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.
A man has died after suffering cardiac arrest onboard a boat attempting to reach the UK.
The vessel turned back towards Equihen beach on the French coast yesterday morning.
A nurse tried to resuscitate the man but was unsuccessful.
Pic: PA
French authorities have now launched an investigation into the circumstances.
A spokesperson for Doctors Without Borders, also known as MSF, has criticised authorities on both sides of the Channel.
Jacob Burns said: “Yet again we have a tragedy in the Channel, that is the consequence of the deadly, costly and ineffective security policies implemented by the UK and France.”
Pic: PA
Later on Saturday, a lifeboat carried migrants who have made the voyage into the Port of Dover.
Photographs showed them huddled under blankets and orange life jackets on board.
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Protesters clash over asylum hotels
Provisional statistics from the Home Office suggest almost 24,000 people have arrived on small boats in the UK so far this year.
Towns and cities across the UK have seen protests in recent days, primarily outside hotels believed to be housing asylum seekers.
Here the Lionesses are again. Another final. Another showdown with Spain.
All of a sudden, what was once so anticipated and longed for can start to seem expected rather than extraordinary.
What happened to the great underachievers of world football? They are now consistently among the final two going for glory.
At Euro 2022, the Lionesses ended England’s 56-year wait for a major trophy by beating Germany 2-1 after extra time. Pic: Reuters
No one is taking that for granted.
Especially not Leah Williamson, with the chance to retain the European Championship trophy lifted three years ago at Wembley.
“The opportunity of tomorrow and what’s on offer is the best thing in football,” the England captain said. “I think we don’t necessarily carry the weight of it and how much it means to people, but we’re aware of it because it means the same to us.”
So often they were only watching other nations making finals.
England’s first was the men winning the 1966 World Cup.
England v Spain: All you need to know
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Lionesses ‘know what win would mean to nation’
Then, with the rebirth of women’s football after bans and neglect, it was the Lionesses’ turn to make it to the finals – in 1984 and 2009.
And the Three Lions had to wait until 2021 to make it to a final, losing to Italy on penalties at Wembley.
It kickstarted an incredible run of five successive years of finals for England senior teams – with another men’s Euros final defeat in 2024.
The Lionesses have led the way, bringing football home by defeating Germany in the Euro 2022 final at Wembley.
They just missed out on going one better when reaching a first Women’s World Cup final a year later.
England manager Sarina Wiegman reacts to defeat against Spain at the Women’s World Cup final in 2023. Pic: Reuters
Lauren James looks dejected after their World Cup defeat, but is confirmed fit for Sunday’s revenge match against Spain. Pic: Reuters
Now, in Basel, comes the chance for revenge against Spain – even though no one in the England camp is saying that, publicly at least, in Switzerland.
Especially knowing how challenging a task it is coming up again against Aitana Bonmati and Alexia Putella – the recent winners of football’s biggest individual honours.
England fans celebrating after England beat Italy to reach the finals. Pic: Reuters
Given England’s history against Spain, it could be a nerve-wracking time for England fans. File pic: Action Images/Reuters
But this is Spain’s first Euros final.
And there is some fear from the world champions at England’s grit and resolve to produce comebacks late in the quarter-finals and semi-finals – with 19-year-old Michelle Agyemang’s goals integral to the fightbacks.
England celebrate their semi-final win against Italy to reach the finals. Pic: Reuters
Michelle Agyemang has propelled England to the Euro 2025 final with two vital goals. Pic: AP
Spain captain Irene Paredes reflected yesterday on how the Lionesses can flip a result late on.
But she was also discussing how their World Cup win was tarnished by the on-pitch kiss that led to former Spanish federation president Luis Rubiales being convicted of a sexual assault on striker Jenni Hermoso.
It sparked a wider clamour in Spain for improved rights and respect for women.
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Spain’s players struggle for respect
“Since then [2023] we took big steps forward,” Paredes said.
“I think this idea is disappearing from society. I still believe we have to continue opening doors… we’re a reference for boys and girls in society, but we still have things to do.”
It is a reminder that while tonight is about collecting silverware, both England and Spain know that emerging as champions can drive further growth in women’s football back home.
Amid it all, they’ll try to savour just what reaching a final means and how rare they are – until recently for English and Spanish women.
A woman who thought she was being injected with Botox was left unable to swallow and doctors thought she had suffered a stroke – after she contracted a life-threatening illness from a potentially illegal product.
Nicola Fairley is one of dozens of people who have developed botulism linked to unlicensed anti-wrinkle injections.
She had the procedure done with her regular beautician after winning a Facebook competition for three areas of “Botox”.
Nicola Fairley
“Within two or three hours my forehead and the sides of my eyes had started to freeze,” Nicola says.
“At first I thought ‘amazing’, that’s what I wanted – then it just carried on.”
Nicola was eventually sent to A&E in Durham, where she met several other patients who all had similar symptoms.
Doctors were stumped. “They thought I’d had a stroke,” she says.
“We all had problems with our eyes, some of us with our breathing. I couldn’t swallow – they put me on nil by mouth because they were worried I would choke in the waiting room.”
Doctors were worried Nicola could choke after she was injected with a suspected illegal product
It turns out all of the patients had recently had anti-wrinkle injections containing botulinum toxin.
Health officials believe they were imported, illegal products.
Botulism – the disease they caused – is so rare many doctors never see it in their entire careers.
It can cause symptoms including slurred speech and breathing problems, and can be deadly.
The disease is so unusual, and so many cases were coming in, that doctors exhausted their stocks of anti-toxin and had to ask hospitals as far away as London to get more.
The UK Health Security Agency has so far confirmed 38 cases of botulism linked to cosmetic toxin injections, but Sky News has been told of several more.
The outbreak began in the North East but cases have now been seen in the East of England and East Midlands as well.
There are only a handful of legal botulinum toxin products in the UK – of which Botox is one.
But cosmetic treatments are largely unregulated, with anyone allowed to inject products like fillers and toxins without any medical training.
Cheap, illegal products imported from overseas are easily available.
Dr Steven Land
‘It’s the Wild West’
Dr Steven Land runs Novellus Aesthetics clinic in Newcastle upon Tyne. He worked for decades as an emergency medicine doctor before moving into aesthetics.
He says he has been warning health officials of an outbreak for years.
“It’s the Wild West,” Dr Land told Sky News.
“Because anyone can do this, there is a lack of knowledge around what is legal, what’s not legal, what is okay to be injected.
“These illegal toxins could have 50 units, 5,000 units or rat poison – there could be anything in there.”
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Dr Land showed us messages that he says he gets on a weekly basis, from sellers trying to push him cheap, unlicensed products.
They advertise “limited time offers” and cheap bundles on toxins imported from overseas. He calls them “drug dealers”.
“They are preying on the lack of knowledge among non-medical practitioners,” he says.
Consultations on how to regulate the aesthetics industry have been ongoing for years – but so far, no changes have been introduced.
The UK government now says it does plan to regulate certain procedures, but it’s not said how it will do this, or when.
“What will it take?” Nicola says. “One of the women we were with did almost die – she had to be resuscitated.”
Nicola’s beautician has stopped responding to her messages, so she says she still has no idea what the product was “or how much of it is in me”.
She doesn’t know how long her symptoms will last, but just hopes she will eventually recover.
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