New data show a worrying increase in opioid prescribing in primary care in England.
An analysis of official government data for opioid prescriptions from August 2010 to February 2014 showed an overall increase in opioid prescribing in primary care in England, specifically for buprenorphine, codeine, morphine, oxycodone, and tramadol, which was the most prescribed opioid in England. Buprenorphine and codeine showed the greatest rate of increase over the study period. Fentanyl was, by far, the least prescribed drug. Only 2 opioids, methadone and dihydrocodeine, showed a decrease in prescribing rates.
A north-south gradient in opioid usage was also found, with 9 out of 10 of the highest prescribing areas located in the north of the country (P<.0001), and there was an association between social deprivation and higher opioid prescribing (P<.0001).
Commenting on the findings, presented in the British Journal of General Practice, the authors conclude: “Long-term opioid prescribing is increasing despite poor efficacy for non-cancer pain, potential harm, and incompatibility with best practice.”
“The British Pain Society and Map of Medicine have produced a series of guidelines aimed at standardising care for the most common types of chronic pain, using evidence-based algorithms. If the treatment of chronic pain in the community followed these, opioid prescription would be likely to fall and the function of those with chronic pain to improve,” they suggest.
