What Are The Most Prescribed Drugs In The UK?
The leading painkiller prescribed in the UK is higher-dose codeine (Co-codamol) with about 15 Million prescriptions given in 2017. [1]
The leading psychopharmaceutical drugs prescribed are Citalopram Hydrobromide (14+ Million in 2017) and Amitriptyline Hydrochloride (13+ Million in 2017). [1].
Both Citalopram and Amitriptyline are used to treat depression.
Citalopram is a Selective Serotonin Reuptake Inhibitor (SSRI), while Amitriptyline is a tricyclic antidepressant.
Both Citalopram and Amitriptyline are used to treat depression.
Meanwhile, Atorvastatin, a drug for high cholesterol tops the list of most prescribed medicine with 37+ Million prescriptions.
Because Aspirin and Paracetamol are available over-the-counter, the figures for these drugs are excluded from this list.
Morphine and morphine-like painkillers are called opioid painkillers.
These painkillers are most often prescribed for the following conditions [2]:
- Orthopedic pain – conditions involving hips, knees, feet, ankles, shoulders, hand and spine
- Dental conditions
- Back pain
- Headaches
- Cancer pain
Opioid painkillers have a high potential for abuse and dependence [3].
The most commonly abused opioid painkillers are [4]:
- >> Tramadol
- >> Hydrocodone
- >> Oxycodone
The number of incidents of prescription drug addiction in the UK is not as high as the number of incidents reported in US.
Authorities credit stricter rules and implementation for this lower incident rate. [5]
However, at the current level, prescription drug addiction has already caused a number of deaths due to overdose.
A number of complications can also be attributed to prescription drug misuse. These are: [6]
- >> Constipation
- >> Feeling sleepy
- >> Dizziness
- >> Nausea/ vomiting
- >> Difficulty breathing
- >> Hyperalgesia (increased sensitivity to pain)
- >> Immune function problems
- >> Hormonal problems
- >> Muscle rigidity
- >> Jerky muscle contractions
- >> Physical and psychological addiction
- >> Risk of overdose when used together with alcohol and/or anti-depressants
In addition, the long-term treatment of conditions using opioids is not definitively proven effective.
Experts warn that using opioids to relieve pain affects multiple organ systems, which influence numerous body functions [6].
Meanwhile, antidepressants are the most commonly prescribed type of psychopharmaceutical drug [7].
In 2018, it was found out that: [8]
- Individuals aged 65 older are given more prescriptions than their younger counterparts
- More women than men are prescribed antidepressants
Aside from depression, anti-depressants are used to treat migraine and diabetic neuropathy. [8]
The most widely known antidepressant is a type of drug called Selective Serotonin Reuptake Inhibitors (SSRIs).
SSRIs are sold under the names:
- >> Citalopram
- >> Dapoxetine
- >> Escitalopram
- >> Fluoxetine
- >> Fluvoxamine
- >> Paroxetine
- >> Sertraline
- >> Vortioxetine
What Are The Most Common Prescription Drugs?
Co-codamol is the most common prescription drug for pain (15+ Million prescribed in 2019) [1].
Meanwhile, three drugs for depression top the list of prescribed psychopharmaceutical drugs. These are: [1]
- >> Citalopram Hydrobromide (14+ Million)
- >> Amitriptyline Hydrochloride (13+ Million)
- >> Sertraline Hydrochloride (nearly 13 Million)
The NHS lists the most popular painkillers as Co-codamol,
Morphine, and Morphine-like drugs. These drugs include:
- >> Oxycodone
- >> Hydrocodone
- >> Fentanyl
- >> Buprenorphine
- >> Codeine
Some health care professionals pinpoint the widespread use of opioids to [3]:
- >> The waiting lists in clinics being too long
- >> Prisons prescribing the use of opioids for pain
- >> Psychiatry consultants preferring the use of these drugs
- >> Popular appeal of opioids in media and social media
- >> Limitations on the prescriptions of stronger painkillers
Psychological dependence on prescription drugs can be assumed if an individual is described as [2]:
- >> Needing more of the prescribed medicine to feel its effects
- >> Taking more prescription medicine than originally intended
- >> Daily activity is planned around the use of the medicine
- >> Previously enjoyed activities are cut short in relation to the use of the medicine
- >> Secretive behaviour surrounding the procurement of prescribed medicine
- >> Moodiness and irritability when unable to obtain the medicine
Physical symptoms of prescription drug abuse vary depending on the drug type.
However, the pattern for psychological dependence is similar, no matter what type of drug is abused [9].
Recently, Public Health England addressed the misuse of Alprazolam (Xanax), a type of benzodiazepine drug [10]
Health risks posed by being dependent on benzodiazepines like Alprazolam include [11]:
- >> Drowsiness, sleepiness, or dizziness
- >> Unusual patterns of sleep
- >> A form of amnesia where the person can have difficulty creating new memories
- >> Next-day drowsiness
- >> Problems thinking and reasoning clearly
- >> Allergic reactions including extreme reactions that need immediate attention
- >> Danger risk when driving and operating machinery
In addition, there is a great chance of becoming physically and psychologically dependent on benzodiazepines if use is not professionally supervised.
