Decision Report 201400695

Summary

Mr C complained that the board’s prison health centre doctor unreasonably stopped his pain medication for a long-term knee injury, on the basis of alleged intelligence that Mr C misused another pain relief medication he had previously been prescribed. Mr C was concerned that the doctors at the health centre would not give him painkillers because of someone else’s say so, with no concrete proof or evidence and that in the meantime he had been left without effective medication.

We obtained independent medical advice on Mr C’s complaint from a GP. We also sought advice from the office of the Chief Medical Officer (CMO) on disclosure of information/confidentiality.

Our adviser noted that Mr C’s records indicated that the decision to stop his co-dydramol and not replace it with co-codamol was made, at least in part due to reported information regarding past drug misuse. However, our adviser explained that the pain guideline followed by the board suggested that there was no evidence for the continued prescribing of opioid based drugs such as tramadol, co-codamol and co-dydramol in patients with unexplained or persistent pain. Our adviser said it was, therefore, not unreasonable for the board to reduce and then stop Mr C’s tramadol or to stop his co-dydramol and not prescribe co-codamol in its place. Our adviser noted that the doctor prescribed appropriate alternative pain relief treatment for Mr C. We were satisfied that Mr C’s pain relief was appropriately managed by the doctor and the medication prescribed was appropriate for Mr C’s condition.

In terms of the disclosure of the information about past drug misuse, the doctor confirmed he did not disclose the information to Mr C at the time he made the decision to stop his opioid based medication. Based on the advice received from the office of the CMO, we were not critical of the prison health centre’s actions in this regard.