Pharmacist led opiate reduction in one PCN in Brighton (2025)

Deans and central PCN

Project summary

To tackle rising rates of long-term opioid use for non-cancer pain, we developed and implemented a pharmacist-led opioid reduction clinic across our Primary Care Network (PCN). Our aim was to improve patient safety, reduce harm, and support individuals living with persistent pain to achieve better quality of life without unnecessary dependence on opioids. This has long been an objective for the Medicines optimisation agenda delivered by the Government.

The clinic was embedded within the existing PCN structure and positioned pharmacists as clinical leaders in medicines optimisation. We carried out structured medication reviews with each patient, identified risks and red flags, and worked collaboratively to create personalised tapering plans. These plans were flexible, realistic, and sensitive to individual needs, often combining gradual dose reduction with the introduction of non-pharmacological alternatives. Many patients were able to significantly reduce or completely stop their opioid medications as a result.

A core strength of the model was our integrated, multidisciplinary approach. Working closely with first contact physiotherapists, social prescribers, and general practice teams, we ensured that patients received wraparound support that addressed not only their physical pain but also the psychological and social contributors to long-term opioid use. This whole-person approach helped us manage not just dependence but also the sense of identity and fear often associated with reducing opioids.

Beyond direct patient care, this project demonstrated the transformative potential of pharmacists working at the top of their clinical capability. By taking a leadership role in both the design and delivery of the clinic, we showcased the strategic role of pharmacy in tackling public health challenges. We also embedded a model of mentorship and coaching, enabling other PCN pharmacists to upskill in opioid de-prescribing and complex pain management. This peer support element was critical to creating a sustainable, scalable service.

This work not only supported individuals at risk of opioid-related harm but also changed the conversation around chronic pain—from one of long-term medication reliance to one of empowerment, choice, and supported self-management.