Other than Alprazolam, other benzodiazepine type drugs include:
- >> Diazepam (Valium)
- >> Chlordiazepoxide
- >> Lorazepam
- >> Lorprazolam
- >> Nitrazepam
- >> Temazepan
- >> Flunitrazepam
- >> Oxazepam
- >> Phenazepam
Addiction to prescription drugs such as benzodiazepines and SSRIs can be treated safely in a rehab clinic such as Abbeycare Scotland.
What Happens To Your Brain When You Use Prescription Drugs?
Prescription opioid pain medicines stimulate the pleasure area of the brain. [12]
Long-term use of opioid painkillers can cause brain damage that affects a person’s ability to reason logically.
Addiction to opioid painkillers changes parts of the brain that make drug cravings irresistible, causing the person to use drugs even if it already harmful.
Opioid drugs quiet the part of the brain that is associated with stress. This area is called locus coeruleus.
However, when opioids are overused, the brain compensates by making the neurons of the locus coeruleus over-active.
When the neurons are over-charged, the person experiences withdrawal symptoms.
Prescription anti-depressants called SSRIs (including Citalopram and Sertraline) affect the brain by regulating the neurotransmitter called serotonin.
An optimum amount of serotonin in the brain makes a person feel calm.
But when the level of serotonin is too high, a person can feel anxious and confused [13]
Prescription anti-anxiety drugs like Valium and Alprazolam slows down the body’s functions by increasing the effect of GABA (gamma amino butyric acid) in the brain. [10]
Prescription stimulant drugs like Concerta XL, Ritalin and Medikinet XL affect the brain by boosting the levels of two key neurotransmitters, dopamine and norepinephrine.
What Are The Dangers Of Prescription Drugs?
Overdose can happen if a person misuses prescription drugs.
Other potential harms include physical and psychological addiction, as well as side-effects associated with the specific prescription drug.
In the UK, the most misused prescription drugs include anti-depressants, anti-anxiety drugs, strong painkillers, and stimulants. [13]
The harms associated with misusing/abusing anti-depressants are: [14]
- >> Nausea, vomiting
- >> Weight gain or appetite increase
- >> Impotence, erectile dysfunction, decreased orgasm
- >> Fatigue, tiredness, drowsiness
- >> Dizziness and headaches
- >> Insomnia, problems falling and staying asleep
- >> Dry mouth
- >> Constipation
- >> Irritability and anxiety
The harms associated with misusing/abusing anti-anxiety drugs are:
- >> Feeling drowsy/ sleepy
- >> Feeling tired all the time
- >> Poor balance or physical coordination
- >> Trouble finishing and concentrating on tasks
- >> Slurred speech
- >> Memory problems
- >> Insomnia or sleep disturbance
The harms associated with misusing/abusing strong painkillers are: [15]
- >> Sleepiness/ drowsiness
- >> Not thinking clearly (blurry thoughts)
- >> Shallow breathing
- >> Nausea/vomiting
- >> Difficulty passing urine
- >> Constipation
- >> High blood pressure
- >> Feeling of euphoria becomes the focus of using medication instead of pain relief
- >> Unsafe use of needles (if drug is used intravenously)
- >> Increased sensitivity to pain (hyperalgesia)
- >> Tolerance to the drug means needing more of the drug to feel less pain
The harms associated with misusing/abusing stimulants are: [16]
- >> Pain in the stomach area
- >> Pain in the chest area
- >> Heart beats too fast or too slow
- >> Appetite loss
- >> Anxiety and restlessness
- >> Nervousness
- >> Difficulty falling asleep
- >> Excessive sweating
- >> Hair loss
- >> Dizziness
- >> Can cause thoughts about suicide
- >> Can trigger psychotic breakdown (lost touch with reality)
- >> Slows growth down (for children and adolescents)
A way to safely detox from prescription drug withdrawal is by entering a detox programme in a rehab clinic.
What Causes Prescription Drug Abuse?
Individuals can abuse prescription drugs because of the belief that the drugs will make them feel good.
The motivation to use drugs, in general, is driven by the perceived benefits drugs have to a person’s happiness.
Young people are at high risk of prescription drug abuse if they have access to these drugs.
According to the National Institute on Drug Abuse (US), young adults (18-25 years old) count as the largest group that tends to misuse prescription drugs [kid].
