North-South divide in opioid and painkiller prescribing with high use in England’s most deprived areas
A North-South divide over the prescription of high dose opioids and other painkillers has been revealed by Sky News research.
The findings are being described as a “time bomb” of potential addiction problems.
In the North East, the amounts prescribed are three times more per head than in London, according to data collated from Open Prescribing.
For example, a practice in Durham with 18,000 patients prescribes over 1.2 million milligrams of opioids a month, (the rough equivalent of 42,000 strong tablets).
An average UK practice of the same size would prescribe about 480,000 milligrams per month (about 16,000 strong tablets).
The region’s lead pharmacist told Sky News: “We’ve all got to re-educate ourselves” about the potential harms of over-prescription.
Opioids are also prescribed to people in the most deprived parts of the country almost twice as much as those in the most well-off areas.
Social workers and other professionals say that GPs are creating the clientele for a growing black market in prescription drugs, and there is a lack of services to help people with their addictions.
While opioid use has fallen slightly in recent years – prescriptions of other painkillers such as pregabalin are on the increase.
‘I don’t know how I’m alive’
Justine Grant beat an additcion to heroin and was clean for 12 years, but says the drug her doctor later prescribed for pain relief was an even greater challenge
Patients have told Sky News that they struggled to beat their addiction and often turned to illegal dealers to top up their medication.
Justine Grant, from Sacriston, near Durham beat an addiction to heroin and was clean for 12 years, but says the drug her doctor later prescribed for pain relief was an even greater challenge.
She said, “I said I need something like ibuprofen but maybe a bit stronger, and that’s when they prescribed us the pregabalin. It’s very, very addictive. More addictive than anything I’ve taken in my lifetime.”
“I immediately got addicted to one of those a day, and then two and then three and then four. Up until I was taking ten a day. I don’t know how I’m alive.”
Justine was topping up her prescriptions using drug dealers, taking 3,000 mg of the drug a day, costing her £25.
She added: “Everybody’s getting them. The doctors think they’re the new wonder drug and they can’t see the problems they’re causing.”
Advice published by NHS England eight years ago warns doctors that this this type of drug “can lead to dependence and may be misused or diverted”.
It also says that the drug is used as a “commodity for trade” in prisons.
‘What will my little girl do if I don’t wake up?’
When Cheryl Parker was addicted to codeine she was being prescribed 100 tablets every three days, and was in constant fear of overdose
Cheryl Parker, also from the Durham area, became addicted to codeine after complications giving birth. Soon she was being prescribed 100 tablets every three days. She was in constant fear of overdose, but was sick if she tried to withdraw.
She said: “God I used to be ill. Spewing, couldn’t walk, constantly on the toilet, mentally just totally drained. I used to have an inhaler down the side of my bed every night. I used to just be panicking. What would I do if I don’t wake up? My little girl’s there, what’s she going to do?'”
Justine and Cheryl are both housed by Positive Directions, which helps accommodate vulnerable people.
Beverly Crooks, one of its support workers, says there’s little help available for those with mental health and addiction problems.
She said: “For the last year there’s been a lot of suicides through drugs and people not getting help. People really depressed, can’t get any help from anywhere, getting told there’s no one that can come out and see them because there’s not enough staff.”
The director of Positive Directions, Gary Crooks, told Sky News: “It’s an absolutely huge problem and a time bomb that’s been simmering under the surface for quite some time now.”
“Being on the frontline, what we’re encountering is an explosion in prescribed drugs from the GPs, and certainly on the black market.
“A lot of people have been accessing drugs from the dark web, and buying prescription drugs that way, at a real big discount, and selling them on the streets.
“They are extremely addictive and quite often the problem is they’re prescribed by medical professionals and so the people who are taking the prescriptions don’t realise how addictive these substances are.”
‘Primary care is overwhelmed’
Ewan Maule, lead pharmacist for the North East and North Cumbria, says there is a link between poverty, especially in declining industrial regions such as the North East, and chronic pain and this in turn leads to greater use of opioids in certain regions.
However, he says that medical understanding about the risk of opioids has evolved and NHS professionals need to take note.
He said: “The conversation is changing and we are starting to talk about non-drug treatments, non-medicines for treatment of chronic pain, because we know the harm that can be done by opioids certainly long-term, outweighs the benefits.
“We all need to re-educate ourselves. People like me, who were educated 20 years ago, need to change the way we think about things.”
Medical academics in the region agree and a programme is being launched in the North East to use GPs’ databases to contact people on high dose opioids offering help.
Professor Julia Newton, from the Newcastle Hospitals NHS Trust, said: “We need to take notice that we’re an outlier in this area and begin to look at why that might be.
“Primary care is overwhelmed at the moment, time is very precious in short GP consultations. And I think sometimes it might just be easier when a patient wants a tablet, for a GP to prescribe or to continue to prescribe a medication.”
