Tag Archives: continues

NHS warns patients they could lose text alerts as GDPR deluge continues

The National Health Service is texting patients to warn they could lose alerts about hospital and doctor appointments, joining the deluge of more than 1bn “GDPR” messages currently hitting personal inboxes to meet an EU deadline this week.

GDPR, which stands for General Data Protection Regulation, has been described as the biggest overhaul of online privacy since the birth of the internet, and comes into force on Friday May 25. It gives all EU citizens the right to know what data is stored on them and to have it deleted, plus protect them from privacy and data breaches. If companies fail to comply, they can be hit with fines of up to €20m (£17.5m) or 4% of global turnover.

Companies and organisations around the world – from giant corporations to charities and church groups – are now anxiously contacting users to check they are happy to carry on receiving their emails and texts.

Q&A

What is GDPR?

The European Union’s new stronger, unified data protection laws, the General Data Protection Regulation (GDPR), will come into force on 25 May 2018, after more than six years in the making.

GDPR will replace the current patchwork of national data protection laws, give data regulators greater powers to fine, make it easier for companies with a “one-stop-shop” for operating across the whole of the EU, and create a new pan-European data regulator called the European Data Protection Board.

The new laws govern the processing and storage of EU citizens’ data, both that given to and observed by companies about people, whether or not the company has operations in the EU. They state that data protection should be both by design and default in any operation.

GDPR will refine and enshrine the “right to be forgotten” laws as the “right to erasure”, and give EU citizens the right to data portability, meaning they can take data from one organisation and give it to another. It will also bolster the requirement for explicit and informed consent before data is processed, and ensure that it can be withdrawn at any time.

To ensure companies comply, GDPR also gives data regulators the power to fine up to €20m or 4% of annual global turnover, which is several orders of magnitude larger than previous possible fines. Data breaches must be reported within 72 hours to a data regulator, and affected individuals must be notified unless the data stolen is unreadable, ie strongly encrypted.

Each person in the UK is understood to have about 100 “data relationships” and with many companies sending out multiple reminders, the total number of GDPR emails is expected to soar above one billion by this Friday.

But with GDPR fatigue setting in, and with many messages heading straight into spam boxes, the figures suggest that few people are responding.

Polling by consultancy Accenture has found that more than half of consumers are not responding to emails from brands, with about a third of people deleting the emails almost as soon as they arrive in their inbox.

Some small businesses are reporting that “reconfirmation” rates are averaging just 10%, meaning they are losing 90% of their marketing email lists.

“Up to the deadline you are going to continue to see some panic and mass communications. Then there will be a lull before it begins again, as this is an ongoing requirement,” said Russell Marsh of Accenture. He is forecasting that some companies will return to direct mail to target customers, as it does not fall under the same GDPR legislation.

Many people are enjoying a once in a lifetime opportunity to clear out their inboxes. But while many can be safely ignored, others – such as from the NHS – will need action.

The NHS message reads: “The law is changing and we must get explicit permissions from patients when using their data. To continue to receive SMS text messages, reply START.”

The messages are being sent from the NHS automated appointment reminder system, used by millions of people across the UK. Data rules mean that the messages are sent by each individual NHS trust rather than centrally from the NHS.

Companies are handling the new rules in different ways, as there is no prescribed format for GDPR approval. If a company has a “legitimate interest” in contacting a customer – such as their principal bank account – then it only needs to let the customer know that privacy details have been updated.

But if the email address had been obtained in other ways – such as a pre-ticked box – then that is not regarded as legitimate, and the company has to contact the consumer and obtain approval for further communications. Some companies are insisting users go through the rigmarole of logging in, which might entail trying to remember a password or setting up a new account.

“It will be their interpretation of what they need to do to be compliant,” said Robert Parker at the UK’s Information Commissioner’s Office.

Companies are resorting to ever more desperate ways to catch the eye of users in inboxes deluged with GDPR emails. Many are in the plaintive “Do you still want to hear from us?” style, others warn that “Time is running out”, while some demand “Urgent action required”. Or as one flower delivery company GDPR email says: “Take it or leaf it”.

