The opioid timebomb: Prescriptions are double what Government told us

The number of people who have been prescribed opioid painkillers in England is twice the total previously released by the Government, the Evening Standard has found.

A Freedom of Information request was sent to the NHS Business Services Authority as part of the Standard’s Opioid Timebomb investigation. It showed that 6.2 million unique identifiable patients were prescribed opioids last year.

Earlier this year, the NHS said the figure was half that, at 3.1 million. The older data from NHS BSA failed to include patients prescribed three common opioid analgesic compounds called co-codamol, co-dydramol and co-proxamol.

This was a significant omission and a strong indicator that the number of opioid addicts in the UK is likely to be significantly higher than experts believed.

European trials suggest a 4 per cent addiction rate, which translates into 250,000 addicts in England, double the 125,000 figure previously assumed. One task of a government review announced this year is to firm up the number of opioid addicts so that adequate treatment can be provided.

Our latest inquiries revealed that the total number of opioid analgesic prescriptions dispensed to the 6.2 million patients in England was also significantly higher than previously thought at 41.4 million. This is 17.5 million more than the 23.9 million figure provided by NHS Digital earlier this year.

It also means that the amount spent on opioids was £350 million, which is £87 million more than the public had been led to believe. Again, this was because co-codamol, co-dydramol and co-proxamol had been separately classified by NHS Digital and not included with the other opioid analgesics.

Roger Knaggs, associate professor in clinical pharmacy practice at Nottingham University, said: “We need to start using the 41.4 million figure when talking about the total number of prescription opioids because that is the correct figure. Opioid compounds like co- codamol are probably stronger and more effective analgesics than opioids we already include, such as codeine phosphate, so I can find no logic in NHS Digital excluding them.”

NHS Digital told the Standard the data was based on classifications set out by the British National Formulary, a reference book used to code medicines. A spokesman for the formulary said: “The Standard is correct to say that co-codamol, co-dydramol and co-proxamol are all opioid analgesics. We recently updated our tables and now have a new hierarchy [classification]. However, the data released by NHS Digital earlier this year appears to be based on our old hierarchy.”

When we presented this information to NHS Digital, its spokesman said: “We used the old classification to aid trend comparison with previous years, but the Standard makes a fair point that the figure we put out to the media understates the true position. Under the new BNF classifications, it is correct to say that the total number of opioids prescribed were 41.4 million and not 23.9 million.”

• To read David Cohen's full Opioids Timebomb investigation, visit standard.co.uk/opioids