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Health department launches 'landmark review' of prescription drug addiction in UK

'We know this is a huge problem in other countries like the United States—and we must absolutely make sure it doesn't become one here,' minister says

Alex Matthews-King
Health Correspondent
Wednesday 24 January 2018 01:28 GMT
UK has been 'complacent' in painkiller prescribing with patients too often started on medication without a plan to take them off it
UK has been 'complacent' in painkiller prescribing with patients too often started on medication without a plan to take them off it (Rex)

The Government will launch a “landmark” review into the rising problem of prescription drug addiction in the UK and avoid repeating mistakes that led to the opioid epidemic in America, ministers have said.

Public Health England will lead the evaluation, with a broad remit spanning commonly prescribed medications for pain, anxiety, insomnia or depression, and report back in 2019.

It comes after President Donald Trump declared a “public health emergency” last year after 64,000 opioid overdoses in a single year.

While prescription drug deaths in the UK are not at the same levels as America, experts warn addiction is up more than a fifth and is set to overtake heroin use.

The review will speak to patients and medical professionals as well review prescribing data for highly addictive pain medications, including opioids and epilepsy drug gabapentin, sleeping pills, and antidepressants – which, while not addictive, can also cause severe symptoms when they’re discontinued.

Prescriptions for these drugs have risen by 3 per cent in the last five years, with one in every 11 NHS patients on a potentially addictive substance which experts say need more safeguards to prevent dependency developing.

Nearly one in 10 adults admit they have taken prescription painkillers that weren’t prescribed to them and the review will seek to establish the true “scale of the problem” and how to mitigate the harms of addiction.

Pain management experts welcomed the review and said that differences in the way drugs are prescribed in the US and UK had led to a “false sense of security”, particularly around opioid pain killers.

“We have been a bit complacent about it, we have kidded ourselves these drugs on prescription are safe and reliable,” said Sam Ahmedzai, a professor of palliative medicine and a council member of the British Pain Society.

Opioids, which are derived from morphine and were marketed in the US as being less addictive, have an important role in managing acute pain after an accident, or to support cancer patients in end-of-life care, he added.

“But we’re seeing more people being prescribed these drugs and they’re not being taken off them -that’s the main issue.”

This is because long-term opioid use can even make pain worse, and studies are now showing that as well as leading to addiction they cause “opioid hyperalgesia” where the drugs feed patients’ pain levels.

Professor Ahmedzai said GPs and pharmacists need to be empowered to require medications reviews where patients are returning for prescriptions, week after week, when their pain should have improved.

The British Pain Society warned there was a natural increase in the levels of chronic pain in British society because people living longer, often with multiple chronic conditions, and said more emphasis needed to be on non-drug based interventions like exercise or physiotherapy.

Prescribing lead for the GP Committee of the British Medical Association, Dr Andrew Green, said doctors “see first-hand the need for greater action and support” to tackle addiction.

The BMA has called for more local services to support patients with prescription drug issues, which often differ from the services needed by those with illegal substance addiction.

“We welcome this important review into prescription drug dependence, which can have a devastating impact on the lives of those affected,” he added.

Royal Pharmaceutical Society pain management spokesperson, Professor Roger Knaggs, said: “Pain relief medicines are only helpful for a minority of patients.

“There needs to be improved understanding by healthcare professionals, policymakers and the public alike, about long-term pain, its influences and meaning.

“Evidence-based strategies to support patients with ongoing pain and continuing to take analgesic medicines but not obtaining any benefit need to be highlighted and funded appropriately.”

Public health minister, Steve Brine, said: “We know this is a huge problem in other countries like the United States — and we must absolutely make sure it doesn’t become one here.

“While we are world-leading in offering free treatment for addiction, we cannot be complacent — that’s why I’ve asked PHE to conduct this review.”

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