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.
Comedy writer Bill Dare, – who worked on shows including Spitting Image and Dead Ringers – has died after an accident overseas, his agent said.
Described as a “super producer” by his peers, Dare, 64, worked on eight series of hugely popular satire puppet show Spitting Image.
Airing on ITV during the 1980s and 1990s, the show delighted in lampooning public figures including politicians, celebrities and royalty, winning BAFTAs and Emmys. It was rebooted in 2020.
Dare also created Dead Ringers, a comedy impressions show broadcast on BBC Radio 4.
He also produced The Now Show, a satirical take on the news which ran on Radio 4 from 1998 to 2024.
Dare worked on a wide range of comedy shows during his career, including the radio production of The Mary Whitehouse Experience in the late 1980s and early 1990s. He had also written several novels.
In a statement released on Monday, his agent JFL Agency confirmed he died at the weekend.
A spokesperson said: “We are shocked and greatly saddened to have to announce the death of our brilliant client Bill Dare, who died at the weekend following an accident overseas.
“Our thoughts are with his wife Lucy, daughter Rebecca, and with all of Bill’s family and friends who will be devastated by his loss.
“Bill was a truly legendary producer and writer, and his comedy instincts were second to none.”
Oasis depicted on Spitting Image in 1996. Pic: ITV/Shutterstock
Colleagues were quick to pay tribute and reflect on his talent.
Impressionist Jon Culshaw wrote on X: “It’s impossible to express the unreal sense of loss at the passing of the incredible Bill Dare. The wisest comedy alchemist and the dearest, dearest friend. Much love to Lucy and all Bill’s family and friends. We shall all miss him more than we can say.”
David Baddiel posted on the social media platform: “Just heard that the original producer of The Mary Whitehouse Experience on radio, Bill Dare, has died. Bill was an amazing creative force. I owe him much. RIP.”
Former EastEnders actress Tracy-Ann Oberman said she was “devastated” and that her “entire comedy career was down to Bill”.
She wrote: “When I was on the BBC Radio 4 rep company early on in career – I ran into Bill in the corridors – He asked if I was good at accents. I said yes.
“He cast me in a sketch show. I had to do about 15 different accents. We recorded in front of a live audience at Broadcasting House – afterwards Bill said ‘Why have I never met you – you’re going to have a big career’.
“He was incredibly loyal and supportive and really opened a path for me into the R4 comedy world and then TV having come out of the RSC and theatre it was all new. I will always be grateful. Fly high Bill.”
Comedian and writer Mark Steel wrote: “This is so grim. Bill was a compassionate hearty soul with the ability to be beautifully grumpy, a marvellously thoughtful comic mind.
“He’d argue but always listen and you’d always laugh, he made a million shows and wanted them all to matter and would have made a million more.”
Have I Got News for You writer Pete Sinclair said: “I am utterly devastated by Bill’s death. I still can’t believe it. He was a comedy genius. A hugely talented writer as well as a brilliant producer. A close friend and co-writer. I cannot begin to say how much I’ll miss him.”
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Julia McKenzie, comedy commissioner for Radio 4, said: “I am so terribly sorry to hear this tragic news and my thoughts are with Bill’s wife, family and friends.
“Bill has been a huge part of Radio 4 comedy for decades, as a writer and producer, and listeners will have heard his legendary name at the end of many of their favourite shows.
“Bill was a comedy obsessive, and very instinctive about making the funniest choices when it came to writing, directing and editing.
“He cared so much about his work that in the production booth during Dead Ringers you’d see him crouched over the script, utterly focused on the show.
“He was funny and very dry in person, amusingly cynical when he needed to be and always pushed to keep the comedy he made, and particularly satire, spiky.
“I’ve known and worked with him for 18 years and like many I can’t believe he has gone, he will leave a big hole in the comedy world and in our hearts.”
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