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Prescriptions for strong opioids up 10% in one year

GPs gave out 10% more prescriptions for strong opioids last year compared with the year before, an analysis of prescribing trends in general practice has revealed.

The analysis produced by healthcare company Cogora, which publishes Pulse, showed that prescriptions for opioids went up 5% overall between 2013 and 2014, while the number issued for strong opioids such as buprenorphine, fentanyl, morphine and oxycodone – reserved for patients with persistent or increasing pain despite treatment with opioids – went up 10% over this period.

Prescriptions for opioids accounted for 55% of total analgesics prescribing costs, and although most opioid prescriptions were still issued for weak opioids, the high costs associated with stronger opioids meant these accounted for the majority of the total net ingredient costs for opioid analgesics.

Buprenorphine and oxycodone each accounted for 19% of the total costs, while fentanyl accounted for 18% and morphine 11%.

The report concluded that the trend of increasing strong opioid use ‘may be of concern considering the risk of addiction associated with use of strong opioids’.

Dr Peter Scott, chair of Solihull LMC, told Pulse it was possible that GPs were prescribing more strong opioids as practices increasingly worked more closely with end-of-life care specialists.

He said: ‘I do feel that with the Gold Standards Framework and the closer working of GPs with Macmillan nurses and district nurses, we have a greater and more integrated understanding of when we need anticipatory care medicine.

‘And there are incidences where you prescribe a pack of everything that fits that bill – usually diamorphine, fentanyl patches and so on – and we’re possibly we’re prescribing these more because of people going down these pathways of integrated care.’

Dr Scott added that GPs were mindful of the problems with opioid prescribing and actively cutting back on their use by auditing their practice lists and carrying out medicines reviews.

Readers' comments (2)

  • Pain is a horrible symptom that drugs I am sad to say are invaluable for and humane. Addiction is a problem but this should be explicitly managed from the outset.

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  • There is a medical myth that dying means pain. Every dying person does not feel pain.
    Often opioids analgesics are showered on palliative care even without pain because we treat families not patients.

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