Tag Archives: opiate

‘Unnecessary’ painkillers could leave thousands addicted, doctors warn | Science | The Guardian

Prescriptions for powerful opioid painkillers have doubled from 12m to 24m in past decade, NHS Digital figures reveal

Dependency, addiction, opiate painkillers

Dependency, addiction, opiate painkillers

Powerful and potentially addictive opiate painkillers are being handed out too readily, leading doctors have warned after it emerged that the number of times the drugs are being prescribed in the UK has doubled in the past decade.

The Faculty of Pain Medicine and the Royal Pharmaceutical Society said they were worried about the high and growing use of opioid drugs such as codeine and tramadol – while other experts warn that hundreds of thousands of patients could be addicted to them.

Dr Barry Miller, dean of the Faculty of Pain Medicine, said that the increase in the prescription rates of painkillers in the UK should be “met with concern”, adding: “While some of the increase can be attributed to an improved understanding of the effectiveness of these medications by medical professionals, we are concerned by reports of unnecessary prescription.”

More on this story

https://www.theguardian.com/science/2017/may/05/unnecessary-opioid-painkiller-prescriptions-thousands-addicted-nhs-doctors-warn

Opioids: Why ‘dangerous’ drugs are still being used to treat pain – BBC

The widespread use of opioids to treat pain frequently prompts concerns about addiction and even deaths. So, why are these sometimes dangerous drugs still being given to patients?

Much stronger than many of the other options, opioids are among the world’s most commonly prescribed painkillers.

These drugs – including morphine, tramadol and fentanyl – are used to treat pain caused by everything from heart attacks to cancer.

But in the UK they were recently linked to the deaths of hundreds of elderly hospital patients, while the US is battling a well-documented opioid epidemic.

Why not just use other painkillers to avoid the risk of harm?

A worldwide problem

Opioids work by combining with receptors in the brain to reduce the sensation of pain – and they are highly effective.

However, opioid receptors are present in areas of the brain responsible for breath control and high doses can dangerously reduce the rate of breathing – the cause of almost all opioid deaths

full article on the BBC

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

Prescription drug addiction: government launches investigation

Public Health England will review prescription of medicines including opioid painkillers

The government has ordered an investigation into the growing problem of addiction to prescription drugs such as painkillers and medicines to treat anxiety and insomnia.

Steve Brine, the public health minister, has acted after it emerged that one in 11 (8.9%) patients treated by the NHS in England last year was given a drug that can induce dependency.

Fears about excessive prescription has also been boosted more than 100% rise in the number of antidepressants prescribed in England over the last decade and the fact antidepressants prescribed in England over the last decade and the fact that prescription of addictive medicines has increased by 3% over the last five years.

Full story – https://www.theguardian.com/society/2018/jan/24/prescription-drug-addiction-government-launches-investigation

The Doctor Who Gave Up Drugs

Two years ago, Dr Chris van Tulleken discovered we are taking more prescription drugs than ever before – a billion prescriptions a year in the UK. He worked with a GP surgery to get patients to try drug-free alternatives – with amazing results.

Now he is on a new mission – to understand why we are giving British kids over three times more medication than we were 40 years ago. As a new dad, Chris has a very personal motivation to explore the reasons behind this explosion in medication. In the series he sets about finding alternatives which might be just as, or even more, effective than drugs. He tackles the shocking rise in teens taking anti-depressants by testing if wilderness therapy can work where the drugs are failing. He investigates why parents are giving out so many over-the-counter meds when they may not be always necessary, and he helps hyperactive kids replace their drugs with mindful meditation.

He also digs deeper into the forces driving the over-medication of UK children and asks whether the drug industry itself could be playing a part in the rise. In 2016 we spent a staggering £64 million on one brand of children’s liquid paracetamol. Chris meets a self-confessed fan who reveals she has bought over 25 bottles in less than two years! As a new dad, Chris doesn’t blame vulnerable parents. His research reveals a pharmaceutical industry that helps create a culture which, he believes, encourages parents to unnecessarily use liquid paracetamol. At a family fair in Bristol, Chris creates a surprising stunt to show Britain’s parents when not to give liquid paracetamol and make sure they don’t waste their hard-earned money giving children drugs they don’t need.

One of the other areas where medication rates have increased the most is treating kids’ behavioural problems – prescription meds for ADHD have increased by 800 per cent since 2000. These drugs do help some symptoms of ADHD in the short-term, but side effects can include loss of hunger, changes in personality and stunted growth. Chris joins a group of hyperactive children as they attempt the impossible – an intense course of stillness and mindful meditation as an alternative to the meds. As the families go on transformative and emotional journeys, they discover, with poignant results, that ADHD remedies do not always have to come in a pill.

https://www.bbc.co.uk/programmes/b0b4jjq3

Drugs and driving: the law

It’s illegal to drive if either:

  • you’re unfit to do so because you’re on legal or illegal drugs
  • you have certain levels of illegal drugs in your blood (even if they haven’t affected your driving)

Legal drugs are prescription or over-the-counter medicines. If you’re taking them and not sure if you should drive, talk to your doctor, pharmacist or healthcare professional.

The police can stop you and make you do a ‘field impairment assessment’ if they think you’re on drugs. This is a series of tests, eg asking you to walk in a straight line. They can also use a roadside drug kit to screen for cannabis and cocaine.

If they think you’re unfit to drive because of taking drugs, you’ll be arrested and will have to take a blood or urine test at a police station.

You could be charged with a crime if the test shows you’ve taken drugs.

Prescription medicines

It’s illegal in England and Wales to drive with legal drugs in your body if it impairs your driving.

It’s an offence to drive if you have over the specified limits of certain drugs in your blood and you haven’t been prescribed them.

Talk to your doctor about whether you should drive if you’ve been prescribed any of the following drugs:

  • amphetamine, eg dexamphetamine or selegiline
  • clonazepam
  • diazepam
  • flunitrazepam
  • lorazepam
  • methadone
  • morphine or opiate and opioid-based drugs, eg codeine, tramadol or fentanyl
  • oxazepam
  • temazepam

You can drive after taking these drugs if:

  • you’ve been prescribed them and followed advice on how to take them by a healthcare professional
  • they aren’t causing you to be unfit to drive even if you’re above the specified limits

You could be prosecuted if you drive with certain levels of these drugs in your body and you haven’t been prescribed them.

The law doesn’t cover Northern Ireland and Scotland but you could still be arrested if you’re unfit to drive.

Penalties for drug driving

If you’re convicted of drug driving you’ll get:

  • a minimum 1 year driving ban
  • an unlimited fine
  • up to 6 months in prison
  • a criminal record

Your driving licence will also show you’ve been convicted for drug driving. This will last for 11 years.

The penalty for causing death by dangerous driving under the influence of drugs is a prison sentence of up to 14 years.

Other problems you could face

A conviction for drug driving also means:

  • your car insurance costs will increase significantly
  • if you drive for work, your employer will see your conviction on your licence
  • you may have trouble travelling to countries like the USA

( source: https://www.gov.uk/drug-driving-law )