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Dependence on prescription medicines linked to deprivation

Prescribing
Hundreds of thousands of people in England becoming addicted on prescription drugs, a Public Health England (PHE) review has found

Hundreds of thousands of people in England becoming addicted on prescription drugs, a Public Health England (PHE) review has found.

Five classes of medicines were included in the review. These were:

  • benzodiazepines (mainly prescribed for anxiety and insomnia)
  • Z-drugs (insomnia)
  • gabapentinoids (neuropathic pain)
  • opioid pain medications (for chronic non-cancer pain such as low back pain and injury-related and degenerative joint disease)
  • antidepressants (depression)

The review found that one in four adults had been prescribed at least one of these classes of medicines in the year ending March 2018, while half of those receiving a prescription (of these classes of medicine) had been continuously prescribed for at least the previous 12 months. Between 22% and 32% (depending on the medicine class) had received a prescription for at least the previous 3 years.

‘These medicines have many vital clinical uses and can make a big difference to people’s quality of life and for some their long-term use is clinically necessary, particularly antidepressants, which can take longer to have their full effect,’ said Professor Paul Cosford, Emeritus Medical Director at PHE.

‘This report shows that while the vast majority of new prescriptions for these medicines are for short term use, within clinical guidelines, it also highlights significant numbers have been taking these medicines for a long time. It is vital that clinical guidelines for prescribing are followed and regular reviews with patients take place to address this.’

The level of prescription has also been linked to deprivation by the review. It found prescribing rates and duration of prescription are higher in some of the most deprived areas of England, while a similar pattern is also seen for the number of medicines co-prescribed (for example, at least 2 of the drugs).

Additionally, for opioids and gabapentinoids, the prescribing rate in the most deprived quintile was 1.6 times the rate in the least deprived quintile, while the co-prescribing rate in the most deprived quintile was 1.4 times higher than in the least deprived quintile (30% compared to 21%).

‘We know that GPs in some of the more deprived areas are under great pressure but, as this review highlights, more needs to be done to educate and support patients, as well as looking closely at prescribing practice, and what alternative treatments are available locally,’ said Rosanna O’Connor, Director of Alcohol, Drugs, Tobacco and Justice at PHE.

‘While the scale and nature of opioid prescribing does not reflect the so-called crisis in North America, the NHS needs to take action now to protect patients. Our recommendations have been developed with expert medical royal colleges, the NHS and patients that have experienced long-term problems. The practical package of measures will make a difference to help prevent problems arising and support those that are struggling on these medications.’