The fight against polio continues – archive, 16 May 1957

Vaccination against poliomyelitis will this year continue through the summer months. Last year, when it was thought there might be a risk of vaccination increasing an epidemic, the programme was stopped through the summer months but, as the Minister of Health announced to the Commons yesterday, he has taken advice from a joint committee set up by the Central and Scottish Health Services Council that vaccination need not be suspended from risk of provoking paralysis.

In his long and detailed statement the Minister also gave encouraging news of increased production of the vaccine and announced that registration for vaccination will be extended. Last year parents of children born between 1947 and 1954 inclusive were given the chance of registering their children for vaccination.

Of the total number of children 31 per cent or 1,910,000 were so registered and of these about 750.000 have so far been vaccinated. The Minister is hoping that if no further production or testing difficulties are encountered those remaining on the list will have been vaccinated by the end of the summer. He has therefore decided that registration will now be extended first to children born in 1955 and 1956 and then to children born between 1947 and 1954 whose parents did not register them last year.

Second chance

The Minister has thought it wise to give this second chance to parents knowing that when registration was opened last year there were still doubts in many people’s minds. Rather than extend vaccination to other age groups he has thought it best to concentrate on the age group below 10 years-old, which is the most vulnerable to the disease.

Another decision which the Minister announced yesterday was that he will not authorise the importation of the American polio vaccine. The reason is that the British vaccine has a different composition and on every count the Minister considers it safer than the American vaccine while being just as effective.

On the assumption that production and vaccination will continue at the present rate the Minister hopes the children already registered will all have been vaccinated by the end at the summer. In the next batch for registration, the 1955-1956 age group, there are some 1,506,000 children and it is expected that a greater proportion than a third will this time register.


Four months’ figures

The decision not to suspend vaccination was not influenced by the large number of cases reported in the first four months of the year, which is more than in any previous year. The Minister is anxious that there should be no undue alarm at the figures. The figures for the first part of the year are not necessarily a reliable indication of the virulence of any epidemic later in the summer. At present this year the unusually large figures are limited to selected areas in the country.

Though the younger age groups, as the most vulnerable, are to be covered first the Minister will not shut his eyes later on to the need for extending the programme to older children and even to adults.

Prescription of opioid drugs continues to rise in England

Doctors give patients drugs such as tramadol despite risks of addiction and ineffectiveness when treating chronic pain

Tramadol packet


Tramadol was the most commonly prescribed opioid in England from August 2010 to February 2014. Photograph: Jeremy Durkin/Rex Features

The prescription of opioid drugs by GPs in England is steadily rising, especially in more deprived communities, even though they are potentially dangerous and do not work for chronic pain, a new study reveals.

The study shines an alarming new light on the legal use of opioids in England; potentially inappropriate yet sanctioned by doctors. It also reveals a north-south divide. Nine out of 10 of the highest-prescribing regions were in the north. Prescriptions of painkillers were higher in areas of socio-economic deprivation.

Opioids have hit the headlines mainly because of their abuse in the United States. The authors of the study in the British Journal of General Practice, which uses official government data, say opioids are rightly given to people to cope with cancer pain and short-lived acute pain. But as the authors also point out, the widespread prescribing of opioids for people with long-term pain is controversial because “opioids are ineffective in much chronic pain beyond modest effects in the short term”.

Q&A

Why is there an opioid crisis in America?

Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. The majority of these fatalities reveal widespread addiction to powerful prescription painkillers. The crisis unfolded in the mid-90s when the US pharmaceutical industry began marketing legal narcotics, particularly OxyContin, to treat everyday pain. This slow-release opioid was vigorously promoted to doctors and, amid lax regulation and slick sales tactics, people were assured it was safe. But the drug was akin to luxury morphine, doled out like super aspirin, and highly addictive. What resulted was a commercial triumph and a public health tragedy. Belated efforts to rein in distribution fueled a resurgence of heroin and the emergence of a deadly, black market version of the synthetic opioid fentanyl. The crisis is so deep because it affects all races, regions and incomes

They are also potentially dangerous. Luke Mordecai, a pain research fellow at University College London Hospital and the lead author of the study, is calling for a register of all those who are taking the equivalent of more than 120mg of morphine a day. “There should be a national database to keep track of these people,” he said. “There is very high morbidity and mortality [among them], a lot of it avoidable.”

