37,000 Wigan residents ‘hooked on prescription drugs’

Public Health England has, for the first time in its history, released the results of a prescribed medicines review.

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This highlights the dependence on and withdrawal from prescribed drugs across the country.

And it shows the estimated proportion of people with a prescription in the month of March 2018 living in Wigan, as well as how many of those people have been receiving the prescription for at least 12 months.

The report has delved into prescribing rates for a variety pills, including antidepressants, opiate pain medicines, gabapentinoids, benzodiazepines, and Z-drugs.

Detailed analysis of the report by addiction treatment experts at UKAT shows that in just the month of March 2018, over 67,000 people living in Wigan were issued a prescription for any of the above drugs.

UKAT’s concern is for that over half of these patients - 36,961- have been repeatedly prescribed these highly addictive drugs for at least 12 months, and for some, perhaps even longer.

The vast majority of prescriptions issued in Wigan were for antidepressants - 32,671 prescriptions issued to people living in Wigan in just one month, of which over half (54 per cent) have been on the same antidepressant prescription for at least 12 months.

Wigan health chiefs today acknowledged that they were trying to reduce the use of certain of these drugs but added that anti-depressants were not considered to be addictive.

UKAT - a group of rehabs which treat hundreds of patients for prescription drug addiction each year - welcomes Public Health England’s review and hopes that it will serve as a “serious wake-up call” adding: “This report shows us that thousands of people living in Wigan are crying out for help, and unfortunately, they’re being given plasters in the form of pills to solve their problems.

“There is no doubt that in the short-term, these drugs may help, but long-term use of these drugs, for the majority, will be ineffective because over time, the patient is likely to develop physical and psychological tolerance to the drug, whilst the root cause of the problem remains untreated,” said Nuno Albuquerque, group treatment lead at UKAT.

Officials at Public Health England have stated that long-term use on such a scale could not be justified and was a sign of patients becoming dependent.

Mr Albuquerque said: “These figures suggest to me that GPs here are stretched and overwhelmed and need better support and investment to be able to offer alternative treatment therapies like pain clinics, talking therapy, yoga, exercise, diet, and acupuncture to better tackle the root cause of their patients problems, instead of simply issuing a repeat prescription.”

Opiate prescription pain medicines can include codeine, morphine, fentanyl and Hydrocodone.

Gabapentinoids (primarily gabapentin and pregabalin) are generally prescribed for epilepsy neuropathic pain. Pregabalin is also used for anxiety disorders. A recent study explored the harms associated with the prescription of Gabapentinoids to adolescents and adults over 15 years old, which included suicidal behaviour, unintentional overdose, injuries, road traffic incidents, and violent crime.

Benzodiazepines are used to treat anxiety, panic disorders and they act as muscle relaxants and include drugs like Xanax and Valium. Z-drugs are generally prescribed for sleep disorders and include zopiclone.

Sally Forshaw, executive director of nursing and quality at NHS Wigan Borough Clinical Commissioning Group (CCG), said: “We have been working closely with GPs, nurses and all local prescribers to reduce the use of these drugs where it is appropriate.

“Some of these drugs can cause withdrawal symptoms, so this needs to be a gradual process that supports individual patients to come off them safely.

“Anti-depressants are a little different to the other drugs on the list as they can be appropriately prescribed for a number of illnesses and conditions for longer periods of time.

“There is NICE guidance that sets out when it is safe to prescribe anti-depressants in this way and we monitor prescribing to make sure that the guidance is followed. If you are on any of these drugs, please don’t stop taking them unless you are told to by your doctor, nurse or pharmacist.

“If you are worried, contact your GP and discuss with them whether you still need the drug and how you can come off them safely.”

The CCG said that it has been actively reviewing prescribing of benzodiazepines, Z-drugs, opioids for chronic non-cancer pain and gabapentinoids used for nerve pain for a number of years as the long-term risks and addiction potential of these drugs is well recognised.

It said its prescribers are reviewing prescribing and supporting patients to reduce gradually and stop medication where appropriate.

As these drugs cause withdrawal reactions this is a gradual process tailored to the individual patient.

With regards to antidepressants the CCG said it should be noted that these drugs are not considered to be addictive and the report focuses on the difficulties that patients may face when stopping these medications.

Antidepressants are indicated for a number of conditions and their use is included in NICE guidance. For patients with more severe symptoms or repeated episodes of depression longer term use may be appropriate.

The CCG advises that any patients who have concerns about the medication they are prescribed discuss this with their doctor, nurse or pharmacist.

It says these medications should not be stopped without advice from a professional as people can experience significant withdrawal reactions if they are stopped suddenly.