Young adults who use prescription drugs say they use these medicines to:
- >> relieve pain
- >> deal with problems
- >> decrease anxiety
- >> feel better
- >> lose weight
- >> sleep
- >> have a good time with friends
- >> increase alertness
- >> experiment
- >> counter effects of other drugs
- >> concentrate
- >> relax
- >> get high
The three types of prescription drugs most commonly abused in the UK are: [13]
Opioid pain killers including morphine and morphine-like medications
- >> Anti-depressants
- >> Anti-anxiety drugs (Benzodiazepines)
- >> Stimulants used to treat Attention Deficit Hyperactivity Disorder (ADHD)
As of the moment, there are no government statistics on the exact number of individuals with prescription drug misuse problems. [8]
However, health experts warn that the more a person uses these drugs in an unsupervised manner, the higher his/her chances are of becoming addicted or dependent.
In addition, a rough approximate of 1/2 million individuals are using opioids for more than three years now.
Information from the Department for Health reveals a 60% increase of opioid prescriptions in recent years.
Since opioids are highly addictive [3], the long-term use of these drugs exposes individuals to the risk of painkiller prescription addiction.
Ways in which a person can accidentally become addicted to opioid painkillers:
- >> Using the painkiller in a primary care circumstance
- >> Taking a higher dose
- >> Taking more of the drug
- >> Refilling or topping up dosage inappropriately
A private clinic with experts handling this type of addiction would be Abbeycare Gloucester.
References
- Mattews, S. (2018). A nation of pill poppers: Record 1.1 BILLION prescriptions written in 2017 as figures reveal the 20 most popular drugs but critics slam the NHS for spending millions on paracetamol. Daily Mail Online. Available at: https://www.dailymail.co.uk/health/article-5505639/NHS-figures-reveal-20-drugs-dished-most.html
- Janakiram, C. et al. (2019). Opioid Prescriptions for Acute and Chronic Pain Management Among Medicaid Beneficiaries. American Journal Of Preventive Medicine, 57(3), 365-373. DOI: 10.1016/j.amepre.2019.04.022. Available at: https://www.ajpmonline.org/article/S0749-3797(19)30216-8/pdf
- Owens, B. (2015, June 11). Tackling prescription drug abuse. The Pharmaceutical Journal. https://www.pharmaceutical-journal.com/news-and-analysis/features/tackling-prescription-drug-abuse/20068685.article?firstPass=false
- NHS. (2019). Which painkiller? Healthy body. Available at: https://www.nhs.uk/live-well/healthy-body/which-painkiller-to-use/
- Britton, R. (2019, September 10). The UK is dangerously close to having a full-blown opioid crisis. Independent. Available at: https://www.independent.co.uk/voices/opioid-crisis-addiction-drugs-prescription-addaction-tramadol-depression-a9099071.html
- Benyamin, R. et al. (2008). Opioid complications and side effects. Pain Physician, 11(2). Available at: https://www.ncbi.nlm.nih.gov/pubmed/18443635
- NHS. (2017). Health Survey for England 2016 Prescribed medicines. Available at: http://healthsurvey.hscic.gov.uk/media/63790/HSE2016-pres-med.pdf
- Walker, A. (2019, November 2). Report reveals severe lack of services for UK opioid painkiller addicts. The Guardian. Available at: https://www.theguardian.com/society/2019/nov/02/report-reveals-severe-lack-of-services-for-uk-opioid-painkiller-addicts
- Drug Free Kids Canada. (2018). help your teens before they help themselves. Available at:https://www.drugfreekidscanada.org/prevention/drug-info/prescription-drugs/
- Public Health England. (2018). Alprazolam (Xanax): What are the facts? Available at: https://publichealthmatters.blog.gov.uk/2018/07/30/alprazolam-xanax-what-are-the-facts/
- Anderson, L. (2019). Benzodiazepines: Overview and Use. Available at: https://www.drugs.com/article/benzodiazepines.html
- Haydon, I. (2018, July 26). How opioids reshape your brain, and what scientists are learning about addiction. Available at: https://www.inquirer.com/philly/health/addiction/what-science-knows-about-how-opioids-reshape-your-brain-20180724.html
- National Institute of Drug Abuse. (2016). Misuse of Prescription Drugs. Available at: https://www.drugabuse.gov/publications/misuse-prescription-drugs/overview
- Roberts, J. (2014). The Most Dangerous & Heavily Promoted Prescription Drugs & Their Potential Natural Alternatives. Collective Evolution. Available at: https://www.collective-evolution.com/2014/10/14/the-most-dangerous-heavily-promoted-prescription-drugs-possible-natural-alternatives/
- Savage, S., Kirsh, K., Passik, S. (2008). Challenges in Using Opioids to Treat Pain in Persons With Substance Use Disorders. Addict Sci Clin Pract 4(2), 4–25. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797112/
- NHS. (2018). Treatment Attention deficit hyperactivity disorder. Available at: https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/treatment/
- National Institute on Drug Abuse. (2012). Prescription Drug Abuse: Young People at Risk. Available at: https://www.drugabuse.gov/related-topics/trends-statistics/infographics/prescription-drug-abuse-young-people-risk
