Letters Misuse of prescription drugs

A legal way to obtain pleasure

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2337 (Published 16 April 2013) Cite this as: BMJ 2013;346:f2337
  1. Rhiannon England, general practitioner
  1. 1HMP Holloway, Pentonville Road, London N7, UK
  1. rhiannon.england{at}nhs.net

As a GP for more than 20 years, I was naive about the addictive potential and use of prescribed drugs; now, as a GP in Holloway prison, such misuse is obvious and shocking.

Most of Holloway’s inmates are young women, who often come in on a cocktail of prescribed analgesics and mind altering drugs of many types. Some of the analgesics have been prescribed by pain clinics, and, as Spence mentions,1 presumably justified as not being addictive because used for pain. That most women also misuse illegal drugs is passed over or not picked up, along with the dubious diagnoses of epilepsy for which only clonazepam works.

It is interesting to talk to women about why they like certain drugs and what currently has street value. Surprisingly, current favourites are quetiapine, mirtazapine, carbamazepine, gabapentin, and pregabalin, as well as the more obvious opioid analgesics and benzodiazepines. All are used for their mind altering qualities but are (presumably) prescribed for “diagnosed” conditions. Illegal drug users recognise that moving to prescribed drugs is an easier and legal way of obtaining pleasure.

The medical profession needs to recognise this too and decide on a strategy to manage the fall out.


Cite this as: BMJ 2013;346:f2337


  • Competing interests: None declared.