After the publication of a recent NHS report, doctors are warning that there is a risk of thousands of patients ending up with codeine addiction as well as addiction to other opioid painkillers due to over-prescription of these powerful and highly addictive drugs.
What Are Opioid Painkillers?
Opioid painkillers are a class of painkillers either extracted from the opium poppy, or synthesised in order to work in the same way as these compounds. Natural opioids extracted directly from opium include codeine and morphine. Synthetic opioids are completely man-made in a laboratory, but their chemical structure allows them to mimic the effects of natural opioids, often more effectively. These include the commonly prescribed drugs tramadol, methadone, and fentanyl. There are also semi-synthetic opioids, made by modifying the structure of natural opioids slightly, and these include hydrocodone, oxycodone, and diamorphine (or to give it its common name, heroin).
They all work in the same way, by mimicking the effect of a natural neurotransmitter found in the brain. They bind to receptors on nerve cells, blocking pain signals and having a calming and sedative effect. They also cause an increase in the production of the neurotransmitter dopamine, stimulating the reward regions of the brain. This produces feelings of euphoria, and is responsible for the highly addictive nature of these drugs.
Why Are Doctors Worried About the Use of Opioid Painkillers?
The figures recently released by the NHS show that the number of prescriptions for these types of painkillers have doubled in the ten years the data covers. In 2006, there were twelve million prescriptions for opioid painkillers handed out, but in 2016 this figure had doubled to over twenty-four million.
Both the Faculty of Pain Medicine (part of The Royal College of Anaesthetists) and the Royal Pharmaceutical Society have expressed concern over the increase in the prescription of opioid painkillers. The Faculty of Pain Medicine represents anaesthetists specialising in the management of chronic pain, acute pain (such as might be experienced after an operation or severe injury), and pain associated with cancer. Dr Barry Miller, dean of the Faculty of Pain Medicine, said, “While some of the increase can be attributed to an improved understanding of the effectiveness of these medications by medical professionals, we are concerned by reports of unnecessary prescription.” He went on to add, “Our greater understanding of these medications can improve the quality of life for tens of thousands of patients in the UK living with complex pain. However, all NHS staff prescribing these medications need to ensure they are not doing more harm than good.”
Warnings have come from doctors regarding the number of patients who could be addicted to these potent painkillers as a result of over-prescription, with a recent estimate showing that as many as 192,000 people could be addicted to prescription opioids. Harry Shapiro of the information service DrugWise has called for an increase in the number of centres specialising in helping those struggling with an addiction to painkillers. He said that this would also help to monitor the scale of the problem. He continued by saying, “People are not staggering around the streets and buying dodgy drugs off dealers, they are getting painkillers. It’s a problem hidden in plain sight – a problem in every GP surgery and pain specialist clinic.”
How Do People Become Addicted to Opioid Painkillers?
For most victims of painkiller addiction, their problem occurs when they are prescribed an opioid painkiller to cope with some sort of severe and debilitating pain. These kinds of pain often need long term treatment, and so patients end up taking these strong, addictive painkillers for longer periods of time than is really safe. But without the painkillers, their quality of life is so poor that they cannot cope.
For one anonymous patient, her addiction began when she was prescribed tramadol to treat an ongoing problem with her back. She was prescribed the drug for over three years, which seems like a long time, but she said that without the drugs her back pain was ‘overwhelming’. Unfortunately, she became addicted to the pills after only a few months, and when she did stop taking them, suffered terrible withdrawal symptoms.
Another former opioid addict is Cathryn Kemp, who now runs a charity set up to help individuals struggling with painkiller addictions. Cathryn was a journalist who was prescribed the synthetic opioid fentanyl to treat post-operative pain after several surgeries. Fentanyl is a particularly strong opioid, and she was old enough to take a maximum of eight lozenges per day alongside dermal patches as her pain was so severe. One day she took an extra lozenge, and after that her addiction became uncontrollable. She ended up taking sixty of the lozenges a day, ten as soon as she woke up in the morning, experiencing withdrawal symptoms of shaking and vomiting one or two hours after taking each dose – prompting her to take more. Severely dependent on the drugs, when her GP gave her the last prescription, she borrowed money and sold her home to pay for private rehab, having been told she was not eligible for rehab through the NHS. Thanks to her addiction, Cathryn lost everything.
What Help Is Available for Painkiller Addiction?
If you are worried that you, or a loved one, could be becoming addicted to painkillers, then call our helpline right now. Our advisors will be able to help you work out what the next step should be for your situation. So please, contact us today.
- (The Guardian) ‘Unnecessary’ painkillers could leave thousands addicted, doctors warn
- (ACSH) Overprescription or Recreation: What Is Driving the Opioid Epidemic?