Addiction experts warn of worrying prescription fall in Wigan

Addiction experts warn that the drop could be caused by alcoholics going “cold turkey” as they struggle to secure a medical appointment.

New NHS Prescription Services statistics reveal that NHS Wigan Borough CCG dispensed 1,897 prescriptions for the two main alcohol dependence drugs – acamprosate calcium and disulfiram – in 2018.

It was 19% fewer than during the previous year, in contrast to the rising number of alcohol-related hospital admissions at both a regional and national level.

In 2018 the NHS prescribed the fewest alcohol dependence drugs across England since 2011 – but saw hospital admissions rise for the 15th successive year. The vast majority of prescriptions in Wigan were for acamprosate calcium (82%), used to help prevent people who have successfully achieved abstinence from alcohol relapsing.

The drug, which makes up the bulk of all alcohol dependence prescriptions nationally, is usually used in combination with counselling to reduce alcohol craving.

In Wigan, the remaining 18% were for disulfiram, which can be used by those trying to achieve abstinence but who are worried about relapsing. It deters someone from drinking by causing unpleasant physical reactions when they do, including nausea, chest pain and vomiting.

​Fewer prescriptions were dispensed in Wigan, but the number of alcohol-related hospital admissions in the North West rose to over 190,000 in 2018-19 – 7% up on the year before.

Nuno Albuquerque, group treatment lead at addiction treatment specialists UKAT, said that with high rates of hospitalisation due to alcohol, he would expect to see higher prescribing rates for the drugs across the country.

It is “both confusing and worrying” that prescriptions had reduced by 13% in just three years across England, he added.

He said: “What could be happening is that more and more people are turning to self-help approaches because they’re having difficulty in booking an appointment with their GP in the first place.

“Someone in active addiction who has their ‘moment of clarity’ and decides to ask for help in that moment will require an urgent appointment to get the prescribed drugs they potentially need.

“If this isn’t possible, because of lengthy waiting times or lack of same-day appointment slots, the addict could try to go ‘cold-turkey’ without the medical and professional support they need. This in itself is extremely dangerous and not advised and could also explain the recent NHS statistics which show an alarming rise in the number of people being admitted into hospital for alcohol-related conditions, including withdrawal.”

Jo Churchill, Public Health Minister for Department of Health and Social Care, said alcohol care teams introduced in hospitals with the highest number of alcohol-related admissions expect to prevent 50,000 admissions over five years.

She added: “This has a terrible impact on their lives and their families. Our aim is to see joined up services ensuring people can be directed to the appropriate place whenever they look for help.”