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It’s no surprise that prescription drug addiction in the UK is on the rise – I should know, they nearly killed me

Ever since I’d started taking the painkiller, I’d had urges and impulses telling me to kill myself. I was sure it was the drug – but the doctor wouldn’t listen, and increased my dose sixfold

Julia Buckley
Thursday 25 January 2018 12:59 GMT
Public Health England has announced an enquiry into prescription drugs
Public Health England has announced an enquiry into prescription drugs (Getty)

Am I surprised that Public Health England has announced an inquiry into prescription drugs? Yes and no. No, because the fact that one in 11 patients was prescribed a potentially addictive drug last year is shocking, and needs to be addressed before we head the way of the US and its opioid crisis. Yes, because patients like me have been scared of this, and warning about this, for years.

What happened now to wake up the authorities? Was it national treasure Ant McPartlin’s well-publicised struggle with addiction to prescription painkillers? Was it Tom Petty’s death – announced last week as a painkiller overdose? Was it Prince? Michael Jackson? Heath Ledger? Prescription painkillers played a role in all of their deaths.

Or was it the 64,000 non-celebs who died from drug overdoses in the US in 2016? The figures for 2017 aren’t out yet, but you can bet they’ll be higher – 2016 figures were already a 22 per cent rise on the previous year. Deaths from fentanyl – a legal prescription drug that is 100 times more potent than morphine and significantly stronger than heroin – have spiked 540 per cent over three years.

More people now die from drug overdoses than from car accidents or guns – which, in the USA, a country that has already seen 11 school shootings 2018, is saying something.

In the UK, we’re not – yet – approaching anything like those levels. But the warning signs are there.

Prescriptions of “addictive medicines” are up by 3 per cent over the last five years. The number of people taking painkillers who weren’t prescribed them is thought to be pushing 8 per cent. Drugs up for review include benzodiazepines (“benzos”), Z-drugs, opioid painkillers, and antidepressants.

Two drugs named specifically are pregabalin and gabapentin. These two I know well. Pregabalin nearly killed me.

There’s nothing doctors hate more than personal experience, of course. Anecdotes, they say, are not facts. While I was researching my book, Heal Me – which deals with the four years I spent in chronic pain, two of which entirely in the medical system – I came across a blog post by a doctor talking about Cochrane reviews (the top rung of systematic reviews in evidence-based medicine). Its premise was that “in my experience” is the most lethal line in medicine, because it means that what you’re saying isn’t evidence-based – it leads from the heart not the head. I remember thinking, maybe that’s true – but it’s also a great way to shut patients up, because the only thing your patients will ever be able to talk about is their own experience.

So here’s mine.

After an accident at work in 2012, I developed chronic pain. I wasn’t prescribed drugs immediately following the accident – when I presented myself to a locum GP, telling her it felt like someone had rammed a carving knife up my armpit and set my arm on fire, I was told to take the rest of the week off work (it was Wednesday). After the pain continued for several months, I was officially termed chronic. I was off work (and would remain so for two years), sent on a pain management course (part of which was spent running us through all the delicious drugs we could take to “manage” our pain – because they said we couldn’t cure it), and written prescriptions.

I tried everything I was given, and I was given a lot – big boxes of the stuff, with enough supplies to last weeks, if not months. I tried opioids, I tried old-school antidepressants like amitriptyline (which is now used for pain), and I tried anticonvulsants, used off-label for pain.

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That’s how I ended up with a stash of pregabalin.

It feels like pregabalin (or “the new valium” as it’s also known) is rarely out of the news these days – last summer doctors called for it to be restricted; this month, in a leaked memo, the BMA said that it was “associated with problems of abuse and addiction”.

Back in 2012, however, it was a different story. The neurologist who prescribed it said it was good for nerve pain, which I had. I started it before Christmas.

