Intended for healthcare professionals

Feature Commentary

Could we see a prescription opioid epidemic in the UK?

BMJ 2017; 356 doi: (Published 15 February 2017) Cite this as: BMJ 2017;356:j790
  1. Michael H Basler, consultant in anaesthesia and pain medicine, Glasgow Royal Infirmary, Glasgow, UK
  1. michael.basler{at}

The World Health Organization lists opioids and benzodiazepines as essential medicines.1 A recent UK report from the charity Drugwise has highlighted the misuse of these prescribed substances.2

But this problem is not new. Many historical remedies (mainly based on opium) have been used to calm nerves and treat tantrums as well as relieve pain.

The report says prescriptions for opioids increased 400% in the past decade and those for antidepressants by 500% since 1992.2 But the degree of our misuse problem is unclear because we lack adequate data, particularly about diagnoses.

Prescription rates cannot differentiate patients with musculoskeletal pain who rely on a mid-range analgesic to function at work from the “Hartlepool housewives” who the report says are using codeine just to “get through the day.” When …

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