Health chiefs fear as many as one in four patients are hooked on prescribed meds
Up to 12 million people are being prescribed potentially addictive prescription medication and health chiefs fear as many as one in four patients could be hooked.
A review by Public Health England into the strong painkillers, antidepressants and sleeping tablets being taken daily by a quarter of UK adults, has found that over half have been on them for at least 12 months.
The report was ordered in response to the US opioid crisis, which has killed thousands.
So when should you worry and how do you know if you are at risk of addiction? Dr Simone Yule, clinical lead for the Action on Addiction charity and GP partner answers the essential questions.
Q Which prescription medicines are the most addictive?
A The five classes of medicines included in the review were: antidepressants, opioid painkillers for acute pain and injury (excluding use in cancer patients), gabapentinoids (used to treat epilepsy, anxiety and nerve-related pain), benzodiazepines (mostly prescribed for anxiety) and Z-drugs (sleeping tablets).
Q How long do you need to be on tablets before it’s a problem?
A If you’re on a prescription for an opiate, benzodiazepine or gabapentinoid for more than three months there is a risk that your body gets used to them.
There has been a pill for every ill historically, which just feeds that need for instant gratification.
But this PHE review is an opportunity for anyone on a prescription for three months or more to have a conversation with your prescriber about changes.
Anyone on those drugs in the review is at risk but they may not go on to develop dependency or addiction because it is an individual process. However, having the opportunity to discuss that with a healthcare professional is the way forward.
GPs don’t like to say no to patients but they need to offer patients alternatives which may not be medication related, and that’s a difficult conversation.
Q How can you tell if you’re actually addicted rather than just taking your prescription?
A If you feel different and that you are not functioning normally when not taking the medication, it may be an indication that you are becoming dependent. The big alarm bell is if you start to have withdrawal symptoms. People do not die from withdrawal symptoms but they feel very unwell – and can feel like they are dying.
They can get rebound anxiety, they can get stomach cramps, sleep patterns are affected, they sweat, but it does get better.
The withdrawal process must be medically managed.
Q If you’re on one or more of the tablets mentioned what questions should you ask your GP?
A You should ask your GP if you really need to be on them and if there are alternatives. If you want to reduce them, then address it with your prescriber. Although that is not always primary care GPs, sometimes it is secondary care such as a mental health team who are prescribing.
Speak to your prescriber when you have a medication review and ask them if you can manage your condition differently.
But if you need that prescription then there has to be a balance between the risk and the benefit – it is about exploring alternatives.
Q Should you stop taking them now?
A No. You should never stop taking medication suddenly.
You must take advice from your prescriber and start a treatment plan to reduce them in a planned and gradual way over a number of months with input and support.
Perhaps a referral to a community pain programme. The first thing to do is approach your prescriber and be realistic. If you have been on the medication for a long time, it is something that will have to be managed over time.
For some people, they will need to stay on those medications, but for a lot of conditions, such as chronic back pain or fibromyalgia for example, we know that opiate medication is just not effective.
Q Your doctor has advised starting anxiety/anti-depressants, should you say no?
A You do not have to refuse but you should ask what the other options are to taking medication.
We know that for depression for example, exercise and psychological support is far more effective than taking Selective Serotonin Reuptake Inhibitors (SSRIs).
There are exercise referral schemes in many areas where you can get reduced entry fees to gyms and swimming pools.
In our area we have something called Natural Choices where you can work with charities outdoors so you can get into the fresh air.
There are lots of different aspects to managing mental health, for example, but it is about having an open mind and knowing what is available and then making an informed patient choice.
It is not one size fits all though, and some people will need medication in conjunction with other help such as group therapy.
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