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Death on Prescription

When asked which drug kills the most users per year what springs to mind? Heroin? Cocaine? Certainly not Paracetamol. But prescription drug abuse is responsible for a significant number of drug related deaths across the globe.

Drug deaths rising year on year

The widely publicised and shocking deaths of celebrities such as Heath Ledger, Michael Jackson and Prince have brought this epidemic hurtling to the forefront of the media. Endemic misuse of prescription drugs has traditionally been thought of as a US affliction, but new research conducted by Dr Scott Novak, and a team from the Biomed Central research institute, has suggested that Europeans are catching up . . . with Britain being one of the worst offenders.

The three main culprits in prescription drug abuse and addiction are sleeping pills, anti-anxiety medication, and painkillers – and sometimes, a lethal cocktail mixing the three, not to mention other substances, both legal and illegal.

The Office for National Statistics released a report this year stating that there were 3,674 drug poisoning deaths involving both legal and illegal drugs in 2015 in England and Wales, the highest number since records began in 1993. The rate has been steadily increasing by as much as 15% per year, and is showing no signs of slowing down.

But for now we’ll stick with the legal stuff. The drugs that are available only with a valid prescription from a qualified medical professional. Doctors are here to help, right?

The ‘Z drugs’

The NHS website states that doctors are usually reluctant to recommend sleeping tablets for the long-term treatment of insomnia, because the pills simply target the symptoms without treating the underlying cause. Despite this, records show that 16 million prescriptions for hypnotics were dispensed in the UK in 2015.

A new and increasingly popular group of hypnotics called ‘Z–drugs’ such as zolpidem and zopiclone, work by reducing anxiety and promoting relaxation and calmness, but can offer up some pretty serious psychiatric side effects in return, including delusions, nightmares and hallucinations.

Research suggests that it can take as little as a month to become dependant on these drugs, and many people don’t realise they’ve become addicted until they try to stop and find themselves suffering withdrawal symptoms.

Deaths involving Zopiclone only account for around 2% of drug related deaths in the UK, but the problem with researching this is that 8 out of 10 deaths involving zopiclone or zolpidem also involve another drug (often an opiate, antidepressant or benzodiazepine) making it difficult to disentangle the precise role that the “Z-drugs” play.

Antidepressants and benzodiazepines

61 million prescriptions for antidepressants were dispensed in the UK in 2015, up 7% on the previous year, This includes increased use of amitriptyline, mirtazapine and citalopram. This increase is the largest in the entire therapeutic prescription area.

In 2016 there were more antidepressant related deaths than cocaine and ecstasy deaths combined – perhaps not surprisingly, as suicidal thinking, particularly in adolescents and young adults, is one of the more poignant side effects of medication intended to reduce depression ironically include increased

Diazepam, better known as Valium, is prescribed for short term relief of anxiety. The risk of pharmacological dependence on diazepam is significant, and patients experience symptoms of benzodiazepine withdrawal syndrome if it is taken for as little as six weeks or longer. In fact, withdrawing too suddenly from diazepam, particularly when large doses have been taken over a long period of time, can be life threatening.

In 2016 there were more antidepressant related deaths than cocaine and ecstasy deaths combined

Opiods, the third most prescribed drugs

But painkillers are by far the biggest prescription killer out there. Opioid misuse related deaths made up a staggering 54% of all drug poisoning deaths in the UK last year. Those figures relate to fatalities purely associated with drug toxicity or poisoning, not factoring in drug related accidents such as car crashes.

They are also the third biggest group of all prescriptions being prescribed in the UK, with 68.8m opioids being prescribed last year in the treatment of pain. They come in only narrowly behind anti-cholesterol medication and drugs used to treat hypertension. Rather bleakly for society today, antidepressants come in fourth place.

Prescription drug death rates down

These statistics paint a depressing picture of the UK as a pill addled nation with its citizens treating their various ailments through prescription medicine peddled bountifully by our NHS. But while prescriptions are indeed on the rise, recent figures suggest that prescription drug related deaths at least are actually falling, with the figures being down for some groups this year, including antidepressants, antipsychotics and zopiclone.

Perhaps this is due to an increased social awareness of the dangers of prescription medication, thankful in part to the widely publicised deaths of beloved celebrities to their harrowing prescription drug addictions. With the right treatment and help, recovery is very much possible, and the importance of seeking help cannot be understated. Suddenly ceasing any type of medication can be highly dangerous and professional medical supervision should always be sought.

City Addictions, April 14, 2017

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