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FPM/CPOC Position Statement on Modified Release Opioids

20th Jun 2023

The Centre for Perioperative Care, the Faculty of Pain Medicine, and the Royal College of Anaesthetists

have issued a position statement on modified release opioids.


There is evidence that the use of modified release opioids after surgery can lead to harm for

patients. Adverse effects such as opioid induced ventilatory impairment, constipation,

delayed mobilisation and long-term opioid dependence can hamper recovery and

rehabilitation efforts.


These harmful effects have gained worldwide recognition, leading to a number of

organisations from the UK, America, Australia and New Zealand recommending the

avoidance of modified release opioids in the perioperative period. Postoperative pain is

acute and largely self-limiting, differing in nature to pre-existing arthritic pain. The use of

controlled release opioids in this setting confers no benefit for patients but carries an

increased risk compared with immediate release formulations.


The Centre for Perioperative Care (CPOC) recommends that opioid prescribers follow best

practice guidance from the Faculty of Pain Medicine (FPM), which can be found here



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