From 1999 to 2018, more than 232,000 people died in the United States from overdoses related to prescription opioids, and deaths increased four-fold.
With similar trends emerging in the UK, are we doing enough to prevent an opioid epidemic at home?
Why the UK is on the verge of a prescription opioid crisis
Researchers at the University of Manchester three years ago studied the trend of opioid prescriptions in the UK. They analysed the primary care health records of nearly 2 million new opioid users and found a significant increase in opioid prescriptions between 2006 and 2017. These included:
- Fivefold increase in codeine prescriptions
- Sevenfold increase in tramadol prescriptions
- Thirtyfold increase in oxycodone prescriptions
In addition, data from the Office for National Statistics (ONS) showed opiates were involved in just under half (49.2%) of drug poisonings registered in 2019. This had increased to 62.4% (excluding deaths with no drug type recorded on the death certificate).
Although ONS data is limited (for example, it doesn’t distinguish between prescribed, over-the-counter and illicitly-obtained medicines), it is possible to deduce overdoses and deaths from prescription opioids are likely to increase in line with the number of prescriptions.
What are the implications of an opioid epidemic?
Opioids are a large class of medications related to the alkaloids found in opium, derived from the resin of the opium poppy, Papaver somniferum. They are effective pain relievers used during surgery and to manage long-term health conditions. However, most have a high potential for dependency and abuse, and can cause serious side effects which could lead to overdose.
This is important because as many as 1 in seven patients with a new prescription become long-term users in the first year - and while prescription opioids are well-known for their pain-relieving effects, there are also side effects to be aware of ranging from mild to severe, both emotionally and physically.
For example, if a user becomes addicted, and they want more than the prescribed dose, they may ask their GP to increase the prescription by saying their pain has increased. If that method fails, then an individual may ask friends or family for pills or turn to the black market.
Even for users who stick to the prescribed dose, long-term use could lead to side effects and overdose - and while most overdoses aren’t fatal, every single one carries an emotional, physical and socio-economic toll.
Ultimately, more opioid prescriptions mean more health problems, overdoses, and deaths.
In 2019, after a national review of opioid risks and benefits, the Medicines and Healthcare Products Regulatory Agency (MHRA) introduced the following changes in response to surging opioid dependency:
How is the UK tackling rising opioid dependency and overdose?
- Packaging for all opioid medicines to carry warnings ‘can cause addiction’ and ‘contains opioid.’
- Warnings to be included on the risk of tolerance, dependence, and addiction in product information
Warnings are a step in the right direction. Raising awareness of the risks before and during opioid use may prevent dependency in some cases. It may even cause some patients to decide against taking opioids in the first place and seek a safer alternative. Even so, lots more could be done to minimise opioid dependency and overdose. But what?
What happened in the US suggests that reducing the number of prescriptions could reduce overdoses. However, the fact remains opioids are very effective at relieving pain. And for some people, they’re the last resort. So, unless a better alternative arises, it’s impractical to stop prescribing opioids altogether.
With that being the case, the real question is: what can we do in the UK to prevent and minimise dependency and the subsequent effects?
Introducing drug testing for opioid monitoring
There are treatments available to reduce opioid dependence overdose risk, but the World Health Organization (WHO) claims less than 10% of people who need these treatments are receiving them.
One explanation for opioid users not receiving treatment for dependency is that the dependency is not detected until it’s too late.
Enter drug testing - an accurate and reliable approach for tracking opioid levels. Drug tests can be used to facilitate intervention in opioid users before serious addiction and health problems occur.
If they were used more frequently, it could have a big impact on the number of people who suffer from opioid dependency and overdose.
For more information about testing and monitoring opioid use, send us a message.
Image: By Eric Hood via Adobe Stock
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