The gold standard, he said, was treatment by a multi-disciplinary team of pain experts, including a specialist consultant, nurse, psychologist and physiotherapist. Yet that is rare: only 40% of pain consultants provide it. Many people could come off opioids altogether with the best care.

Chronic pain is very common. As many as one in seven people have complained of moderate to severely disabling pain and the numbers rise with age. Opioids do not work, but, says the study, many GPs prescribe them because they think it is unethical to refuse their patients painkillers.

The study looks at the total amount prescribed in grams of each of eight common opioid drugs and finds a rise in six of them. Mordecai talked of “a steady increase” but declined to quantify it in percentage terms because of the relatively short time period.

The most prescribed opioid drug in England over the 43 months of the study, from August 2010 to February 2014, was tramadol. It is stronger than over-the-counter codeine but does not have the stigma of the powerful morphine.

“It is not seen as a strong opiate although actually I think it really is,” said Mordecai. “It is the first port of call for troublesome pain but it can become quite addictive.”

Tramadol is implicated in a rising number of deaths due to drug misuse – in Northern Ireland up from 9% to 40% in 2011. In England it was found responsible for 132 deaths in 2010 but 240 in 2014. In that year, it was reclassified as schedule 3 and prescription was limited to one month’s supply at a time. But, the study’s authors note, that failed to work with codeine in Australia. Prescriptions of buprenorphine, oxycodone, codeine and morphine also rose, the study finds. There was a small rise in fentanyl prescription, while prescribing of methadone and dihydrocodeine dropped.

Mordecai said more studies would be needed to find out why prescriptions were highest in more deprived areas and in the north. “We know that chronic pain affects more people of low socio-economic status,” he said. The paper notes that an association has also been found between unemployment and poor outcomes in chronic pain.

“It is something that needs a great deal more work. People of higher socio-economic status might have access to better facilities and ask more questions or want the best treatment possible,” he said.

“This study exposes increasing rates of prescription of a class of drugs whose use for chronic pain is controversial, with potential for abuse, and an association with serious adverse effects and premature death,” concludes the paper. “The authors call on policymakers to identify the reasons for this variation to enable avoidable harm to be addressed.”

Prescription of opioid drugs continues to rise in England

Doctors give patients drugs such as tramadol despite risks of addiction and ineffectiveness when treating chronic pain

Tramadol packet


Tramadol was the most commonly prescribed opioid in England from August 2010 to February 2014. Photograph: Jeremy Durkin/Rex Features

The prescription of opioid drugs by GPs in England is steadily rising, especially in more deprived communities, even though they are potentially dangerous and do not work for chronic pain, a new study reveals.

The study shines an alarming new light on the legal use of opioids in England; potentially inappropriate yet sanctioned by doctors. It also reveals a north-south divide. Nine out of 10 of the highest-prescribing regions were in the north. Prescriptions of painkillers were higher in areas of socio-economic deprivation.

Opioids have hit the headlines mainly because of their abuse in the United States. The authors of the study in the British Journal of General Practice, which uses official government data, say opioids are rightly given to people to cope with cancer pain and short-lived acute pain. But as the authors also point out, the widespread prescribing of opioids for people with long-term pain is controversial because “opioids are ineffective in much chronic pain beyond modest effects in the short term”.

Q&A

Why is there an opioid crisis in America?

Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. The majority of these fatalities reveal widespread addiction to powerful prescription painkillers. The crisis unfolded in the mid-90s when the US pharmaceutical industry began marketing legal narcotics, particularly OxyContin, to treat everyday pain. This slow-release opioid was vigorously promoted to doctors and, amid lax regulation and slick sales tactics, people were assured it was safe. But the drug was akin to luxury morphine, doled out like super aspirin, and highly addictive. What resulted was a commercial triumph and a public health tragedy. Belated efforts to rein in distribution fueled a resurgence of heroin and the emergence of a deadly, black market version of the synthetic opioid fentanyl. The crisis is so deep because it affects all races, regions and incomes

They are also potentially dangerous. Luke Mordecai, a pain research fellow at University College London Hospital and the lead author of the study, is calling for a register of all those who are taking the equivalent of more than 120mg of morphine a day. “There should be a national database to keep track of these people,” he said. “There is very high morbidity and mortality [among them], a lot of it avoidable.”

