The United States is in the grip of an opioid misuse epidemic, with 142 opioid-related deaths every day. Could prescription painkiller misuse reach crisis levels in the UK too?
Wikipedia describes Opioids as “substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anaesthesia…Tolerance and dependence will develop with continuous use, requiring increasing doses and leading to a withdrawal syndrome upon abrupt discontinuation. The euphoria attracts recreational use, and frequent, escalating recreational use of opioids typically results in addiction. An overdose or concurrent use with other depressant drugs commonly results in death from respiratory depression.”
Opioids have hit the headlines mainly because of their abuse in the United States. Deaths from addictive painkillers have almost doubled in a decade as trends in Britain follow “alarming” US patterns, new research shows.
Health care providers, including those in primary care settings, report concern about opioid-related risks of addiction and overdose, as well as insufficient training in pain management. Although prescription opioids can help manage some types of pain, there is not enough evidence that opioids improve chronic pain, function, and quality of life. Moreover, long-term use of opioid pain relievers for chronic pain can be associated with abuse and overdose, particularly at higher dosages.
A study led by University College London Hospital shows a sharp rise in prescribing opioid drugs, despite repeated warnings that the drugs should not be given for long periods because of their addictive qualities.
Last month ministers ordered a landmark review of prescription drug addiction, amid concern over the rising number of women becoming hooked on painkillers, anti-anxiety drugs, and antidepressants. The Guardian shed some light on this topic last month – “The new research, published in the British Journal of General Practice, shows a sharp increase in deaths attributed to opioids, over a 10year period. The figures, comparing trends in the decade ending 2011 show almost 900 such deaths, compared with almost 500 in 2001.
Researchers tracked the prescribing of the most common opioids, used for chronic pain, as well as for cancer pain, and showed a rise in prescriptions of six in eight drugs. The scientists said separate research suggests just 12 percent of such medication is for cancer pain, with the remainder being used for more “contentious” purposes.”
In 2015, the annual European Drug Report recorded 330,445 high-risk opioid users in the UK, the highest number in Europe. According to the Public Health Research Consortium, the proportion of patients on the Clinical Practice Research Datalink prescribed opioids doubled between 2000 and 2012, and the length of continuous prescribing periods increased from 64 days to a peak of 102 days in 2013 and 2014. In addition to this, NHS Digital figures show that, in England, the number of patients admitted to hospital for overdosing on opioid painkillers almost doubled between 2005–2006 and 2016–2017.
Figure 1: Percentage of patients prescribed opioids in the UK, 2000–2015, source: Prescribing patterns in dependence forming medicines. 2017. Public Health Research Consortium
The percentage of patients prescribed opioids in the UK doubled between 2000 and 2012, peaking at 5.4% in 2012. Since 2012, there has been evidence of a slight decline in opioid prescribing. Statistics from the Office for National Statistics, 2016, show that there were 58 deaths involving fentanyl and 75 deaths involving oxycodone in England and Wales compared with 34 and 51 deaths respectively registered in 2015. The number of drug-related deaths involving tramadol fell by 12% from 208 deaths registered in 2015 to 184 deaths in 2016, which may be explained by the fact that tramadol has been controlled under the Misuse of Drugs Act 1971 as a class C substance since June 2014.
In the United States, President Donald Trump declared the country’s opioid misuse epidemic a public health emergency following an interim report from the Commission on Combating Drug Addiction and the Opioid Crisis, published in August last year. It is estimated there are 142 opioid-related deaths in the United States every day.Back to resources