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Addiction: Dramatic rise in UK opioid use as prescriptions for CODEINE jump five-fold in 10 years

Dramatic increase in opioid use in the UK as prescriptions for CODEINE jump five-fold in 10 years raising concerns of an addiction crisis

  • Manchester experts studied opioid use among 2 million primary care patients
  • They found use of less common drugs like tramadol and oxycodone is also rising
  • One-in-seven first time opioid patients take the drugs for long periods of time
  • The North-West, South-West and Yorkshire had a higher ratio of long-term users 

Prescriptions of opioid medications have dramatically increased in the UK — with usage of codeine, for example, having risen five-fold in the last decade.

The findings by experts from Manchester raise fears that the UK could soon face an addiction crisis — similar to the one currently taking place in the US. 

The team studied the prescription of opioids — used to treat pain — among 2 million patients. They found rising use of less common drugs like tramadol and oxycodone.

Furthermore, the data showed that one-in-seven patients with first-time opioid prescriptions went on to become long-term users. 

While short-term opioid usage is safe, long-term use can lead to not only addiction but also conditions including depression, anxiety and liver/kidney damage.

The team identified three regions of the UK that appear associated with a higher risk of long-term opioid use — the North-West, the South-West and Yorkshire. 

Around a quarter of GP practices were associated with a high proportion of long-term opioid use among their patients.

Some experts have argued that the rising uptake of opioid medications and their long-term use is primarily being driven by the prescribing behaviour of physicians.

However, other researchers contended that the increase is merely a reflection of the actual needs of the patient population.

Individuals taking opioids should consult with their physician before ceasing their course of medication. 

Prescriptions of opioid medications have dramatically increased in the UK ¿ with usage of codeine, for example, having risen five-fold in the last decade (stock image)

Prescriptions of opioid medications have dramatically increased in the UK — with usage of codeine, for example, having risen five-fold in the last decade (stock image)

UK OPIOID USE STATS

The researchers studied around 2 million patients prescribed opioids in a primary care setting.

Codeine increased five-fold, from 484 prescriptions per 10,000 in 2006 to 2,456 per 10,000 in 2017.

Oxycodone usage increased 30-fold from 5 per 10,000 in 2006 to 169 per 10,000 in 2017.

Tramadol prescriptions increased seven-fold from 101 per 10,000 in 2006 to 690 per 10,000 in 2017. 

‘The opioid crisis in the US is well-known and well researched, however it has been unclear how the UK compares,’ said paper author and epidemiologist Meghna Jani, of the University of Manchester.

‘These figures show that UK prescribing of opioids, especially codeine has increased considerably in recent years, while others such as tramadol have started to plateau.’

‘All opioids have a potential for dependence and addiction, a fact that has been highlighted by the Medicines and Healthcare products Regulatory Agency recently through stronger warnings to patients starting these drugs.’

‘Importantly after adjusting for individual patient differences, prescribing practices resulting in long-term opioid use differ considerably across the country.’

‘Social deprivation, certain conditions such as fibromyalgia, rheumatological conditions, after major surgery and high initial opioid dose were amongst factors associated with long-term opioid use,’ Dr Jani continued.

Other factors included a history of substance or alcohol abuse, inclinations towards self-harm or suicide.

‘Given the potential harms of these drugs, we think it is imperative to promote safe practices in prescribing opioids and reduce the variability we observed between in regions, practices and prescribers.’

‘One way to do this would be to harmonise prescribing practices across regions through future well-researched policies.’

‘The other would be developing targeted interventions in high risk groups including areas of social deprivation and for those undergoing major surgery.’

‘Chronic pain is estimated to affect more than 40 per cent of the UK population,’ said paper author Will Dixon, who is the director of the Centre of Epidemiology Versus Arthritis at the University of Manchester.

‘The frequency of this common problem hasn’t changed noticeably in the last decade, yet these new results show that the use of opioids for treating pain have escalated considerably.’

‘It is always vital to balance the benefits and potential harms of treatments. The variations in opioid prescribing shown here, even allowing for differences in types of disease and other factors, means there is room for improvement.’

The full findings of the study were published in the journal PLOS Medicine.

IS THE OPIOID CRISIS THIS GENERATION’S AIDS EPIDEMIC?

The last time the US saw an epidemic on this scale was with AIDs in the 1980s and 90s. 

Dr Robert Redfield Jr, a virologist and physician, was one of the top researchers on AIDs when the epidemic was emerging. 

He made several references to similarities between the AIDS epidemic and today’s opioid crisis both in scale and with the surrounding stigma.  

He said that the AIDS epidemic is expected to be brought to an end in the next three to seven years, which was possibly meant to convey hope for an end to the opioid crisis as well. 

However, there are several key differences between the AIDS and opioid epidemics. 

The AIDS epidemic primarily affected a small subset of the population, gay men, whereas the opioid epidemic has been devastating across demographics from blue collar workers in suburban areas to affluent college students.

The opioid epidemic has also been more deadly thus far. 

At the peak of the AIDS epidemic in 1995 there were 51,000 deaths by the disease.

There’s no telling when we’ll reach the peak of the opioid epidemic, but in 2015 and 2016 the death toll surpassed the number from 1995 at 52,000 and 64,000.

Treating opioid addiction and preventing overdose is also much less straight-forward because unlike AIDS, opioid use is not a virus that can be vaccinated for, and handing out items such as clean needles and condoms can’t stop it.

Instead, researchers are treating the opioid use as a ‘social contagion’ that spreads through family and friends who have been prescribed opioids.  

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