The gold standard, he said, was treatment by a multi-disciplinary team of pain experts, including a specialist consultant, nurse, psychologist and physiotherapist. Yet that is rare: only 40% of pain consultants provide it. Many people could come off opioids altogether with the best care.

Chronic pain is very common. As many as one in seven people have complained of moderate to severely disabling pain and the numbers rise with age. Opioids do not work, but, says the study, many GPs prescribe them because they think it is unethical to refuse their patients painkillers.

The study looks at the total amount prescribed in grams of each of eight common opioid drugs and finds a rise in six of them. Mordecai talked of “a steady increase” but declined to quantify it in percentage terms because of the relatively short time period.

The most prescribed opioid drug in England over the 43 months of the study, from August 2010 to February 2014, was tramadol. It is stronger than over-the-counter codeine but does not have the stigma of the powerful morphine.

“It is not seen as a strong opiate although actually I think it really is,” said Mordecai. “It is the first port of call for troublesome pain but it can become quite addictive.”

Tramadol is implicated in a rising number of deaths due to drug misuse – in Northern Ireland up from 9% to 40% in 2011. In England it was found responsible for 132 deaths in 2010 but 240 in 2014. In that year, it was reclassified as schedule 3 and prescription was limited to one month’s supply at a time. But, the study’s authors note, that failed to work with codeine in Australia. Prescriptions of buprenorphine, oxycodone, codeine and morphine also rose, the study finds. There was a small rise in fentanyl prescription, while prescribing of methadone and dihydrocodeine dropped.

Mordecai said more studies would be needed to find out why prescriptions were highest in more deprived areas and in the north. “We know that chronic pain affects more people of low socio-economic status,” he said. The paper notes that an association has also been found between unemployment and poor outcomes in chronic pain.

“It is something that needs a great deal more work. People of higher socio-economic status might have access to better facilities and ask more questions or want the best treatment possible,” he said.

“This study exposes increasing rates of prescription of a class of drugs whose use for chronic pain is controversial, with potential for abuse, and an association with serious adverse effects and premature death,” concludes the paper. “The authors call on policymakers to identify the reasons for this variation to enable avoidable harm to be addressed.”

Prescription of opioid drugs continues to rise in England

Doctors give patients drugs such as tramadol despite risks of addiction and ineffectiveness when treating chronic pain

Tramadol packet


Tramadol was the most commonly prescribed opioid in England from August 2010 to February 2014. Photograph: Jeremy Durkin/Rex Features

The prescription of opioid drugs by GPs in England is steadily rising, especially in more deprived communities, even though they are potentially dangerous and do not work for chronic pain, a new study reveals.

The study shines an alarming new light on the legal use of opioids in England; potentially inappropriate yet sanctioned by doctors. It also reveals a north-south divide. Nine out of 10 of the highest-prescribing regions were in the north. Prescriptions of painkillers were higher in areas of socio-economic deprivation.

Opioids have hit the headlines mainly because of their abuse in the United States. The authors of the study in the British Journal of General Practice, which uses official government data, say opioids are rightly given to people to cope with cancer pain and short-lived acute pain. But as the authors also point out, the widespread prescribing of opioids for people with long-term pain is controversial because “opioids are ineffective in much chronic pain beyond modest effects in the short term”.

Q&A

Why is there an opioid crisis in America?

Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. The majority of these fatalities reveal widespread addiction to powerful prescription painkillers. The crisis unfolded in the mid-90s when the US pharmaceutical industry began marketing legal narcotics, particularly OxyContin, to treat everyday pain. This slow-release opioid was vigorously promoted to doctors and, amid lax regulation and slick sales tactics, people were assured it was safe. But the drug was akin to luxury morphine, doled out like super aspirin, and highly addictive. What resulted was a commercial triumph and a public health tragedy. Belated efforts to rein in distribution fueled a resurgence of heroin and the emergence of a deadly, black market version of the synthetic opioid fentanyl. The crisis is so deep because it affects all races, regions and incomes

They are also potentially dangerous. Luke Mordecai, a pain research fellow at University College London Hospital and the lead author of the study, is calling for a register of all those who are taking the equivalent of more than 120mg of morphine a day. “There should be a national database to keep track of these people,” he said. “There is very high morbidity and mortality [among them], a lot of it avoidable.”

