The UK opioid epidemic that is ruining families
Thousands are left fighting addiction to legally prescribed drugs, reports Helen Chandler-wilde
Nestled among England’s greenest lands are places such as Primrose Lodge. The converted Victorian Villa, in Worplesdon, near Guildford in Surrey, sits opposite the village cricket pitch – a smart redbrick building surrounded by trees. It is also one of a number of discreet clinics treating the UK’S latest major drug addiction: opioids.
Behind closed doors all over Britain, thousands of people are now addicted to the painkillers prescribed for them. According to new figures by Public Health England, one in eight adults in the UK is currently on one of these drugs, which include co-codamol, tramadol and morphine. There were 141 million prescriptions issued for them last year, up from 89 million in 2008. Medics have warned that we are in the grip of a growing crisis, a situation they warn could become as “devastating” as the epidemic in the US. What’s more, it is middle-aged women in their fifties and sixties have fuelled the 60 per cent rise in the numbers of heavy painkillers, anxiety medications and antidepressants in the last decade.
Primrose Lodge is one of several private facilities run by UK Addiction Treatment (UKAT) and is currently home to 19 such patients.
The £11,000-a-month clinic looks more like a house than a hospital. Downstairs is a dining room where everyone eats together and a sitting room where the residents spend their evenings. There are board games, a TV and books – but reading options are kept limited to airport thrillers, and Alcoholics Anonymous classic Twelve Steps and Twelve Traditions. Each patient is given a cosy but minimal en-suite room, with thick carpets and basic furniture.
Despite cosy surroundings, it’s on the front line of opioid dependency. The number of people being treated at UKAT’S centres has increased by 45 per cent in the past three years, with one in 10 people hooked on legal prescriptions. “It’s an epidemic rising quickly,” says Johnny Beggache, acting manager of Primrose Lodge.
“It’s ruining families.” The clinic runs a strict programme to help patients get clean. Days are tightly scheduled, with activities including art and drama therapy, counselling and exercise. They are allowed a maximum of an hour a day on their phones. Once a person has come through the doors, they will not be allowed out unaccompanied until their treatment is over. “They like rules as there are no boundaries outside,” explains Beggache. They are also set chores. “We have cleaners, but we set them basic tasks,” says Beggache. “They are learning to care for themselves. Most are prima donnas from nice backgrounds who think the world is run for them.”
As he is speaking, a woman in her thirties emerges. She’s missed lunch and would like something to eat. A few minutes later, a chef brings her homemade soup with bread, and a counsellor supervises as she eats.
Primrose Lodge has seen patients as young as 21 who are addicted to opioid painkillers. But many are “middleaged to older”, says Beggache, and have become addicted after being prescribed pain relief after surgery.
With limited time, GPS can struggle to monitor the short-term use of these drugs, adds Nuno Albuquerque, group treatment lead at the centre. He says that doctors often dole out longer prescriptions to patients just “to make them go away”. There is frequently not enough time, he thinks, for doctors to get to the root of the problem: “We think that people should be given a choice of other ways to alleviate pain: yoga, acupuncture, therapy.”
Lisa Peake, 48, spent three years addicted to a cocktail of co-codamol, codeine and tramadol given to her for neck pain. It was, she says, chronic and she would have liked some advice about natural methods to treat it, but her doctor didn’t have time to discuss those in their 10-minute appointments. “Even though GPS are doing their best, alarm bells should have been ringing when three years later I was still being prescribed opioids,” she says.
Once addicted, patients will become desperate for their medication, says Albuquerque. They might turn to a private GP to get an extra dose, something made possible by the poor sharing of patient records.
Some patients circumvent medical professionals and purchase drugs online. “I had a client who came to detox from diazepam and opioid that he had been buying from the dark web. He had stacks of it,” says Beggache.
Many people have no idea how addictive these drugs can be. Albuquerque recalls one patient who became hooked on opiates after he broke his shoulder. He wrongly thought that painkilling skin patches wouldn’t be as addictive. “He ended up scratching himself until he bled to get the morphine [in] more quickly.”
Nicki Hari, who now works at UKAT, suffered bad symptoms when she tried to come off co-codamol, which she’d been prescribed for knee pain, aged 18. Her entire body ached and she felt like she had flu. Her mood changed and she became withdrawn and depressed. This discouraged her from trying to come off the drugs, and she kept taking them for years.
The turning point came after two decades, when her children, then aged eight and six, told friends that mum slept and cried “all the time”.
The friends took Hari to rehab, where she was shocked when a therapist described her as a Class A drug addict. “I’m not in a street alley jacking up heroin or using cocaine or alcohol, I’m taking what the doctor has told me to take,” she recalls.
After an addiction has formed, it is very difficult to break and going cold turkey on opioids can be dangerous: “Patients can have seizures or zombie legs, where they can’t hold their foot down,” Albuquerque says. Instead, they must gradually reduce their medication under the supervision of a doctor. It is so physically draining that patients are given bedrooms on the ground floor for the first week to limit the chances of collapsing on the stairs.
Despite this, there’s still a worrying lack of awareness around opioids in Britain, with many GPS continuing to overprescribe potentially addictive painkillers and many patients unaware of the consequences.
“Addicts fly under the radar, as people don’t see it as a drug,” says Albuquerque. “If you’re wearing a nice suit, no one questions it.”
‘Even though GPS are doing their best, alarm bells should have been ringing’