According to Public Health England, a staggering 11.5 million adults received prescriptions for medications with potential for abuse from 2017 to 2018. This figure reflects a significant increase in the misuse of commonly abused prescription drugs, including prescription painkillers, benzodiazepines, stimulant medications, opiates, and opioids, highlighting a growing trend that poses serious threats to individual and public health.
That said, let’s dig deeper into how the rise in prescription drug addiction is becoming more prevalent in the UK, along with its potential threats and other valuable information.
Key Takeaways
● Prescription drug addiction leads to multiple health issues and dependency.
● Public Health England’s 2019 report indicates significant levels of addiction in adults, particularly to antidepressants and opioid pain medicines.
● In 2022-2023, nearly thousands of people sought help for substance misuse, with opiates and alcohol being the most common concerns.
● The increased use of prescription drugs in the UK is attributed to factors like easy accessibility and societal stressors, such as the COVID-19 pandemic and rising mental health issues.
● Opioids, ketamine, and benzodiazepines are majorly misused prescription drugs in the UK, posing significant public health threats.
● Prescription drug abuse poses serious threats across health, economic, and social dimensions in the UK, necessitating targeted interventions to mitigate its impact.
● Prevention of prescription drug addiction requires collaboration among physicians, pharmacists, and patients, emphasizing education and responsible medication use.
● Abuse-Deterrent Formulations (ADF) for opioids aim to reduce abuse by preventing unauthorized routes of administration.
What is Prescription Drug Abuse?
Prescription drug abuse refers to using a medication in a manner that the prescribing physician does not intend. It may include several scenarios with a drug, such as:
● Taking it without a prescription
● Using it for purposes other than what it was prescribed for
● Not consuming it per the prescribed dosage
● Going for a non-intended method of administration
Prescription opioids are the most commonly misused prescription drugs, known for their strong painkilling properties and addictive nature, which can lead to continued abuse and addiction.
There are a few prescription medications that can make a patient susceptible to addiction. Therefore, physicians recommend them for a short time for any health reason. However, people often prolong this duration as they start to depend on the drug for everyday functioning, like sleeping well or managing pain.
With time, their body builds tolerance to it and may require higher doses to feel the same effects. This practice, if followed frequently, can lead to significant health issues, including physical symptoms, mental dependence, and addiction.
Social consequences, like increased healthcare costs and legal issues, are also expected. Overdosing may even lead to death in worse-case scenarios.
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Prescription Drug Addiction Statistics in the UK
After marijuana and cocaine, prescription drugs are misused the most in the UK. Public Health England’s 2019 review highlights this rising trend, stated that addiction rates to medications like benzodiazepines, gabapentinoids, opioids, and antidepressants:
Medication Type | Number of Dependent People | Addiction Rate of Adult Population |
Antidepressants | 7.3 million | 17% |
Opioid Pain Medicines | 5.6 million | 13% |
Gabapentinoids | 1.5 million | 3% |
Benzodiazepines | 1.4 million | 3% |
Z-drugs | 1.0 million | 2% |
The findings revealed that one in four people had been prescribed these medications in 2018, particularly among women and older adults. These rates are notably higher in areas of greater socio-economic deprivation. Recognizing prescription drug addiction symptoms is crucial in addressing this issue, as it allows for the provision of tailored treatment options and directly tackles the addiction treatment process.
Moreover, approximately 290,635 adults were in contact with drug and alcohol services in the UK, out of which 137,749 adults opted for treatment related to substance misuse between 2022 and 2023. Of them, a significant portion dealt with opiates (48%) and alcohol (30%) addiction.
This data reflects the ongoing drug abuse challenges faced by the UK, highlighting the need for targeted interventions to reduce inappropriate prescribing and support individuals at risk of addiction.
What is Leading to the Rise of Prescription Drug Addiction in the UK?
The UK is now being called a nation of pill poppers as prescription drug addiction has increased drastically over the last ten years. Here are some reasons why it’s on the rise:
Easy Access to Medicines: It’s easier to obtain prescription drugs via different means, like online black markets or borrowing them from friends or family. Moreover, some patients even get prescriptions from multiple doctors to keep buying medications they’re dependent on.
● Impact of the COVID-19 Pandemic: It’s been a few years since the COVID-19 pandemic hit the world. But its negative consequences, like financial worries, isolation, physical and mental effects, and health fears, can still be seen on a large scale. This is another reason why individuals started popping pills to feel temporary relief from everyday struggles.
Social Adaptability: People often believe that prescribed drugs are safer than illegal drugs because they are recommended by healthcare professionals. This false perception may lead to higher rates of misuse, especially among individuals who typically stay away from illicit drug usage.
Mental Health Issues: In the UK, almost 1 in 4 people experience some form of mental health issues every year. As more individuals are diagnosed, the prescription for related medications like benzodiazepines and benzos (Xanax, Valium, and Ativan) has also increased. Although they’re advised to be taken in smaller, safe doses, the risk for substance abuse has increased, typically by those with addiction issues.
