioner)
  • Rachael Barton (Specialist Nurse Chronic Pain)
  • Kathryn Wilford (Associate Nurse Specialist)
  • Angela Harris (Associate Nurse Specialist) 

Can I experience withdrawal symptoms if I reduce or stop opioid drugs?

Yes, this is possible. This is more likely if:

  • You are on a high dose of opioids
  • You have been taking the opioid drug for a long time
  • You are reducing your opioid drug and/ or changing over to a different opioid drug
  • You reduce your opioid drug too quickly

Sometimes people may experience some symptoms of withdrawal and it is important to remember that these are often quite normal during the transition phase, but quickly settle once your dose is established.

Your Specialist Pain Nurse will work with you to help alleviate any of these symptoms. Sometimes slowing down the rate at which you are reducing your opioid can assist with the transition or weaning phase.

Symptoms of withdrawal are:

  • Agitation, anxiety and irritability
  • Sweats
  • Nausea, vomiting and sometimes diarrhoea
  • Insomnia (unable to sleep)
  • Widespread increased pain in bones or joints (sometimes you may find pain in places you did not have pain before)
  • Yawning excessively
  • Feeling generally unwell, as if you have flu
  • Runny nose or eyes

I am struggling to make the changes, what should I do?

It can be a difficult time for patients, your pain may even increase initially! This often settles very quickly once your body has become used to the changes. During this time please also focus on the reasons why we may be asking you to make changes to your opioid drugs.

If you feel that you may be experiencing some withdrawal symptoms or are struggling to make the changes we have asked of you, please contact your Specialist Pain Nurse for advice on 0151 556 3686.

The Walton Centre NHS Foundation Trust
Lower Lane
Fazakerley
Liverpool
L97LJ
Tel: 0151 529 3611
Fax: 0151 529 5500

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