3 days ago
Painkiller addiction warning as opioid prescriptions rise by 25% in eight years
The use of painkillers has jumped, with a 25% rise in opioid use and 50% increase in medication containing oxycodone, experts have said as they warn of addiction risks.
They also found Irish people use far more pain medication than patients in England, and called for better access to other types of treatment here.
Long waiting lists for orthopaedic care, such as knee operations, can leave people with severe chronic pain 'potentially waiting several years to be considered for joint replacement surgery' and relying on medication in the meantime, the study team also warned.
The researchers, including Emma Wallace at University College Cork, looked at medicines given to patients with medical cards in Ireland between 2014 and 2022.
Opioid use in Ireland up 25%
In Ireland, the use of opioids rose by about 25% over the study period, while prescriptions for paracetamol rose by 50%.
During that time, they saw a relative rise of 389% in the use of tapentadol found in brand name drugs such as Palexia. This is prescribed for severe chronic pain not responding to other painkillers.
They also found a 104% rise in the use of amitriptyline (10mg). This can be given for pain, including migraines and rheumatic conditions.
Oxycodone prescriptions up 50%
Use of medication containing oxycodone also shot up by 50%. Oxycodone is also only given when other painkillers are not working.
The data also shows a 59% increase in the use of non-steroidal anti-inflammatory drugs.
These can include creams, sprays, and gels such as those sold under the brand names Voltaren or Solaraze.
Irish painkiller use higher than in England
In contrast, when the team looked at general practice patients in England, they found much lower use. For example, the dispensing rate for tapentadol was 26 times higher in Ireland.
They acknowledged that medical card patients in Ireland include older people and people on lower incomes who would typically need more supports than a general population. However, they said: 'The discrepancy is likely too large to be fully accounted for by this.'
The analysis also shows prescribing levels in Ireland compared to England were two times higher for opioids and four times higher for anti-inflammatories. They were nearly five times higher for paracetamol.
Frank Moriarty, senior author and associate professor at the RCSI School of Pharmacy and Biomolecular Sciences, warned about the risks of this high use. He said:
Many of these medications carry risks such as dependency, which can be worsened by overprescribing.
'While medication can play an important role in treating pain, we must address issues like orthopaedic surgery waiting times and ensure Irish patients also have access to safe, evidence-based alternatives to medications.'
Professor Moriarty also called for better access to data so that these patterns can be analysed.
Alternatives to drugs
The research team pointed out that, in England, patients have better access to pain clinics and alternatives such as physical therapy.
Molly Mattsson, lead author and a postdoctoral fellow at the RCSI School of Pharmacy and Biomolecular Sciences, highlighted the 'growing trend' towards reliance.
'The trends raise important questions about healthcare access and the availability of non-drug options to manage pain, particularly for medical card holders who avail of public services,' said Dr Mattsson.
The study team also included the HSE's Quality and Patient Safety Directorate, the University of Oxford and University College Dublin. Overall, they recommended 'further research to understand the drivers for this high volume of use is required'.
• The study is published in the British Journal of Clinical Pharmacology.