I don’t remember that Christmas. I remember very little of the two months I was on it. I remember that I was aware I couldn’t remember stuff – that I would walk into rooms forgetting what I’d walked into them for, that I would get halfway through a sentence and forget what I had wanted to say, that I would decide to write an email to someone, write their name and then stare at the screen, wondering why I was writing to them.

I was completely out of it, and not in a good way. Why anyone would want to abuse that drug is beyond me.

What I do remember – because I was so horrified by the encounter that it etched itself onto my brain – is going back to the consultant after two months, and telling him about the side effects. It had dampened my pain a little, but not enough to make me able to function. And even if it had killed the pain completely, I still wouldn’t be able to return to work, because I was pharmaceutically lobotomised. It had caused terrible constipation – I was pretty sure I hadn’t taken a single dump the entire time I was on it, though I was too out of it to realise how serious that was – and more importantly, I was suicidal.

Ever since I’d started taking the drug, I’d had urges and impulses – not exactly voices in my head, but flashes of instinct – telling me to kill myself. I was sure it was the drug.

You’re just depressed, the doctor said, it’s not the drug – let’s increase your dosage by six times. I left his clinic with a new prescription for several months of the new dose, wondering what to do – follow instructions or my intuition.

And then I did the thing that saved my life: I made an emergency appointment with my GP, and said I was scared to increase the dose when I thought it was making me suicidal. The GP – knowing that “suicidal ideation”, as they coyly call it, is a known side effect of taking pregabalin – whipped me off the drug immediately (you’re supposed to taper them down when you come off, but this was a crisis). I survived.

I can’t speak for people who get addicted to these drugs – the only physical thing that happened to me going cold turkey was shitting myself, as two months of crap poured out of my system in one fell swoop – but I know it’s too easy to get addicted.

What saved me was my body’s insane overreaction to everything I was given. Nothing really helped the pain, but everything caused dizziness, brainfog, constipation (yes constipation is funny, but it also isn’t at all. Last year, 23-year-old Faye Howard took her own life because the amitriptyline she’d been prescribed for migraines had caused constipation and then debilitating bowel problems). One drug made me pass out after every meal. So I came off them all before I got addicted.

One drug I really did want to take, interestingly enough, was Sativex – a cannabis-based mouth spray clinically proven to help with pain. It’s available for MS sufferers but not pain patients – because of the cannabis. Several doctors spent several minutes lecturing me about the dangers of cannabis; then offered me big bags of opioids instead. Of those 64,000 overdose victims in 2016, by the way, not one of them was from cannabis. The number of recorded overdose deaths from cannabis – ever – is zero.

My experience, of course, is anecdotal. So is that of a colleague with chronic pain issues, who went to the doctor recently for a single sheet of 28 codeine tablets and was given 112 of the Class B opiate. The one with back pain who’s given months-long supplies of the Class C opiate Tramadol every time she sees the doctor. The friend who was prescribed so many opioids after a Caesarean section that, in a well-meaning but totally illegal gesture, she posted me – her chronic pain patient friend – a jiffy bag full of her extras.

I didn’t take them, knowing that painkillers rarely work for chronic pain. They reduce pain by an average of 30 per cent in about 30 per cent of patients – pretty terrible odds for drugs with such serious ramifications.

Ironically, they’re most likely to work at the point of injury, to stop acute pain turning chronic. If the GP who’d seen me initially had prescribed painkillers, and told me why she was doing so, there’s a chance I might not have lost the next four years of my life.

Of course, drugs (especially the antidepressants flagged in the review) have their place – but they’re not always the answer. And time pressed doctors, under pressure from patients to be seen to be doing something, are trying to help. Nobody was trying to kill me when they were prescribing all those drugs. If I’d died, that would have been an unintended side effect.

But I do believe that more care needs to be taken over who they’re being prescribed to and how many people they’re being prescribed to. Apart from anything else, it’s a waste of NHS money to dole out 200 pills when 20 will do. Bring on the enquiry.

Heal Me, by Julia Buckley, is published by W&N (£16.99). If you require more information about prescription painkiller addiction, visit Talk To Frank

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