Offered heroin at a rehab centre
While getting hooked is easy, finding help to get off is a struggle. Addicts told us that the main rehab centre in Durham, called County Durham Substance Misuse Service – Centre for Change, often has dealers outside and sometimes inside.
One recovering addict said it was a great place to “go for a hit” rather than rehab.
When Sky News paid a visit, a social worker with our team was offered heroin by a client coming out of the premises.
Humankind, which runs the centre, said that it takes any reports of drug use and dealing within its centres “extremely seriously” and it has “strong, well-communicated policies in place prohibiting these acts”.
It added: “Anyone found to be dealing, sharing or using drugs on a Humankind site will be challenged and reported to the police, and any claims of drug dealing are investigated thoroughly.”
When it comes to the government’s levelling-up agenda, clearly this is another area that needs attention. Communities that have seen industrial decline and rising poverty have also added addiction to their list of problems.
Former addict Justine says: “How are they going to break the cycle? There’s no jobs, no help, no future, no dreams.”
And it seems medication is no substitute for investment, jobs and services.
Let’s deal, first of all, with the question many of you will have: after today’s reduction to 4.25% will there be more interest rate cuts to come?
Today, the Bank of England did nothing to sway you – or the financial markets that bet on such things – from the assumption that after today’s quarter percentage point cut there will be further reductions in the cost of borrowing.
Indeed, right now, financial markets assume the Bank will cut UK interest rates down to 3.5% by early next year, and the Bank didn’t contradict that today.
Money blog: What interest rate cut means for your money
But (this being economics, there’s always a “but”) if there was one theme that overarched the Bank’s latest set of forecasts, it was that it’s becoming fiendishly difficult to predict the future.
Take tariffs. In theory, the Bank thinks they’ll actually be much less damaging than many had assumed, with the total impact not enough to push the UK into recession.
But that’s based on a few important assumptions, chief among them that Donald Trump doesn’t re-impose the reciprocal tariffs announced on 2 April – despite the fact that he’s explicitly said they are only temporarily paused. It was based on the assumption that the UK wouldn’t get a trade deal with the US, an assumption that was already out of date by the time the document was published.
Keep up with all the latest news from the UK and around the world by following Sky News
No one really has a clue
The Bank’s forecasts are, in other words, even more uncertain than usual.
Perhaps that helps explain why the nine members of the Monetary Policy Committee had a rare three-way split in their vote this month, with two members voting to leave rates on hold, two voting to cut them by half a percentage point, and the remaining five carrying the decision and reducing them by 0.25%.
Now, even taking this uncertainty into account, there are a few things one can take from today’s Bank of England news, and the update from its American counterpart, the Federal Reserve, yesterday.
While tariffs are expected to push inflation up in the US, they are expected to push inflation down in the UK. The upshot is while the Federal Reserve is pausing its interest rate cuts, UK rates are coming down.
Every Bank of England forecast is, by definition, a historic document. Such things take time to model and write so, by the time they come out, they are always a little bit out of date. But never has this been more true of a Bank forecast than the one published today.
The big picture, however, is that no one really has a clue. No one knows what Donald Trump will do next. No one knows what the impact of his tariffs will be on the UK or, indeed, elsewhere. No one knows what this all spells for inflation or unemployment.
UK
VE Day anniversary: Veteran who lost three brothers in Second World War hopes celebrations offer people the chance to ‘learn from history’
A 101-year-old veteran, who has never publicly talked about her wartime experience, wants the VE Day 80th anniversary events to be a chance to reflect on the “unnecessary” conflicts we see today that she says are driven by “pure greed”.
Pauline Alexander was one of five siblings who all served in the Second World War – with three of them among the four family members she lost during the conflict.
She was encouraged to talk about what she went through by her daughter after she saw the Royal British Legion appealing for more surviving veterans to tell their stories.
80 years ago, as Sir Winston Churchill declared there was finally victory in Europe and the celebrations erupted in London, Ms Alexander was in Chelmsford with her mother and sister-in-law.
Sir Winston Churchill announces ‘victory in Europe’ in 1945
“I was at home on leave,” she said.
“We joined in the celebrations, the singing and dancing. It was very exciting. Everyone in Chelmsford had turned out, well those who were still there. But it was very… how can I put it? A feeling of what next… life had changed completely.
“We started [the war] as a family of seven, we ended as three.”
Like so many, Ms Alexander’s war was punctuated by loss.
Her father died while running the family surgical instrument business in 1943, and three of her brothers were killed.
Peter Kipling, an Army dispatch rider, died in a bike accident delivering a message to the war office in London. He was about to be sent to the front in preparation for D-Day.
Guy and Bernard Kipling, who were twins, were both navigators on RAF bombers.
They were shot down in 1941 and 1943, their bodies never came home.
