PHE said it is not possible to put an exact figure on the prevalence of dependence and withdrawal from current data. Photo: iStock

A review published by Public Health England (PHE) has found that over 11 million – one in four – adults were prescribed addictive drugs between 2017 and 2018.

The government agency says too many people are being prescribed medicines that can cause dependence. Half of the people have been on these medicines for twelve months or more, and more than a fifth for over three years.

The first-ever PHE review, published today, assessed five categories of medicines – antidepressants, opioid painkillers, benzodiazepines (prescribed for anxiety), gabapentinoids (for neuropathic pain) and z-drugs (for insomnia).

It found an increase in the number of antidepressant prescriptions and a decrease in prescriptions for benzodiazepines. Prescriptions for opioid pain medicines and z-drugs were now falling, after years of increase prior to 2016.

Keith Ridge, Chief Pharmaceutical Officer at NHS England, said: “As PHE rightly say, these medicines have many vital clinical uses and can make a big difference to people’s quality of life and for some their long-term use is clinically necessary, particularly antidepressants, which can take longer to have their full effect. But for many patients, they may not be the best option.”

Some of the most deprived areas in England have the highest prescription rates, the review suggests. It also observed a similar pattern for the number of medicines co-prescribed.

Authors of the report recommend new guidance for prescribers and better information for patients on the risks and benefits of the medicines. The National Institute for Health and Care Excellence (NICE) has confirmed it is developing a guideline for the NHS on the safe prescribing and withdrawal of prescribed drugs.

Dr Paul Chrisp, director of the Centre for Guidelines at NICE, said: “Antidepressants are one of the groups of medicines included in the PHE evidence review. Ensuring patients can safely discontinue using antidepressants, when they are no longer clinically required, is a topic which requires careful investigation because there is limited high-quality data in this area.”

Welcoming the review, the Royal Pharmaceutical Society (RPS) suggested that pharmacists could support GPs as they had a huge role in discussing and reviewing medicines with patients.

“These medicines can be very useful for some patients, but they are also associated with dependence and risk of harm. This means it’s incredibly important that prescribing guidelines are followed and that patients taking them are monitored closely,” said RPS chair Claire Anderson, adding: “This must be part of a collaborative approach as patient involvement in decisions about their health is crucial to success, particularly when dependence is an issue.”

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