Tag Archives: epidemic

Opioid Epidemic UK

It is not easy to get a comprehensive picture of the overall situation regarding the prescribing of OP and the purchase of codeine-containing OTC formulations, but piecing together the evidence from various datasets reveals that the UK population is consuming considerable and increasing amounts of OP:

 In 2012, some ten million people in the UK were prescribed an OP, more than double the next nearest EU country France at four million

 In 2013, the UK had the highest sales of morphine by volume than any other country in the EU

 In 2013, the UK had the highest sales of opiates like codeine by volume than any other country in the EU and between 2010-2013 the UK had a 6% growth in sales, against the next largest margin increase in the EU.

 In 2011, Northern Ireland has highest annual prevalence of prescription opioid use in the world (8.4%)

 In the period 1994-2009, Tramadol prescribing increased tenfold and all OP showed significant increases in level of prescribing during this period with the exception of dihydrocodeine. Just in England, the number of prescriptions rose from around three million in 1991 to 23 million by 2014.

 Defined Daily Doses for Tramadol in England have increased from 5.9 million in 2005 to 11.1 million in 2012.

 Between 2001-2011, prescription for co-codamol almost doubled from 8.8 million to 15 million

Since the early 1980s, the extensive professional, political and media discourse about drug misuse and addiction has centred on the use of a wide range of illicit drugs such as heroin, cocaine, cannabis, amphetamine, and ecstasy. There is also a public and professional awareness about the dependency potential of tranquillisers and antidepressants highlighted, for example, by class actions brought against pharmaceutical companies, media reports and articles, popular and medical books, TV documentaries, and guidelines produced by the medical profession to advise against over-prescribing. That said, the very existence of this APPG indicates continuing and very real concerns not only about the startling level of prescribing of tranquillisers and antidepressants3, but also the lack of specialist help underlined by the recent closure of some of the few charitable helping agencies that do exist.

In recent years too, there has been a growing awareness of the dangers of OP, most notably dependency and overdose. The evidential base is most developed in the USA where celebrity revelations including Michael Jackson, Burt Reynolds, Melanie Griffiths and Jamie Lee Curtis have served to foreground the risks demonstrated by the epidemiological evidence and clinical case reporting.4 It has been suggested that much of the problem has derived from the progression from only prescribing OP for acute pain and cancer treatment to more generalised chronic pain conditions which has led to more widespread misuse and rising mortality in many Western countries.

In the UK, public and professional awareness in the UK of the potential dependency and overdose risks of OP has been patchy. Despite some sporadic press coverage going back into the 1990s, the subject really didn’t hit the headlines until 2009 with the publication of the All Party Parliamentary Group on Drugs report, An inquiry into physical dependence and addiction to prescription and over-the-counter medication. The remit covered tranquillisers, anti-depressants and OP and MPs took evidence from campaigners, doctors, clinical researchers, government agencies and the pharmaceutical industry.

Exerpts from

Opioid painkiller dependency (OPD): an overview.
A report written for the All-Party Parliamentary Group on Prescribed Medicine Dependency by Harry Shapiro

Misuse of opioids such as tramadol and fentanyl is ‘global epidemic’, report finds

The misuse of pharmaceutical opioids is fast becoming a “global epidemic”, with the largest quantities being seized in African countries for the second year in a row, according to a UN report.

While huge attention has been paid to the opioid crisis in the US – where the misuse of prescription drugs like fentanyl dominates – figures released by the United Nations Office on Drugs and Crime has revealed seizures in Africa of opioids now account for 87% of the global total.

Unlike in the US, the seizures – concentrated in west, central and north Africa – have largely consisted of the drug tramadol, followed by codeine.

The figures were disclosed in the latest UN world drug report, which noted that opioids were the most harmful global drug trend, accounting for 76% of deaths where drug-use disorders were implicated.The report said that while fentanyl and its analogues remain a problem in North America, tramadol – used to treat moderate and moderate-to-severe pain – has become a growing concern in parts of Africa and Asia.

The report added that the global seizure of pharmaceutical opioids in 2016 was 87 tonnes, roughly the same as the quantities of heroin impounded that year.

The figures on pharmaceutical opioids were rivalled by global cocaine manufacture, which the agency said had reached the highest level ever reported in 2016, with an estimated 1,410 tonnes produced.

Most of the world’s cocaine comes from Colombia, but the report also showed Africa and Asia emerging as cocaine trafficking and consumption hubs.

From 2016-17, global opium production also jumped by 65% to 10,500 tonnes, the highest estimate recorded by the agency since it started monitoring global opium production nearly 20 years ago.

“The findings of this year’s world drug report show that drug markets are expanding, with cocaine and opium production hitting absolute record highs, presenting multiple challenges on multiple fronts,” said the UNODC’s executive director, Yury Fedotov.

“Non-medical use of prescription drugs has reached epidemic proportions in parts of the world,” he added. “The opioid crisis in North America is rightly getting attention, and the international community has taken action.

“However … the problems go far beyond the headlines. We need to raise the alarm about addiction to tramadol, rates of which are soaring in parts of Africa. Non-medical use of this opioid painkiller, which is not under international control, is also expanding in Asia. The impact on vulnerable populations is cause for serious concern, putting pressure on already strained healthcare systems.”

Despite the increase in availability and production, the report disclosed that the number of people worldwide using drugs at least once a year remained stable in 2016 at around 275 million people – or roughly 5.6% of the global population aged 15-64 years. Drug use among the older generation (aged 40 years and above) has been increasing at a faster rate than among those who are younger.

Despite that, global deaths directly caused by drugs use increased by 60% from 2000 to 2015, with mortality among people over the age of 50 increasing from 27% of these deaths in 2000 to 39% in 2015. About three-quarters of deaths from drug-use disorders among those aged 50 and older were among opioid users.

Read full article here: https://www.theguardian.com/global-development/2018/jun/27/misuse-opioids-tramadol-fentanyl-global-epidemic