Deprivation link in addiction to prescription medicines

DEPENDENCE on prescription medicines is higher in areas of deprivation, according to a new review published by Public Health England.

The Prescribed medicines review assesses the scale and distribution of prescribing in five classes of medicines, including benzodiazepines, Z-drugs, gabapentinoids, opioid pain medications and antidepressants.

The review found that prescribing rates and duration of prescription are higher in some of the most deprived areas of England, and a similar pattern is also seen for the number of medicines co-prescribed. The prescribing rate for opioids and gabapentinoids in the most deprived quintile was 1.6 times the rate in the least deprived quintile.

Among other findings, the review also reveals that one in four adults had been prescribed at least one of these classes of medicines in the year ending March 2018, and in that month half of those receiving a prescription had been continuously prescribed for at least the previous 12 months. Between 22 per cent and 32 per cent (depending on the medicine class) had received a prescription for at least the previous three years

Long-term prescribing of opioid pain medicines and benzodiazepines is falling but still occurs frequently – which PHE says is not in line with guidelines or evidence on effectiveness. Such prescribing, it adds, is likely to result in dependence or withdrawal problems, but it is not possible to put an exact figure on prevalence from current data.

The review makes a number of recommendations focusing on education and treatment.

Rosanna O’Connor, Director of Alcohol, Drugs, Tobacco and Justice at PHE said: "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.

"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."