● Ageing Population: The UK has a significant number of older citizens, usually those over 100 years old, who are at a high risk of prescription drug misuse. Since they tend to take more medications than younger people, it makes them susceptible to dependency. Moreover, it’s common to mistake the signs of prescription drug use and abuse, like memory loss, as that of ageing, making it harder to detect.
3 Prescription Drugs that Pose a Huge Threat to Public Health in the UK
Let’s explore three major types of prescription drugs that are more likely to be misused in the UK and pose a significant threat to public health:
Among these, prescription opioids stand out due to their strong painkilling properties. These drugs, while effective for managing pain, can induce a sense of relaxed euphoria, making them highly susceptible to misuse. The misuse of prescription opioids can lead to addiction and even fatal overdose if used recreationally, highlighting their role as a significant threat to public health.
Prescription stimulants used medically to treat conditions like ADHD and narcolepsy work by increasing attention, energy, and alertness through the enhancement of brain chemicals like dopamine. However, the misuse of prescription stimulants poses serious risks, including the potential for addiction and irreversible damage, underscoring the importance of awareness and caution in their use.
1. Opioids
According to a report by the World Health Organization, around 50% of deaths caused by drug abuse in 2019 were due to synthetic opioids. Since this drug offers feelings of euphoria (a temporary surge in happiness), it’s highly abused globally.
Some of the most commonly prescribed opioid painkillers include codeine and tramadol. People even turned to potent alternatives like fentanyl when it was difficult to get these drugs easily during lockdown. It’s 50 times stronger than heroin, doubling the risk of abuse.
Even the use of heroin in the UK is on the rise, with almost 300,000 individuals being addicted to it. However, its availability is seeing a decline as there’s a reduction in opium cultivation in Afghanistan – a major supplier of heroin in England.
To counter this shortage, new and more potent synthetic opioids like the Nitazene group have been introduced in the market. The worst part is that abuse of these drugs led to record-high deaths in the UK during 2023, and the threat is still lingering around.
Moreover, there is a concern that these drugs are mistakenly being sold as other substances or contaminating non–opioid drugs, which could further increase the danger.
2. Ketamine
While ketamine was initially introduced as an anaesthetic, its use as an antidepressant in recent times has led to growing concerns about drug abuse. Factors like the drug’s low cost, immediate effects, and widespread availability majorly contributed to its popularity.
Moreover, patients using it recreationally experience euphoria and detachment, which induces dependency and addiction. As per stats, the prevalence of ketamine abuse was reported to be at an all-time high (0.8%) during lockdown. Talking about demographics, 3.2 % of the younger population, aged 16 to 24, was involved, while a lesser percentage was that of older adults.
One of the major risk factors of ketamine abuse is its mixing with alcohol, which heightens the risks of urinary incontinence and mental health issues. Overdosage can be fatal. However, the mortality rate is lower than other drugs, with 30 deaths being reported per year in England.
Even law enforcement data has raised concerns about capturing ketamine in bulk. According to reports, the seized amount drastically increased from 187 kilograms in 2021 to 1837 kilograms in 2022.
3. Benzodiazepines
England saw the second highest number of deaths, i.e., 509, due to benzodiazepine misuse in 2022. Similarly, Scotland also recorded a higher number of fatalities related to this drug’s misuse, i.e., 1,339 in 2020, the highest since 2014.
There are multiple reasons that have contributed to these unfavourable circumstances, which primarily include the following:
● Co-Use with Opioids: The combination of benzodiazepine and opioids can lead to respiratory depression – a fatal condition.
● Availability of Illicit Counterparts: There has been a notable rise in the use of illicit benzodiazepines, which are more potent than those prescribed by healthcare providers.
Although the prescription rates of this drug have decreased, the illegal drug market continues to thrive. The absence of quality control and reliable dosage information further aggravates the problem.
Reducing the use of benzodiazepines and the rising number of related deaths remains a significant challenge in 2024. There are few signs of changes in these drugs’ demand or supply.
Threats Posed by Prescription Drug Misuse in the UK
The rise in prescription drug abuse poses several significant threats to the UK, impacting society and the healthcare sector as a whole. These include:
● Healthcare Strain: Increased addiction rates lead to greater demand for recovery and treatment services, straining an already burdened healthcare system. This can divert resources from other critical areas that demand attention.
● Increased Overdose Rates: As prescription drug addiction rises, so does the risk of overdose, which can result in increased fatalities or severe health complications among users.
● Economic Impact: The economic burden of prescription drug abuse includes increased healthcare costs, lost productivity due to illness or death, and higher crime rates associated with drug-seeking behaviour.
● Mental Health Issues: There is a strong link between substance abuse and mental health disorders. The misuse of prescription drugs can increase existing psychological issues or lead to the development of new psychiatric conditions.
● Family and Social Problems: Addiction may lead to family breakdowns, child neglect, and increased domestic violence. Moreover, social relationships can deteriorate, leading to isolation and worsening mental health.
● Criminal Activity and Legal Issues: The demand for prescription drugs can fuel illegal activities, such as the forging of prescriptions and the burglary of pharmacies. Legal issues can also arise for both users and healthcare providers involved in the inappropriate distribution of medications.
