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“Too many people are being prescribed medicines that can cause dependence”

One in four adults in England are taking medicines for pain, depression or insomnia, which they can find hard to stop, a government review says.

Public Health England says too many people are being prescribed medicines that can cause dependence.

The PHE review considered benzodiazepines, Z-drugs, gabapentinoids, opioid pain medications, and antidepressants.

In March 2018, half of those receiving a prescription (of these classes of medicine) had been continuously prescribed for at least the previous 12 months.

Between 22% and 32% (depending on the medicine class) had received a prescription for at least the previous 3 years

It says long-term prescribing of opioid pain medicines and benzodiazepines is falling but still occurs frequently – which is not in line with the guidelines or evidence on effectiveness.

Furthermore, prescribing rates are 1.5 times higher for women than for men.

Rosanna O’Connor, Director of Alcohol, Drugs, Tobacco and Justice at PHE said: “More needs to be done to educate and support patients, as well as looking closely at prescribing practice, and what alternative treatments are available locally.

“While the scale and nature of opioid prescribing does not reflect the so-called crisis in North America, the NHS needs to take action now to protect patients.”

The review recommends new guidance for GPs and better information for patients on the risks and benefits of the medicines, as well as improved data collection and a national helpline for worried members of the public.

It also notes that prescribing rates and duration of prescription are higher in some of the most deprived areas of England.

For opioids and gabapentinoids, the prescribing rate in the most deprived quintile was 1.6 times the rate in the least deprived quintile.

Opioids for chronic non-cancer pain are known to be ineffective for most people when used long-term (over 3 months), while benzodiazepines are not recommended to be used for longer than 28 days.

The review identified that when first used these medicines are prescribed for short term use. However, some patients do still end up being prescribed these medicines for longer periods.

NICE said it was working on a guideline for the NHS on the safe prescribing and withdrawal of prescribed drugs.

Professor Paul Cosford, Emeritus Medical Director at PHE said: “This report shows that while the vast majority of new prescriptions for these medicines are for short term use, within clinical guidelines, it also highlights significant numbers have been taking these medicines for a long time.

“It is vital that clinical guidelines for prescribing are followed and regular reviews with patients take place to address this.

“We also know how difficult it is for some people to come off these medicines and more research is needed for us to understand better how we help people to stop using them when they are no longer clinically helpful.”

Read the full review.

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