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.
Many Labour MPs have been left shellshocked after the chaotic political self-sabotage of the past week.
Bafflement, anger, disappointment, and sheer frustration are all on relatively open display at the circular firing squad which seems to have surrounded the prime minister.
The botched effort to flush out backroom plotters and force Wes Streeting to declare his loyalty ahead of the budget has instead led even previously loyal Starmerites to predict the PM could be forced out of office before the local elections in May.
“We have so many councillors coming up for election across the country,” one says, “and at the moment it looks like they’re going to be wiped out. That’s our base – we just can’t afford to lose them. I like Keir [Starmer] but there’s only a limited window left to turn things around. There’s a real question of urgency.”
Another criticised a “boys club” at No 10 who they claimed have “undermined” the prime minister and “forgotten they’re meant to be serving the British people.”
There’s clearly widespread muttering about what to do next – and even a degree of enviousness at the lack of a regicidal 1922 committee mechanism, as enjoyed by the Tories.
“Leadership speculation is destabilising,” one said. “But there’s really no obvious strategy. Andy Burnham isn’t even an MP. You’d need a stalking horse candidate and we don’t have one. There’s no 1922. It’s very messy.”
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Starmer’s faithfuls are ‘losing faith’
Others are gunning for the chancellor after months of careful pitch-rolling for manifesto-breaching tax rises in the budget were ripped up overnight.
“Her career is toast,” one told me. “Rachel has just lost all credibility. She screwed up on the manifesto. She screwed up on the last two fiscal events, costing the party huge amounts of support and leaving the economy stagnating.
“Having now walked everyone up the mountain of tax rises and made us vote to support them on the opposition day debate two days ago, she’s now worried her job is at risk and has bottled it.
“Talk to any major business or investor and they are holding off investing in the UK until it is clear what the UK’s tax policy is going to be, putting us in a situation where the chancellor is going to have to go through this all over again in six months – which just means no real economic growth for another six months.”
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Why is the economy flatlining?
Read more:
Starmer and Reeves ditch plans to raise income tax
Former chancellor Osborne is shock contender to head HSBC
After less than 18 months in office, the government is stuck in a political morass largely of its own making.
Treasury sources have belatedly argued that the chancellor’s pre-budget change of heart on income tax is down to better-than-expected economic forecasts from the Office for Budget Responsibility.
That should be a cause of celebration. The question is whether she and the PM are now too damaged to make that case to the country – and rescue their benighted prospects.
UK
Home secretary vows to end UK’s ‘golden ticket’ for asylum seekers – as Denmark-based reforms to be unveiled
The home secretary is set to unveil sweeping measures to tackle illegal migration, vowing to end the UK’s ‘golden ticket’ for asylum seekers.
People granted asylum in the UK will only be allowed to stay in the country temporarily, in the changes expected to be unveiled on Monday by Shabana Mahmood.
Modelled on the Danish system, the aim is to make the UK less attractive for illegal immigrants and make it easier to deport them.
Planned changes mean that refugee status will become temporary and subject to regular review, with refugees removed as soon as their home countries are deemed safe.
The Home Office said the “golden ticket” deal has seen asylum claims surge in the UK, drawing people across Europe, through safe countries, onto dangerous small boats.
Under current UK rules, those granted refugee status have it for five years and can then apply for indefinite leave to remain and get on a route to citizenship.
As part of the changes, the statutory legal duty to provide asylum seeker support, including housing and weekly allowances, will be revoked.
The government will seek to remove asylum support, including accommodation and handouts, to those who have a right to work and who can support themselves but choose not to or those who break UK law.
Home Secretary Shabana Mahmood. Pic: PA
‘Last chance for a decent politics’
A government source said Ms Mahmood believes her reforms are about “more than the electoral fortunes of her party”.
“This is the last chance for a decent, mainstream politics. If these moderate forces fail, she believes, something darker will follow,” they said.
“But this demands that moderates are willing to do things that will seem immoderate to some. She has reminded those who are reluctant to embrace her ambition for bold reform, with an ultimatum: ‘if you don’t like this, you won’t like what follows me.'”
Ms Mahmood said they were the most sweeping changes to the asylum system “in a generation”, as she vowed the government will “restore order and control to our borders”.
The home secretary also told The Sunday Times that “I can see – and I know my colleagues can – that illegal migration is tearing our country apart”.
Read more:
What Sky News witnessed after tip-off about migrant crossings
Could Danish model save Labour’s bacon?
System being ‘gamed’
The source said Ms Mahmood believes the system is being “gamed by those travelling on boats or abusing legal visas”.
Some 39,075 people have arrived in the UK after making the journey across the Channel so far this year, according to the latest Home Office figures.
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The gangs smuggling people to the UK
That is an increase of 19% on the same point in 2024 and up 43% on 2023, but remains 5% lower than at the equivalent point in 2022, which remains the peak year for crossings.
What happened in Denmark?
The UK government points to Denmark remaining a signatory of the European Convention on Human Rights, while also cutting the number of asylum applications to the lowest number in 40 years and successfully removing 95% of rejected asylum seekers.
Shadow home secretary Chris Philp said the Labour government has “lost control” of the UK’s borders” with illegal channel crossings “surging to over 62,000 since the election”.
He said some of the new measures were welcome but “they stop well short of what is really required and some are just yet more gimmicks – like the previous ‘smash the gangs’ gimmick”.
Mr Philp added: “Only the Conservative borders plan will end illegal immigration – by leaving the ECHR, banning asylum claims for illegal immigrants, deporting all illegal arrivals within a week and establishing a Removals Force to deport 150,000 illegal immigrants each year.”
And Enver Solomon, chief executive of Refugee Council, said: “These sweeping changes will not deter people from making dangerous crossings, but they will unfairly prevent men, women and children from putting down roots and integrating into British life.”
Ms Mahmood will be appearing on Sunday Morning with Trevor Phillips from 8.30am on Sunday.
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