Secret drug problem that can affect anyone

The growth in prescription painkiller addiction is alarming – and victims are not the people you’d think

We need to talk about drugs again. No, not the latest hippy highs for revellers at summer festivals, the horrors of Trainspotting-style squalid dens haunted by pale ghosts, or even the Bacchanaliac excess of high-powered executives snorting cocaine off prostitutes. This is far more insidious.

We need to talk about the problem that, it was reported yesterday, was responsible for the Crown Prince of Saudi Arabia being forced out in a “coup”; that has seen the likes of TV presenter Ant Mcpartlin and golfer Tiger Woods check in to rehab; that has cost the lives of icons of film and music. Welcome to the world of prescription painkiller addiction.

Nobody knows the extent of the problem in the UK – the data just isn’t there. We do know, however, that opioid prescribing has doubled in the past decade, to 24million prescriptions a year; prescriptions for tramadol saw an equally dramatic rise, from 5.9million to 11.1million.

You can add to that the untold number of people who buy opioids, such as codeine, from pharmacies – the UK tops the EU charts for painkiller sales. And that’s just those taking them for their own meds. Last year, a Home Office report found that some 7.5 per cent of adults had taken a painkiller they hadn’t been prescribed; it estimated that 33,000 people had done it purely for the buzz.

Who is the unseen face of addiction? According to a report to the All Party Parliamentary Group for Prescribed Drug Dependence, your typical misuser of painkillers isn’t the person you’d expect. A survey of GPS found that it’s generally a woman aged 30 to 50, with low mood, often unemployed, and with people who depend on her. Pain specialists report it can be older men with depression or diabetes, or young men with sports injuries. These are people who needed help – just some of the 28 million in the United Kingdom estimated to suffer from pain.

Such addiction is hard to spot and easy to conceal. It is, the report concludes, “a problem hidden in plain sight”: a seditious ride that never warns you where it leads, that never tells you you’re addicted until you try to stop and hit a wall of discomfort. Taking painkillers plays off a patient’s own anxieties: it is all too easy to justify until it becomes simply habitual. Even then, the addiction is easy to deny – it doesn’t happen to people like you and I, does it?

And yet it does. Even at the lowest end of its spectrum, it causes physical symptoms such as sleepiness, nausea and constipation; it impacts work and relationships. In some professions, it’s grounds to lose your livelihood. The eventual consequences can be devastating. We know, for example, that deaths have skyrocketed. In 1996 there was one tramadol-related death in England and Wales; in 2014 there were 240.

The real concern is that the UK is following the same pattern as the US, where the latest statistics estimate that 2million people have an addiction involving prescription pain relief. Drug overdoses are now the largest cause of accidental death in America, causing 15,000 deaths a year. Every day, 1,000 people in the US are treated in emergency departments because of opioid misuse. In 2013, when the makers of the drug Oxycontin were being sued by the state of Kentucky, a survey was run in Pike County to see if an impartial jury could be found. It discovered that a third of the county knew someone who had overdosed on the medicine.

The good news is that the UK isn’t there yet and a crisis is easy to avert. Addiction is treatable, and the solution requires a healthy blend of compassion, understanding and vigilance. As with every addiction, we need to break down the stigma and make sure that people can share the fact that they have a problem.

Health professionals need to do their bit too. Pharmacists have to challenge repeat customers who regularly pick up packs of codeine, and doctors must keep a watchful eye on how long a patient is prescribed pain relief, regularly reviewing their needs.

We may not know the extent of the problem of prescribed painkiller addiction, but we know the solution. And it starts by talking about drugs again.