Opioid Prescribing vs Drug Misuse Patterns

This week’s Pharmaceutical Journal has an interesting piece on a study published in another journal about patterns of opioid prescribing in relation to social deprivation levels.

The paper outlines the work of researchers who “used publicly available data from 2015 to calculate the total amount of opioid prescriptions dispensed for each practice and analysed it alongside data from the Index of Multiple Deprivation (IMD), a UK government qualitative study of deprived areas in England.”

Their findings were that, “opioid prescribing in general practice is highest in North West England and the East Midlands, mirroring general geographical health inequalities.” In other words, there appears to be a correlation between poverty and the prescribing of opioids.

At first glance there is a temptation to attribute this to a higher level of illicit drug use among economically deprived populations. However, when you look up the rates of mortality from illicit drug use and accidental drug poisoning you get the following picture:

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This shows that the two areas with the highest level of opioid prescribing are actually on opposite ends of the scale in terms of drug misuse deaths. It would therefore be false to assert that high levels of opioid prescribing in socially deprived areas are a result of higher level of drug misuse.

It is no wonder that the authors of the original paper admit to not knowing the reasons for the observed patterns and highlight the need for further studies to ascertain the causes.