The prescription rates of certain addictive medicines are higher in the most deprived areas of England, says a new evidence review published by Public Health England.
In the first such review of its kind in England, PHE assessed the scale and distribution of five classes of prescription medicines. This included benzodiazepines for anxiety and insomnia, z-drugs for insomnia, gapapentinoids for neuropathic pain, opioid pain medications for chronic non-cancer pain and antidepressants.
According to the review, one in four adults had been prescribed at least one of these classes of medicine in the year ending March 2018. PHE also found that the number of prescriptions for antidepressants and gapapentinoids are increasing, while those for opioid pain medicines, z-drugs and benzodiazepines are falling.
One of the additional main findings was that those being prescribed these medicines are often using them long-term, despite this being against the guidelines on effectiveness. The review found that half of those receiving a prescription of one of these medicine classes had been continuously prescribed it for at least the previous 12 months, with between 22% and 32% having received a prescription for at least the previous three years.
PHE also found a significant link between prescription rates and deprivation, with some of the higher rates occurring in the most deprived areas of the country. The prescribing rates in the most deprived quintile for opioids and gabapentinoids was 1.6 times the rate in the least deprived quintile.
“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,” she added.
The US opioid epidemic has garnered increasing attention and criticism, with Johnson & Johnson recently being the first manufacturer to be sued for its role in the crisis. Other manufacturers in the US are facing more than 2,000 similar lawsuits, with the first federal opioid trial set to begin soon.
Health experts in the UK are now becoming aware that the danger of certain prescription drugs could become serious if not prevented at the earliest stages. Earlier this year, the government announced that all opioid medicines in the UK must carry prominent warning signs on their labels to highlight the risk of addiction.
However, the PHE review calls for more direct action, recommending that clinical guidance should be updated and new guidance should also be developed on the safe management of dependence and withdrawal problems.
Sheuli Porkess, executive director, research, medical and innovation, ABPI
“Medicines prescribed for pain, depression and insomnia support millions of people every day. But it’s critical that they are used in the right way and that regular reviews give patients the support they need to come off a medicine when necessary,” said Sheuli Porkess (pictured above).
“Pharmaceutical companies are fully committed to playing their part. We’re working with the MHRA, Public Health England and other professional bodies to help make sure that all medicines are prescribed and used safely and appropriately,” she added.