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.
UK
UK weather: New ice warnings issued and runway closure causes travel delays – as temperatures set to reach -16C
The Met Office has put yellow weather warnings over snow and ice in place from this afternoon covering much of the UK.
It had a number of yellow warnings in place on Thursday across the country, but most were initially set to expire by 11am, with only a snow and ice alert in Scotland remaining until midnight.
But it has now updated its map to show yellow ice warnings for much of the Midlands, North West England, Eastern England, Wales and Northern Ireland from 4pm on Thursday until 10am on Friday, while the snow and ice warning for Scotland has been extended to 10am on Friday.
Met office weather warnings for Thursday Pic: Met Office
Weather warnings for Friday. Pic: Met office
A separate yellow warning for ice is in force from 3am on Friday until 11am, covering South West England and parts of South Wales.
It comes as large swathes of the country deal with disruption caused by the freezing weather, with temperatures expected to fall as low as -16C on Thursday night both in the northeast of England and Scotland, the Met Office has said.
Manchester Airport has warned passengers of delays after temporarily closing its runways due to “significant levels of snow”.
In a statement on Thursday morning, the airport said: “Our runways are temporarily closed due to significant levels of snow, as our teams work hard to clear them as quickly as possible.”
The airport announced its runways had reopened at 10am, but warned “as a result of the earlier closure, some departures and arrivals may still experience delays”.
“The safety of our passengers remains our top priority. Thank you for your understanding and patience,” it added.
Commuters wait for a tram on a snow-covered platform in Manchester. Pic: Reuters
Snow covers a vehicle in Buxton. Pic: Reuters
The A30 in Cornwall was closed westbound between the A3047 junctions Avers and Tolvaddon on Thursday morning following a multiple vehicle collision, according to National Highways, after an amber warning for snow and ice was in place yesterday.
It said at 8.45am that emergency services were at the scene while traffic built on the roads.
Devon and Cornwall Police and Devon County Council Highways had earlier warned of roads closing and motorists being stationary for “long periods of time” in a joint statement.
Snow ploughs became stuck in queues of traffic caused by “minor incidents”, the statement added.
All of the warnings in place across the country are yellow, meaning there is a danger of injury from slips and falls and some disruption to travel expected.
A yellow warning for snow and ice is in place for the following regions from 4pm on Thursday to 10am on Friday:
- East Midlands
- North West England
- Northern Ireland
- Wales
- West Midlands
Get the forecast for your area
Icicles hang from the Killhope Lead Mine in Durham. Pic: PA
Other yellow warnings which covered much of the country on Thursday morning have now expired.
They included a warning for snow and ice affecting Cornwall, much of Wales and parts of northwest England until 11am, an ice warning for parts of southern England and south-east Wales until 10.30am and a fog warning for Northern Ireland until 9am.
Menston, West Yorkshire
Snow covers the Killhope Lead Mine in Durham. Pic: PA
Travel disruption to road and rail services are likely on Thursday in the warning areas, as well as the potential for accidents in icy places, the forecaster said.
As icy conditions persist, motorists are being urged to stick to major roads that are most likely to have been gritted.
Car insurer RAC said it has seen the highest levels of demand for rescues in a three-day period since December 2022.
UK
Stuart Hogg: Former Scotland rugby captain given community payback and non-harassment orders for domestic abuse
Former Scotland rugby captain Stuart Hogg has been handed a community payback order and a non-harassment order for abusing his estranged wife over the course of five years.
Hogg, 32, last year pleaded guilty to a single charge of domestic abuse of his ex-partner, Gillian Hogg, between 2019 and 2024.
The sportsman admitted shouting and swearing, tracking her movements and sending her messages which were alarming and distressing in nature.
At Selkirk Sheriff Court on Thursday, he was given a community payback order with one year of supervision and a five-year non-harassment order.
Sheriff Peter Paterson warned Hogg the sentence was an “alternative to custody”.
Hogg arriving at Selkirk Sheriff Court on Thursday. Pic: PA
Hogg leaving court. Pic: PA
A court heard how he berated Mrs Hogg for “not being fun” after going on drinking binges with his colleagues, and once sent more than 200 text messages to her in the space of a few hours which caused her to suffer a panic attack.
Hogg had been due to stand trial at Selkirk Sheriff Court last November, but pleaded guilty to the abuse which was said to have taken place at various locations including Hawick in the Scottish Borders and Bearsden in East Dunbartonshire.
Hogg arriving at Jedburgh Sheriff Court in December. Pic: PA
At Jedburgh Sheriff Court in December, he was initially handed the five-year non-harassment order and fined £600 for breaching bail conditions by repeatedly contacting Mrs Hogg last June.
The former Glasgow Warriors and Exeter Chiefs, who plays for French club Montpellier, now lives abroad and is said to be in the process of getting a divorce.
Stuart and Gillian Hogg in 2017. Pic: Stuart Wallace/Shutterstock
Prosecutor Drew Long said the couple moved to Exeter in 2019 with their three young children, who were all under three, but Hogg’s behaviour “deteriorated” as he went out partying.
