The opioid crisis: No longer a ‘uniquely American’ problem

Throughout the pandemic, concerns have frequently been raised over the potential for other healthcare crises to be neglected, as so much of the country’s efforts are focused on stemming the spread of COVID-19. The number of people stuck on hospital waiting lists has skyrocketed and potentially vital routine check-ups have been sacrificed, in light of the unprecedented strain that the pandemic has put on our National Health Service (NHS). 

In recent weeks, one such crisis has been brought to the forefront, as figures from the Office for National Statistics (ONS) have raised fears about a US-style opioid crisis washing up on UK shores. 

The ONS’s figures found there to have been almost 700 deaths from high-street pills in England and Wales in 2019 – double the number recorded just 10 years ago. Experts have also raised concerns that, in a year of persistent lockdowns, reliance on pain relief prescriptions might have increased, as those suffering with long-term pain have had to wait longer to see specialists and receive treatment. 

Opioids are legally controlled drugs which work by blocking pain transmitting receptors in the brain. They can be prescribed by medical professionals for end-of-life care or injury, however, when used to treat longer-term discomfort, can lead to problems with dependency and addiction.

Reliance on prescription-painkillers can also act as a gateway to the use of increasingly dangerous substances, including fentanyl; a synthetic opioid originally designed as a painkiller, that is considered to be 50 times more potent than heroin. Along with a range of other new opioid drugs, fentanyl has recently found its way into illegal UK markets in recent years. A government report from earlier this year found that deaths related to fentanyl had also seen a significant rise in the last 10 years – from just 8 in 2008 to 135 in 2017. 

In the US, an opioid crisis has plagued the country for years, with deaths from opioid overdoses now exceeding those from HIV or Aids. Like many things, the epidemic has been largely overshadowed in the last 12 months by other ongoing events, however it continues to claim lives all over the country at a shocking rate. In the two decades since it was first identified as a problem, the crisis has claimed more than 800 000 American lives. 

The roots of the US’s crisis are widely attributed to the cunning ways of ‘big pharma’. Private pharmaceutical companies have long been accused of suppressing the highly addictive nature of opioid drugs in pursuit of profit, leading to them being overprescribed for pain in healthcare settings. Recent research from the US’s National Institute of Drug Abuse found that between 20 and 30% of patients who are prescribed opioids for chronic pain misuse them, and that up to 12% subsequently develop a disorder. The scale of the problem has meant that attempts at state and federal levels to clamp down on it have been largely in vain – and in fact had the unintended consequence of turning individuals to heroin, when they are denied access to drugs through legal means. The Institute’s report also found that roughly 80 per cent of people who have used heroin reported first misusing prescription opioids.

In the past, the crisis has been seen to be a uniquely American problem, as the structure of the US healthcare system means that many people rely on private health insurance – whose plans invariably favour drug prescriptions over more expensive therapies of treatment. Experts have also identified the different legal framework for prescribing in the UK as a further barrier to us importing the same scale of crisis. 

Opioid deaths by region in the UK. Image: The Times

The many differences between the way that our healthcare system operates in the UK compared with across the pond does mean that it is unlikely that deaths from prescription opioids could ever reach the same levels here as they have done in the US. However, the fact that deaths from drugs prescribed by medical professionals have doubled in 10 years nonetheless indicates the existence of a significant and growing problem. Last week, Dr Arun Bhaskar, president of the British Pain Society, told The Times: “There are isolated areas in the UK which are as bad as the USA. As a nation we need to wean ourselves off opioids and it needs to start in primary care, with GPs and pharmacists.” 

Other experts support Bhaskar’s view – advocating for greater collaboration between doctors, physiotherapists and clinical psychologists, in helping patients manage long-term pain and reduce their reliance on pills. It is also considered that improving education for healthcare professionals about the long-term effects of opioids could help stem the impact of the problem.

Thankfully, the risk of a US-scale crisis here in the UK still seems an unlikely prospect. However, when the number of deaths associated with prescription drugs is rising by the year in the UK, it is clear that something needs to be done. The lessons learnt from mistakes made overseas must be both examined and heeded, in order to prevent any more people losing their lives to the very drugs that were meant to make them better.

Featured Image via Jonathan Elderfield/AP