PATIENTS living in poorer areas are more likely to be prescribed opioids by their GPs, according to a new study.
The research, led by University of Manchester and University of Nottingham researchers, also shows how smoking, obesity and depression are all associated with more prescribing of high-strength painkillers for problems such as lower back pain and arthritis.
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The study, published today [Mon] in the International Journal of Drug Policy, analysed data for 7000 GP practices across England and compared it against the postcode's deprivation status.
They found that three out of the highest five GP areas for opioid prescribing are based in the North West of England, with Blackpool highest overall for England.
The study is the first to quantify the association between opioid use and socioeconomic status in England.
Previous studies have also shown a "continuous and substantial increase" in opioid prescriptions in Scotland, with "marked differences in regional prescribing rates by NHS health board", suggesting patterns may be similar north of the Border.
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Opioid overdosing of drugs including Fentanyl, Morphine, Oxycodone, Tramadol and Codeine have risen dramatically in the Western world over the past two decades.
Lead researcher Dr Li-Chia Chen, a Senior Lecturer at Manchester, said: “Chronic pain is difficult to manage and unfortunately, because their workload pressures are so stringent, GPs have limited capacity to counsel patients with persistent pain.
“This might explain why drug therapy is the main way how GPs manage pain.
“There’s no guarantee that long term use of opioid analgesics can resolve chronic pain. Indeed the risk of opioids’ side-effects such as dependency, respiratory depression and immuno-suppression may sometimes outweigh the potential benefits."
Read more: Prescription drugs gabapentin and pregabalin cited in quarter of Scots overdoses
The researchers also found that an increase in numbers of smokers of just 1% within a GP area is associated with an increase in the average use of morphine by 130 mg per 1000 patients per day.
Similarly, an increase of 1% in the number of patients with depression is associated with an increase in the average use of morphine by 43 mg per 1000 patients per day.
Furthermore, a 1% increase in the number of obese patients corresponds with an increase in the average use of morphine by 36 mg per 1000 patients per day.
Co-author Dr Roger Knaggs, Associate Professor in Clinical Pharmacy Practice at the University of Nottingham said: “The results from our study confirm the substantial variation in opioid prescribing throughout the UK from two other studies published earlier in 2018.
“We need to understand more about why opioids are prescribed more commonly in areas of greater deprivation and to ensure there is collaboration between different parts of the healthcare system to provide appropriate services and support are available for people who are prescribed opioids.”
Co-author Dr Teng-Chou Chen, from The University of Manchester said: “This study shows that the socioeconomic status has a strong association with opioids prescribing for pain.
“We suppose an average manual worker, which is common in socially deprived areas, is more likely to have musculoskeletal problems, and therefore needs opioids.
“Smoking and depression are also more prevalent in poorer areas, but whatever the causes, it’s clear that people living in more deprived areas are at a higher risk of overdose, and it is helpful for clinicians to be aware of this.”
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