The gold standard, he said, was treatment by a multi-disciplinary team of pain experts, including a specialist consultant, nurse, psychologist and physiotherapist. Yet that is rare: only 40% of pain consultants provide it. Many people could come off opioids altogether with the best care.

Chronic pain is very common. As many as one in seven people have complained of moderate to severely disabling pain and the numbers rise with age. Opioids do not work, but, says the study, many GPs prescribe them because they think it is unethical to refuse their patients painkillers.

The study looks at the total amount prescribed in grams of each of eight common opioid drugs and finds a rise in six of them. Mordecai talked of “a steady increase” but declined to quantify it in percentage terms because of the relatively short time period.

The most prescribed opioid drug in England over the 43 months of the study, from August 2010 to February 2014, was tramadol. It is stronger than over-the-counter codeine but does not have the stigma of the powerful morphine.

“It is not seen as a strong opiate although actually I think it really is,” said Mordecai. “It is the first port of call for troublesome pain but it can become quite addictive.”

Tramadol is implicated in a rising number of deaths due to drug misuse – in Northern Ireland up from 9% to 40% in 2011. In England it was found responsible for 132 deaths in 2010 but 240 in 2014. In that year, it was reclassified as schedule 3 and prescription was limited to one month’s supply at a time. But, the study’s authors note, that failed to work with codeine in Australia. Prescriptions of buprenorphine, oxycodone, codeine and morphine also rose, the study finds. There was a small rise in fentanyl prescription, while prescribing of methadone and dihydrocodeine dropped.

Mordecai said more studies would be needed to find out why prescriptions were highest in more deprived areas and in the north. “We know that chronic pain affects more people of low socio-economic status,” he said. The paper notes that an association has also been found between unemployment and poor outcomes in chronic pain.

“It is something that needs a great deal more work. People of higher socio-economic status might have access to better facilities and ask more questions or want the best treatment possible,” he said.

“This study exposes increasing rates of prescription of a class of drugs whose use for chronic pain is controversial, with potential for abuse, and an association with serious adverse effects and premature death,” concludes the paper. “The authors call on policymakers to identify the reasons for this variation to enable avoidable harm to be addressed.”

Prescription of opioid drugs continues to rise in England

Doctors give patients drugs such as tramadol despite risks of addiction and ineffectiveness when treating chronic pain

Tramadol packet


Tramadol was the most commonly prescribed opioid in England from August 2010 to February 2014. Photograph: Jeremy Durkin/Rex Features

The prescription of opioid drugs by GPs in England is steadily rising, especially in more deprived communities, even though they are potentially dangerous and do not work for chronic pain, a new study reveals.

The study shines an alarming new light on the legal use of opioids in England; potentially inappropriate yet sanctioned by doctors. It also reveals a north-south divide. Nine out of 10 of the highest-prescribing regions were in the north. Prescriptions of painkillers were higher in areas of socio-economic deprivation.

Opioids have hit the headlines mainly because of their abuse in the United States. The authors of the study in the British Journal of General Practice, which uses official government data, say opioids are rightly given to people to cope with cancer pain and short-lived acute pain. But as the authors also point out, the widespread prescribing of opioids for people with long-term pain is controversial because “opioids are ineffective in much chronic pain beyond modest effects in the short term”.

Q&A

Why is there an opioid crisis in America?

Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. The majority of these fatalities reveal widespread addiction to powerful prescription painkillers. The crisis unfolded in the mid-90s when the US pharmaceutical industry began marketing legal narcotics, particularly OxyContin, to treat everyday pain. This slow-release opioid was vigorously promoted to doctors and, amid lax regulation and slick sales tactics, people were assured it was safe. But the drug was akin to luxury morphine, doled out like super aspirin, and highly addictive. What resulted was a commercial triumph and a public health tragedy. Belated efforts to rein in distribution fueled a resurgence of heroin and the emergence of a deadly, black market version of the synthetic opioid fentanyl. The crisis is so deep because it affects all races, regions and incomes

They are also potentially dangerous. Luke Mordecai, a pain research fellow at University College London Hospital and the lead author of the study, is calling for a register of all those who are taking the equivalent of more than 120mg of morphine a day. “There should be a national database to keep track of these people,” he said. “There is very high morbidity and mortality [among them], a lot of it avoidable.”