Mr Long said Hogg would “shout and swear and accuse Mrs Hogg of not being fun” for not joining in drinking, and that her family “noticed a change in her”.
In 2022, Mrs Hogg went on a night out and was bombarded with text messages from the rugby player which “caught the attention of the people she was with”, the prosecutor said.
The following year, the couple moved to Hawick in the Borders, but Hogg used an app to track his wife and “questioned her whereabouts” while she was dropping the children off.
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In 2023, she decided to leave the sportsman and sought advice from a domestic abuse service.
Mr Long said in September of that year, Hogg “sent in excess of 200 texts in a few hours despite being asked to leave her alone”, which led to Mrs Hogg having a panic attack.
On 21 February 2024, police were called due to Hogg “shouting and swearing”.
He was taken into custody and thereafter placed on a bail order stipulating not to contact Mrs Hogg or to enter the family home.
The Crown Office and Procurator Fiscal Service (COPFS) said “no one should have to live in fear of a partner or former partner”.
Lynne Barrie, procurator fiscal for Lothian and Borders, added: “Stuart Hogg has now been convicted and held accountable for subjecting his estranged wife to years of domestic abuse.”
Hogg made his Scotland debut in 2012 and went on to make 100 appearances for his country.
He also made two appearances for the British and Irish Lions and was made an MBE for services to the sport in last year’s New Year Honours list.
Following his guilty plea, Mrs Hogg thanked all those who had shown support.
She praised her family and friends, and also singled out those who had given her “a hi, a smile, a hug or even just a look to show they care”.
Mrs Hogg said she had thought “long and hard” about posting on Facebook, but added: “Now, it’s time to start my next chapter.
“To move on and to keep showing my kids every day that strength comes from unconditional love and support around you, and even when it hurts, love wins.”
Following the court case, Scottish Women’s Aid said coercive control – including stalking and micromanaging how women mother, where they go, what they wear and what they’re allowed to say – can be “more traumatic than a physical assault”.
Dr Marsha Scott, chief executive of the charity, added: “The sentence in this case, like so many handed down in Scotland, hardly meets the test of being proportionate when compared to the harm this man has caused.”
UK
Liz Truss sends cease and desist letter to Sir Keir Starmer over claims she ‘crashed the economy’
Liz Truss’ lawyers have sent a cease and desist letter to Sir Keir Starmer over his claims she “crashed the economy”.
The letter says Sir Keir’s continued claim the former Conservative prime minister crashed the economy with the September 2022 mini budget is defamatory and will “likely continue to cause serious harm to her reputation”.
It focuses on the Labour leader’s claims made in June last year during the general election campaign, and says accusations she crashed the economy were made with the purpose of damaging public opinion of Ms Truss as she stood as a parliamentary candidate.
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Ms Truss, who stepped down as prime minister in under two months in charge, lost the South West Norfolk seat she had held since 2010 to Labour’s Terry Jermy in last year’s election.
Sir Keir’s spokesman said the prime minister has no plans to “moderate his language” based on the letter.
He also questioned whether Ms Truss will be writing to the “millions of people up and down the country” who shared Sir Keir’s view.
The letter also says it is “false” to claim the mini budget crashed the economy and provides details of a definition of “crash of the economy” by Dr Andrew Lilico, an expert from right-wing thinktank the Institute of Economic Affairs and managing director of economic consultancy Europe Economics.
Market movement following the mini budget did not constitute a “crash”, the letter says, and accuses Sir Keir of displaying an “ignorance of basic economics” by doing so.
The letter calls for Sir Keir Starmer to stop saying Liz Truss crashed the economy
Following the mini budget, which included £45bn of unfunded tax cuts, the UK government’s long-term borrowing costs rose sharply by 0.3 percentage points over a day.
The pound then fell to record lows against the dollar, and there was another sharp rise in the cost of long-term government borrowing by 0.5 percentage points after then chancellor Kwasi Kwarteng hinted there would be further tax cuts.
This led to rising mortgage rates, with hundreds of products withdrawn, and an impact on UK pension funds.
Ms Truss’ lawyers blamed the interest rate changes on the Bank of England, “in particular by its poor handling of the liability-driven investment bonds (LDI) crisis, and its regulatory failures”.
It points out the Bank of England is independent of government and says: “Thus the relevant rate changes were not ’caused’ by our client.
“These facts were clear as early as May 2024, if not before.”
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The letter argues there was “no rise in unemployment…no sustained loss of wealth”, and no “enduring economic impacts”.
It says Ms Truss and the mini budget did not play “a significant causal role in the financial market volatility of September/October 2022” and said almost everything, in fiscal terms, had been announced before the mini budget.
The letter requests Sir Keir “immediately cease and desist” from repeating she crashed the economy on an “amicable basis”.
“This request is made in the context of the basic levels of civility which is due between senior politicians, and we trust that you will respond accordingly,” the letter says.
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