Helping patients to manage chronic pain without strong opioids – a real possibility

Experts from our Wolfson Research Institute for Health and Wellbeing have developed a ten-footsteps training programme with the Live Well with Pain team. 

It provides effective ways for patients to self-manage their pain and equips clinicians to feel more confident in advising their patients how to manage their pain without medication. 

People who live with painful health conditions worked with our researchers to develop the programme which has been accredited by the Personalised Care Institute (PCI). 

The original training scheme offered to clinicians is the Gabapentinoid and Opioid Toolkit, known as the GOTT, was developed and evaluated during the pandemic. 

It was tailored to individual clinicians’ learning needs and is designed to raise confidence in how medical staff treat and advise patients experiencing chronic pain. 

Positive results 

In a new paper published in the British Journal of Pain (BJP), clinicians from a GP practice in a highly deprived part of County Durham, UK, implemented the GOTT. 

Its effectiveness was assessed over a 12-month period. 

Follow-up analysis was carried out 30-months later to evaluate the ongoing impact of the programme on strong opioid prescription rates. 

At the start of the study, the GP practice had one of the country’s highest rates of prescribing opioids, and clinicians were very low in confidence to deliver a pain management programme to their patients. 

After clinicians adopted the GOTT, confidence was significantly raised and the practice brought high dose opioid prescriptions down to zero. 

It also halved major opioid and gabapentinoid prescriptions – bringing the GP practice well below the national average.  

This project won the AHSN Bright ideas Health award in 2021. 

Potential ‘game-changer’ 

The research is a small-scale proof of concept study, but the researchers say that depending on the results of formal pilot and clinical trials, it could be a ‘game-changer’ in the non- pharmacological management of chronic pain in the UK. 

Professor Paul Chazot from our Department of Biosciences and Wolfson Research Institute said: “Although this is a relatively small study, the programme we developed has been promoted by NICE and rolled out across the UK. 

“It has been digitalised, and there are follow-up papers to come, including more patient-focused evaluations. 

“We have also developed a ‘LWWP 10-Creative Footsteps’ programme, based on our FUSE Health award-winning Unmasking pain programme”. 

Dr Frances Cole an Honorary Fellow of the Wolfson Research Institute and lead of the ‘Live well with Pain’ Team, said: “The harmful side-effects of taking high doses of opioids are well-known and we’ve probably saved people’s lives by reducing their use to zero as a result of this training programme.” 

The research was an interdisciplinary study between our Anthropology (Dr Lucy Johnson and Prof Kate Hampshire), and Biosciences departments.

Find out more 

• Read the full study published in the British Journal of Pain (BJP)  
• Prof Paul Chazot is a Fellow and Director of the Pain Challenge Academy in the Wolfson Research Institute for Health and Wellbeing. 
• Learn more about the Live Well with Pain programme and view a map showing practictioners trained across the UK. 
• Read related publications: ‘Power to the People, to the people’: Training for social prescribers improves support of persistent pain and Confidence of practitioners to support self-management of pain: A multidisciplinary survey 
• Our Department of Biosciences is ranked fifth in the UK in the Complete University Guide 2025. Visit our Biosciences webpages for more information on our undergraduate and postgraduate programmes.