What is meaning of an opioid being licensed?

[pianoplayerPLMD]

I am told in the UK methodone and buprenorphine (for example), are not licenced for use in RLS. But some people seem to have access, so how is that? Is it that they have to pay for them? Can a GP prescribe them? how does it work?

[Joolsg]

It means there have been no trials of Buprenorphine or methadone for RLS, so the MHRSA cannot report on their effectiveness etc.However, pregabalin and gabapentin are also not licensed for RLS, but GPs regularly prescribe them.

If a doctor decides to prescribe a drug in the UK that is not specifically licensed for a disease, the doctor has to satisfy themself that they have considered available evidence and are monitoring the patient.

If the patient abuses the drug or overdoses or has a serious side effect, the doctor is at risk of losing their licence to practise.

So, a GP CAN prescribe Buprenorphine in certain areas, as long as they can back up their reasoning.

But, in many areas of the UK, Buprenorphine is 'red listed' and that means GPs absolutely cannot prescribe. A specialist has to issue the prescription.

The good old NHS post code lottery.

[pianoplayerPLMD in reply to Joolsg]

Thank you Jools, that's really helpful; it is quite a muddy picture isn't it. But you have made it clear for me. By the way, you advised me to see Dr. Jose Thomas at Cardiff, which I did; I found him really excellent; very attentive and meticulous, so thank you again🙂

[Joolsg in reply to pianoplayerPLMD]

I'm delighted to hear it. He's one of the very small number of UK doctors who understands RLS.

[Dotmowatee]

I believe that Targinact which is an opioid is licensed in the UK for rls. I have no problem obtaining this drug from my GP. It works well for me. I am withdrawing from mirapex by filing a little off the tablet gradually.