The problem of prescription opioid abuse is usually highlighted as a problem exclusive to the United States, given that the country consumes the largest percentage of these medications in the world.
However, experts at the All Party Parliamentary Group for Prescribed Drug Dependence, gave a clear warning: the UK could also be heading for a public health disaster.
Jane Quinlan, an academic at the University of Oxford noted that patients first become hooked on opioids after being prescribed these drugs following an injury or surgery. Patients take the medication according to their doctor’s instructions, often developing a problem of dependence.
Recent studies indicate that the number of prescriptions for addictive opioids has soared in the UK over the past decade, largely because doctors wish to stop patients’ suffering.
One study in particular shows that prescriptions for patients without cancer rose seven-fold in the first decade of the new millennium.
According to the National Treatment Agency, opioid prescriptions rose from three to 23 million between 1991 and 2014.
Defined daily doses for Tramadol in England increased from 5.9 million to 11.1 million between 2005 and 2012, while prescriptions for co-codamol jumped from 8.8 million in 2001 to 15 million in 2011.
Opioid painkillers are very effective at quelling pain but patients quickly build up a tolerance and these drugs increase nerve sensitivity, meaning that previously non-painful stimuli become painful following long-term opioid use. These medications also lead to insomnia and can increase the risk of developing infections.
Of course, the most serious side-effect of opioid use is overdose, since the medications are so potent.
In the United States, mortality trends show a tremendous rise in the number of opioid-related overdose deaths.
In the UK, the situation isn’t nearly so dire, though figures shows that, for instance, there was just one overdose death from Tramadol overdose in 1996. In 2014, in England and Wales, this number rose to 240.
Another danger of opioid painkillers lies in its strong link to heroin use. When patients run out of medication or their health professional refuses to supply them with another prescription, they can turn to heroin use, which in turn increases the risk of contracting viruses such as Hepatitis-C and HIV through needle sharing. While syringe exchange centres are doing plenty to lower the chance of infection, more needs to be done to stop heroin use in the first place. The danger of overdose is particularly high in those who simultaneously use heroin and prescription meds.
Some of the most common painkillers used by people living in the UK include codeine, tramadol and fentanyl. They are derived from opium or synthetic equivalents. Estimates indicate that the total amount spent on this type of medication amounts to over £160 million.
The problem reaches far beyond the use of opioids for medical purposes. Home Office statistics released in 2015 showed that for the first time, a cohort of individuals from different age groups are taking opioid pills which are not prescribed to them for recreational purposes. This increases the likelihood of addiction and overdose among inexperienced users and indicates that prescription meds are more available among members of the general community than previously thought.
Medical organisations have made many efforts to stop opioid abuse in the UK in its tracks.
These include publishing more comprehensive patient information leaflets, reducing the package size of specific medications, and calls for GPs to conduct annual reviews of patients relying on opioid medications.
Drug treatment agencies are also doing their share, via Change Programme Treatment Protocols (which work alongside GPs to reduce prescriptions or encourage patients to switch to opiate substitutes such as buprenorphine or naloxone) and psycho-social intervention/behavioural change treatments to help patients reduce or end their dependence on opioids.
Various patient advocacy groups also exist, to provide support to those who are dependent on painkillers.