It’s been said that when the United States gets a cold, the United Kingdom sneezes. Is the UK heading toward a US-style opioid crisis? Evidence accumulated over the past decade suggests that it might be if urgent steps aren’t taken to head it off.
Within two years, the number of deaths attributed to opioids in the United States has exceeded that from the Vietnam War. In the UK, opioids account for approximately 2,000 deaths a year, an increase of 41 per cent since 2007, according to an analysis of data from the Office for National Statistics (ONS) by the Sunday Times.
The figures for opioid fatalities in the UK include deaths from heroin. Experts say that four out every five people who try heroin began with prescription painkillers.
There are other signs that set the alarm bells ringing:
- The number of Britons who end up in hospital after overdosing on opioids has almost doubled in the past decade. There were 11,500 such cases in 2017-18.
- The vast majority are handed out by GPs to patients at home, not in a hospital. GPs dispense more than 113,000 opioid prescriptions every day.
- There is a clear north/south divide in the intensity of the UK’s incipient opioid crisis. There are four times as many opioid prescriptions written in the North as there are in London and three times as many opioid deaths.
What are opioids?
The term opioids embraces natural compounds derived from the opium plant as well as their synthetic analogues. These drugs are typically used to relieve acute pain of short duration. In the UK, the most commonly prescribed opioids are co-codamol, tramadol, codeine, co-dydramol, dihydrocodeine, oxycodone and fentanyl.
What’s driving the U.K. Opioid Crisis?
While the black market and the dark web certainly have their hands in propagating a market for illegal drugs, the largest factor driving the opioid epidemic is overprescribing. For example, a patient relates that he was prescribed Oramorph, an oral formulation of morphine. Unsupervised, he collected refill prescriptions, taking 20 ml every day for three years.
Can the epidemic be contained?
According to the evidence, convincing overworked GPs to issue fewer opioid prescriptions would go a long way to forestalling the epidemic. Nicholas Levy, Consultant Anaesthetist at West Suffolk NHS Trust in Bury St Edmunds, published a letter in the BMJ on 11 March 2019, expressed the opinion that deprescribing should be an integral part of any clinician’s practice. Regular reviews of patient medication should be undertaken as per the advice of the General Medical Council in 2013.