Distressed coronavirus patients need swift treatment – the government should put any political dogma aside and change drug rules

The government needs to take a hard look at things like the use of morphine to make sure patients are getting what they need, writes Ian Hamilton

NHS staff have had to make difficult decisions about how to treat patients (EPA)

It seems to me that the home secretary, Priti Patel, has a case of "opiophobia", a phenomenon which gives you an exaggerated concern about the risks of using opiates like morphine to treat medical problems. What else would explain why a call from the Royal College of General Practitioners (RCGP) to loosen the regulations on drugs like morphine has so far been ignored.

In its letter to the home secretary the RCGP highlights two problems their members are encountering. First patients who are in pain or experiencing severe breathlessness are not receiving medication like morphine in a timely way. Second drugs like morphine can currently only be given to named patients and any unused medication must be destroyed, even though there is a shortage of this medication in some areas.

Both examples point to the tight restrictions and cumbersome bureaucracy involved in prescribing and administering controlled drugs. Given the rapid way that some patients with coronavirus can deteriorate, time is of the essence in prescribing drugs like morphine to ensure the patient has some relief. Imagine how frustrating it is to be a clinician witnessing this, knowing you have the solution but not the right paperwork.

The evidence for using drugs like morphine in these situations is not contested, so this isn’t about listening to differing scientific opinion, there is uniquely only one view. Nor is this about the risk of euthanasia by the back door, this is about responding by using evidence coupled with compassion.

The home office has already sought and received advice on this issue from its own scientific advisors who supported this change, albeit with a recognition of the risks of diversion and potential for misuse. That was nearly a month ago, with no movement since then.

So, if the science is clear and clinicians are united in requesting this change to the law something else must explain why this relatively simple change has not been made to the regulations for these drugs.

Unfortunately, in my view it is likely to be conservative, with a small and capital C, ideology. The fear that these opiates might be diverted onto the black market or misused in some way is denying patients relief and treatment.

This risk has always been there, prior to Covid-19 and there is nothing to suggest the risk is elevated during this coronavirus outbreak. Strong opiates are always at risk of being misused or diverted. All medication carries risks and benefits, balancing these two aspects is not new and something clinicians should be trusted with.

The RCGP is not asking for unfettered access to these drugs just minor tweaks to legislation. Checks and oversight of prescribing and dispensing would still be in place, just not at the expense of timely treatment.

Of course, like all government departments the home office is not looking for things to do, but these changes could be made swiftly and easily by executive action, they don’t need lengthy parliamentary debate.

There are many aspects about this virus that are beyond government control, these regulations are within their jurisdiction. This isn’t about competing advice or complex technicalities which is inflicting unnecessary suffering on patients and those trying to provide humane care for them.

Urgent change is needed to these regulations but that will only happen if this government is willing to put patient need above political dogma.