The act of repeatedly consuming prescription medication for non-medical reasons exacerbates these threats, leading to a cycle of physical and even psychological symptoms and dependence that necessitates professional addiction treatment.
How Can It Be Avoided?
When it comes to preventing prescription drug addiction, emphasizing the importance of professional prescription drug addiction treatment is crucial. Everyone, from physicians to patients and pharmacists, must play an active role.
Physicians, in particular, have a pivotal role in providing prescription drug addiction support, offering resources and guidance to patients to navigate the challenges of addiction.
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The Role of Physicians
Doctors must identify the non-medical usage of prescribed medicines and take measures to avoid them. This can be done by:
● Utilizing evidence-based screening tools designed for detecting non-intended use of prescription drugs
● Encouraging open and honest communication with patients about their drug use
● Monitoring patients for signs of escalating medication usage, such as rapid increases in dosage requirements or frequent unscheduled refill requests
● Being vigilant for behaviours indicative of doctor shopping, where patients seek prescriptions from multiple providers to obtain excessive amounts of medication
● Providing education and resources to patients about the risks of over-abusing prescription drugs and drug misuse, including the dangers of addiction and withdrawal from prescription medication such as opioids, benzodiazepines, and stimulants, and the importance of following prescribed dosages
The Role of Pharmacists
Pharmacists are equally responsible in efforts to minimize non-medical usage of prescription drugs, which encompass:
● Educating patients about safe medication usage and how it treats their condition
● Identifying false orders or potential alterations in prescriptions
● Informing other pharmacies in the region if any fraudulent prescriptions are detected through hotlines
● Collaborating with physicians and utilizing Prescription Drug Monitoring Programs to track opioid-prescribing and dispensing patterns in patients
● Sharing insights with physicians and other healthcare providers to manage medication therapy and promote patient safety
The Role of Patients
Patients can prevent drug abuse by familiarizing themselves with the following effective strategies:
● Adhering strictly to the directions provided on the drug label or as instructed by the pharmacist
● Consulting healthcare professionals about potential interactions between prescribed medicines and any other drug that they’re taking
● Not altering their dosing regimen or discontinuing medication without seeking advice from the physician
● Refraining from using drugs that are prescribed to others or letting others consume their prescribed medicines
● Utilizing designated Drug Enforcement Administration collection sites to dispose of unused or expired medicines safely
Development of Abuse-Deterrent Opioid Formulations
Since opioid abuse is becoming more prevalent, manufacturers are actively pursuing the development of Abuse-Deterrent Formulations (ADF) to fight it. Such drugs employ various technologies to prevent unauthorized routes of administration, like snorting or injection.
Some of these research strategies include:
● Inclusion of physical or chemical barriers that disallow crushing, grinding, or dissolution of the drug
● Incorporation of agonist/antagonist combination – drug manipulation releases the antagonist, counteracting its effects
● Addition of such substances that induce unpleasant sensations if the medication is consumed for non-medical reasons
● Deployment of novel delivery systems like long-acting injections or implants for gradual and controlled release of the medication
● Development of new molecular entities or prodrugs that attach chemical extensions, making the drug inactive unless ingested orally
Several ADF opioids have entered the market, and there’s a call from the FDA for similar formulations for stimulants. Studies indicate that abuse-deterrent formulations contribute to reducing the illicit value of drugs. Additionally, prescription drug rehab is a critical component of the recovery process for individuals struggling with prescription drug addiction, offering a medically assisted detoxification process and intensive therapy to support a healthier lifestyle.
In Summary
The rise of prescription drug addiction in the UK presents a significant threat to public health and safety. Recognizing the signs and symptoms of addiction is a crucial part of a comprehensive approach to combating this growing issue. Awareness of the symptoms of prescription drug abuse is essential for early intervention and treatment. By working together, healthcare professionals, policymakers, and the public can address this complex issue and ensure that prescription drugs are used safely and effectively.
Authors
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Perry is the founder of Rehab Today by PCP and opened the first treatment centre at Luton in 2004. Perry’s background apart from his own personal struggle with addiction over 20 years ago is in the recruitment industry where he started his career and became Finance Director of a UK PLC and in the late 90’s was part of a new start up and became the leading recruitment consultancy in Intellectual Property across Europe. Perry is passionate about recovery from addiction and liaises with family members to coordinate admissions, often sharing his own experience to help people when they first admit into treatment. Most certainly the driving force behind the success of Rehab Today by PCP which now boasts 60 primary and 68 move on beds in all locations. Perry is a keen fitness fanatic and Arsenal fan!
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Dr Otulana is PCP’s longest-serving doctor. He is an experienced Physician with Specialist Interest in Substance Misuse Management and he has a wide range of experience in the assessment and management (including detoxification) of clients with various drug and substance addiction problems. Dr Otulana started practising as a doctor in 2000 and with over 10 years as an Addiction Physician. He is an Advanced Addiction Practitioner Member of Addiction Professionals and also holds the Certificate in Clinical Psychopharmacology (Part 1) of the British Association for Psychopharmacology. He is additionally a strong healthcare services professional with a Master of Business Administration (M.B.A.) degree from Cambridge University Judge Business School.
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