The number of dependency forming medicines prescribed in England has decreased by just 1% since 2015 – when the All Party Parliamentary Group for Prescribed Drug Dependence was launched to address the growing problem of prescribed drug dependence.
The 67 million items for dependency forming medicines prescribed in England in 2022/23 represent a 1% decrease from 2015/16 levels according to figures released today by the NHS Business Services Authority (NHSBSA).
But the number of patients prescribed dependency forming medicines has decreased by 12% and the overall cost to the NHS of the medicines has decreased by 51% in the same time period.
The steep reduction in costs between 2016/17 and 2018/19, from £756m to £410m, was due to the gabapenintoid pregabalin coming off patent, meaning that cheaper generic equivalents could be prescribed from August 2017.
The cost and number of items, as well as demographic information, relate to opioid pain medicines, gabapentinoids, benzodiazepines and Z-drugs.
A total of 7,060,000 identified patients were described these dependency forming medicines in 2022/23.
Some 4,330,000, or 61% of them were female, and 6% or 410,000 were women aged 55 to 59.
Among male patients, the most common age group prescribed dependency forming items was those aged 60 to 64.
Rates of dependency forming drugs were higher in the most deprived areas in England, with 1,830,000 patients living in the 20% most deprived areas being prescribed at least one opioid pain medicine, gabapentinoid, benzodiazepine or Z-drug.
This is 56% more than the 1,180,000 patients prescribed a dependency forming item living in the 20% least deprived areas in England.
In March, NHS England launched a framework for pharmacists, prescribers and ICBs aiming to reduce inappropriate prescribing of dependency forming drugs.
It said that prescribing rates of antidepressants, opioid pain medicines, gabapentinoids, benzodiazepines and Z-drugs were at ‘higher than expected’ rates.
The guidance sets out how clinical pharmacists could help patients make shared decisions about their medication.
And it suggests that community pharmacists could help identify people who have been on these medicines for longer than a specified time, or who are self-medicating to deal with adverse effects of these medications. They can then review them or refer them to a general practice team.
This follows several years of work to address prescribed drug dependence.
In June 2015, the All Party Parliamentary Group for Prescribed Drug Dependence was launched.
And in September 2019, now dissolved government body, Public Health England (PHE) published its prescribed medicines review (PMR) to identify the scale, distribution and causes of prescription drug dependence.
It suggested that there should be more transparency around the data on the prescribing of dependence forming medications.
And it said that clinical guidance should be enhanced, that information for patients and carers should be improved and informed choice and shared decision making should be increased.
It also recommended there should be more support from the healthcare system for patients experiencing dependence on, or withdrawal from, prescribed medicines, and it said that more research was needed in this area.
Following this, in August 2021 the Medicines and Healthcare products Regulatory Agency (MHRA) published an updated opioid medicines and the risk of addiction safety leaflet.
And in April 2022 the National Institute for Health and Care Excellence (NICE) published guidance on safe prescribing and withdrawal management.
Last year, the NHSBSA also published a dashboard to help Primary Care Networks (PCN) and GP practices identify patients who have been on opioids for three but not yet six months, in order to help prevent acute use of opioids turning into chronic use for non-cancer pain.