An “inexorable” rise in the use of opioids for pain relief may be linked to rising death rates from the drugs, researchers warn today.
Tramadol is the most prescribed opioid in England – but increased rates of prescribing of buprenorphine, codeine, morphine and oxycodone were also found over a four-year period, according to a report in the British Journal of General Practice.
Rates of prescribing of tramadol increased by 30% during the 43 months of the study.
The highest rates of prescribing are in the north of England, according to the study.
Nearly 900 people died from deaths attributed to opioids in England, Scotland and Wales in 2011 compared with 500 in 2001, the researchers warn.
The study was led by Luke Mordecai, a pain research fellow at University College London Hospital, UK.
The researchers say the increased use of opioids is “controversial” and has potential for abuse.
They warn of a lack of capacity in specialist pain services – and call for a national database of patients taking large amounts of opioids. These patients should be known to specialist services, they say.
The Royal College of GPs said GPs would make patients aware of the risks and side-effects of medicines.
Chair Professor Helen Stokes-Lampard said: “Most patients don’t want to be on long-term prescriptions and, where possible, GPs will always try to explore non-pharmacological treatments – but these are often hard to come by at a community level, leaving family doctors with few alternatives that are still of equal benefit to the patient.
“We need to ensure that GPs and their teams continue to work with patients by encouraging them to attend the regular medication reviews that they are invited to, and that, crucially, these drugs are only prescribed for the shortest amount of time, which is tailored to the individual.”
Patterns of regional variation of opioid prescribing in primary care in England: a retrospective observational study BJGP 13 February 2018 [abstract]
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