All three are remembered on Peter’s gravestone in Broomfield Cemetery.
Pauline Alexander with her brother Peter Kipling who died before he was due to be sent to the front for D-Day
Pauline Alexander with her brother Guy Kipling who died in the conflict
Looking at photographs of her brothers, Ms Alexander quietly said: “That’s just how I remember them all, just like that.”
When I asked her how she felt when she heard they had died serving their country, she replied: “In those days of war you just had to accept these things.
“It was bound to happen at some time or other. Bernard served on Whitley bombers, and they were known as flying coffins.”
Ms Alexander’s story about her family, and the clerical work she did in the Women’s Royal Air Force (WRAF) from 1942-1946, including at bomber command at RAF Waddington, only came to light because of the Royal British Legion appeal.
She said she previously just thought: “It was our duty to do what we could and that was life, everyone was losing family… it was just something that happened.
“All part of life and living.”
Children wave flags from the ruins of their homes in Battersea, south London, as they celebrate VE Day in 1945. Pic: PA
Families fly flags and bunting in the street on VE Day in 1945. Pic: PA
I asked her how her mother reacted when she said she wanted to sign up.
Ms Alexander replied: “She said yes. It would do me good. I was getting too spoilt at home.”
She added: “If my brothers were in, I had to be in to do my bit too.”
Her mother, Rosa Kipling, was also a remarkable woman.
She lived until 105 and was recognised for bravery in the first honours list to feature MBEs in 1918, after surviving an explosion during the First World War in a munitions factory.
It is no wonder then that her children were all so committed to do their bit.
An elderly woman gets a hug from a GI in London on VE Day. Pic: AP
Sky’s Rhiannon Mills with Pauline Alexander
The sense of service and the acceptance of the sacrifices that had to be made now feel more important than ever, especially in the context of ongoing global conflicts.
That was something that Ms Alexander was keen to talk about from her home in March, Cambridgeshire, where she will be watching today’s events.
Read more:
New photos show how wartime films were made
Why King’s message to veterans is very personal
VE Day 80th anniversary celebration in pictures
Asked why she believes it is so important that we take time to remember today, she said: “Because it’s all part of history, and history is very important, because we learn from history.
“When you think of all the conflicts that are going on now and how it’s all unnecessary in a sense, just pure greed. Because what they went through [in the Second World War] was absolute hell.”
As I reflected with her that they truly are an amazing generation, Ms Alexander simply replied: “Yes, there’ll never be another one like it.”
The King and Queen have paid their respects to Britain’s war dead at a service to mark the 80th anniversary of VE Day.
The royal couple were among 2,000 people – including 78 veterans – who attended the ceremony at Westminster Abbey in London.
The thanksgiving service, which included music and readings, paused at midday for a national two-minute silence in memory of those who died.
Poppies surrounded the grave of the Unknown Warrior in the abbey
King Charles lays a wreath at the grave of the Unknown Warrior. Pic: Reuters
Followed by his son, the Prince of Wales. Pic: Reuters
State trumpeters play a fanfare during the service. Pic: Reuters
Other attendees included the Prince and Princess of Wales, along with Prime Minister Sir Keir Starmer and some of his Downing Street predecessors, including David Cameron and Boris Johnson.
The King laid a wreath, which featured the message “We will never forget”, at the grave of the Unknown Warrior, followed by the Prince of Wales.
The Princess and Prince of Wales also paid their respects. Pic: Reuters
Tory leader Kemi Badenoch and Prime Minister Sir Keir Starmer were among the dignitaries. Pic: Reuters
David Cameron, pictured arriving at the abbey with his wife Samantha, was one of several former prime ministers who attended. Pic: Reuters
At their side, watching from his wheelchair, was veteran Ken Hay, 99, who served in the infantry regiment.
Actor Josh Dylan read a letter from Lance Corporal Fredrick Burgess to his seven-year-old son Freddie, written while he was serving in Italy.
He quoted the serviceman, whose granddaughter Susan was among those in the abbey, as writing: “When I do come home, and it will not be very long now, I’m going to buy you something extra specially nice for being such a good boy.”
Members of the royal family at the thanksgiving service.
Pic: Reuters
Pic: PA
RAF veterans Kathleen, 101, and Roy Lawrence, 101, who have been married for 74 years, share a kiss at a VE Day anniversary event in Staffordshire. Pic: PA
Lance Corporal Burgess also described the rain in Italy and how his small tank, which he named Freddie II after his son, had been damaged with a “whacking big hole” by a bomb.
Dylan revealed: “Seven months after writing this letter, Lance Corporal Burgess was killed.”
An excerpt of wartime prime minister Sir Winston Churchill‘s 1945 victory speech, in which he declared the war in Europe was over, was also played.
His great-great-grandson Alexander Churchill, aged 10, lit a peace candle and later read a prayer for “peace in Europe and across the world”.
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