‘Safety First: Five-Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness’ recommends that patients at risk of suicide, including all patients with a recent history of self-harm, who are treated with psychotropic drugs should receive modern, less toxic drugs and/or supplies lasting no more than 2 weeks.

1. It is important that analgesics are given regularly for chronic pain as they are more effective in preventing than relieving pain. Adequate doses of non-opioids given regularly will often make the use of opioids unnecessary.

2. Analgesics have a 'dose ceiling' with regard to efficacy, and the variable side-effect profile up to the maximum useful dose will influence the choice of a particular analgesic.

For advice on pain relief in palliative care see BNF Prescribing in Palliative Care, Joint Formulary Palliative Care Guidelines (chapter 16) and contact the medical staff at:

Mount Edgcumbe Hospice - 01726 65711

St Julia's Hospice - 01736 759070

St Luke's Hospice - 01752 401172

Guidance on other supportive treatments may be obtained from the Pain Relief Clinic at Royal Cornwall Hospital Trust - 01872 252792