The gold standard, he said, was treatment by a multi-disciplinary team of pain experts, including a specialist consultant, nurse, psychologist and physiotherapist. Yet that is rare: only 40% of pain consultants provide it. Many people could come off opioids altogether with the best care.

Chronic pain is very common. As many as one in seven people have complained of moderate to severely disabling pain and the numbers rise with age. Opioids do not work, but, says the study, many GPs prescribe them because they think it is unethical to refuse their patients painkillers.

The study looks at the total amount prescribed in grams of each of eight common opioid drugs and finds a rise in six of them. Mordecai talked of “a steady increase” but declined to quantify it in percentage terms because of the relatively short time period.

The most prescribed opioid drug in England over the 43 months of the study, from August 2010 to February 2014, was tramadol. It is stronger than over-the-counter codeine but does not have the stigma of the powerful morphine.

“It is not seen as a strong opiate although actually I think it really is,” said Mordecai. “It is the first port of call for troublesome pain but it can become quite addictive.”

Tramadol is implicated in a rising number of deaths due to drug misuse – in Northern Ireland up from 9% to 40% in 2011. In England it was found responsible for 132 deaths in 2010 but 240 in 2014. In that year, it was reclassified as schedule 3 and prescription was limited to one month’s supply at a time. But, the study’s authors note, that failed to work with codeine in Australia. Prescriptions of buprenorphine, oxycodone, codeine and morphine also rose, the study finds. There was a small rise in fentanyl prescription, while prescribing of methadone and dihydrocodeine dropped.

Mordecai said more studies would be needed to find out why prescriptions were highest in more deprived areas and in the north. “We know that chronic pain affects more people of low socio-economic status,” he said. The paper notes that an association has also been found between unemployment and poor outcomes in chronic pain.

“It is something that needs a great deal more work. People of higher socio-economic status might have access to better facilities and ask more questions or want the best treatment possible,” he said.

“This study exposes increasing rates of prescription of a class of drugs whose use for chronic pain is controversial, with potential for abuse, and an association with serious adverse effects and premature death,” concludes the paper. “The authors call on policymakers to identify the reasons for this variation to enable avoidable harm to be addressed.”

Prescription of opioid drugs continues to rise in England

Doctors give patients drugs such as tramadol despite risks of addiction and ineffectiveness when treating chronic pain

Tramadol packet


Tramadol was the most commonly prescribed opioid in England from August 2010 to February 2014. Photograph: Jeremy Durkin/Rex Features

The prescription of opioid drugs by GPs in England is steadily rising, especially in more deprived communities, even though they are potentially dangerous and do not work for chronic pain, a new study reveals.

The study shines an alarming new light on the legal use of opioids in England; potentially inappropriate yet sanctioned by doctors. It also reveals a north-south divide. Nine out of 10 of the highest-prescribing regions were in the north. Prescriptions of painkillers were higher in areas of socio-economic deprivation.

Opioids have hit the headlines mainly because of their abuse in the United States. The authors of the study in the British Journal of General Practice, which uses official government data, say opioids are rightly given to people to cope with cancer pain and short-lived acute pain. But as the authors also point out, the widespread prescribing of opioids for people with long-term pain is controversial because “opioids are ineffective in much chronic pain beyond modest effects in the short term”.

Q&A

Why is there an opioid crisis in America?

Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. The majority of these fatalities reveal widespread addiction to powerful prescription painkillers. The crisis unfolded in the mid-90s when the US pharmaceutical industry began marketing legal narcotics, particularly OxyContin, to treat everyday pain. This slow-release opioid was vigorously promoted to doctors and, amid lax regulation and slick sales tactics, people were assured it was safe. But the drug was akin to luxury morphine, doled out like super aspirin, and highly addictive. What resulted was a commercial triumph and a public health tragedy. Belated efforts to rein in distribution fueled a resurgence of heroin and the emergence of a deadly, black market version of the synthetic opioid fentanyl. The crisis is so deep because it affects all races, regions and incomes

They are also potentially dangerous. Luke Mordecai, a pain research fellow at University College London Hospital and the lead author of the study, is calling for a register of all those who are taking the equivalent of more than 120mg of morphine a day. “There should be a national database to keep track of these people,” he said. “There is very high morbidity and mortality [among them], a lot of it avoidable.”

The gold standard, he said, was treatment by a multi-disciplinary team of pain experts, including a specialist consultant, nurse, psychologist and physiotherapist. Yet that is rare: only 40% of pain consultants provide it. Many people could come off opioids altogether with the best care.

Chronic pain is very common. As many as one in seven people have complained of moderate to severely disabling pain and the numbers rise with age. Opioids do not work, but, says the study, many GPs prescribe them because they think it is unethical to refuse their patients painkillers.

The study looks at the total amount prescribed in grams of each of eight common opioid drugs and finds a rise in six of them. Mordecai talked of “a steady increase” but declined to quantify it in percentage terms because of the relatively short time period.

The most prescribed opioid drug in England over the 43 months of the study, from August 2010 to February 2014, was tramadol. It is stronger than over-the-counter codeine but does not have the stigma of the powerful morphine.

“It is not seen as a strong opiate although actually I think it really is,” said Mordecai. “It is the first port of call for troublesome pain but it can become quite addictive.”

Tramadol is implicated in a rising number of deaths due to drug misuse – in Northern Ireland up from 9% to 40% in 2011. In England it was found responsible for 132 deaths in 2010 but 240 in 2014. In that year, it was reclassified as schedule 3 and prescription was limited to one month’s supply at a time. But, the study’s authors note, that failed to work with codeine in Australia. Prescriptions of buprenorphine, oxycodone, codeine and morphine also rose, the study finds. There was a small rise in fentanyl prescription, while prescribing of methadone and dihydrocodeine dropped.

Mordecai said more studies would be needed to find out why prescriptions were highest in more deprived areas and in the north. “We know that chronic pain affects more people of low socio-economic status,” he said. The paper notes that an association has also been found between unemployment and poor outcomes in chronic pain.

“It is something that needs a great deal more work. People of higher socio-economic status might have access to better facilities and ask more questions or want the best treatment possible,” he said.

“This study exposes increasing rates of prescription of a class of drugs whose use for chronic pain is controversial, with potential for abuse, and an association with serious adverse effects and premature death,” concludes the paper. “The authors call on policymakers to identify the reasons for this variation to enable avoidable harm to be addressed.”

Prescription of opioid drugs continues to rise in England

Doctors give patients drugs such as tramadol despite risks of addiction and ineffectiveness when treating chronic pain

Tramadol packet


Tramadol was the most commonly prescribed opioid in England from August 2010 to February 2014. Photograph: Jeremy Durkin/Rex Features

The prescription of opioid drugs by GPs in England is steadily rising, especially in more deprived communities, even though they are potentially dangerous and do not work for chronic pain, a new study reveals.

The study shines an alarming new light on the legal use of opioids in England; potentially inappropriate yet sanctioned by doctors. It also reveals a north-south divide. Nine out of 10 of the highest-prescribing regions were in the north. Prescriptions of painkillers were higher in areas of socio-economic deprivation.

Opioids have hit the headlines mainly because of their abuse in the United States. The authors of the study in the British Journal of General Practice, which uses official government data, say opioids are rightly given to people to cope with cancer pain and short-lived acute pain. But as the authors also point out, the widespread prescribing of opioids for people with long-term pain is controversial because “opioids are ineffective in much chronic pain beyond modest effects in the short term”.

Q&A

Why is there an opioid crisis in America?

Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. The majority of these fatalities reveal widespread addiction to powerful prescription painkillers. The crisis unfolded in the mid-90s when the US pharmaceutical industry began marketing legal narcotics, particularly OxyContin, to treat everyday pain. This slow-release opioid was vigorously promoted to doctors and, amid lax regulation and slick sales tactics, people were assured it was safe. But the drug was akin to luxury morphine, doled out like super aspirin, and highly addictive. What resulted was a commercial triumph and a public health tragedy. Belated efforts to rein in distribution fueled a resurgence of heroin and the emergence of a deadly, black market version of the synthetic opioid fentanyl. The crisis is so deep because it affects all races, regions and incomes

They are also potentially dangerous. Luke Mordecai, a pain research fellow at University College London Hospital and the lead author of the study, is calling for a register of all those who are taking the equivalent of more than 120mg of morphine a day. “There should be a national database to keep track of these people,” he said. “There is very high morbidity and mortality [among them], a lot of it avoidable.”

The gold standard, he said, was treatment by a multi-disciplinary team of pain experts, including a specialist consultant, nurse, psychologist and physiotherapist. Yet that is rare: only 40% of pain consultants provide it. Many people could come off opioids altogether with the best care.

Chronic pain is very common. As many as one in seven people have complained of moderate to severely disabling pain and the numbers rise with age. Opioids do not work, but, says the study, many GPs prescribe them because they think it is unethical to refuse their patients painkillers.

The study looks at the total amount prescribed in grams of each of eight common opioid drugs and finds a rise in six of them. Mordecai talked of “a steady increase” but declined to quantify it in percentage terms because of the relatively short time period.

The most prescribed opioid drug in England over the 43 months of the study, from August 2010 to February 2014, was tramadol. It is stronger than over-the-counter codeine but does not have the stigma of the powerful morphine.

“It is not seen as a strong opiate although actually I think it really is,” said Mordecai. “It is the first port of call for troublesome pain but it can become quite addictive.”

Tramadol is implicated in a rising number of deaths due to drug misuse – in Northern Ireland up from 9% to 40% in 2011. In England it was found responsible for 132 deaths in 2010 but 240 in 2014. In that year, it was reclassified as schedule 3 and prescription was limited to one month’s supply at a time. But, the study’s authors note, that failed to work with codeine in Australia. Prescriptions of buprenorphine, oxycodone, codeine and morphine also rose, the study finds. There was a small rise in fentanyl prescription, while prescribing of methadone and dihydrocodeine dropped.

Mordecai said more studies would be needed to find out why prescriptions were highest in more deprived areas and in the north. “We know that chronic pain affects more people of low socio-economic status,” he said. The paper notes that an association has also been found between unemployment and poor outcomes in chronic pain.

“It is something that needs a great deal more work. People of higher socio-economic status might have access to better facilities and ask more questions or want the best treatment possible,” he said.

“This study exposes increasing rates of prescription of a class of drugs whose use for chronic pain is controversial, with potential for abuse, and an association with serious adverse effects and premature death,” concludes the paper. “The authors call on policymakers to identify the reasons for this variation to enable avoidable harm to be addressed.”

Prescription of opioid drugs continues to rise in England

Doctors give patients drugs such as tramadol despite risks of addiction and ineffectiveness when treating chronic pain

Tramadol packet


Tramadol was the most commonly prescribed opioid in England from August 2010 to February 2014. Photograph: Jeremy Durkin/Rex Features

The prescription of opioid drugs by GPs in England is steadily rising, especially in more deprived communities, even though they are potentially dangerous and do not work for chronic pain, a new study reveals.

The study shines an alarming new light on the legal use of opioids in England; potentially inappropriate yet sanctioned by doctors. It also reveals a north-south divide. Nine out of 10 of the highest-prescribing regions were in the north. Prescriptions of painkillers were higher in areas of socio-economic deprivation.

Opioids have hit the headlines mainly because of their abuse in the United States. The authors of the study in the British Journal of General Practice, which uses official government data, say opioids are rightly given to people to cope with cancer pain and short-lived acute pain. But as the authors also point out, the widespread prescribing of opioids for people with long-term pain is controversial because “opioids are ineffective in much chronic pain beyond modest effects in the short term”.

Q&A

Why is there an opioid crisis in America?

Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. The majority of these fatalities reveal widespread addiction to powerful prescription painkillers. The crisis unfolded in the mid-90s when the US pharmaceutical industry began marketing legal narcotics, particularly OxyContin, to treat everyday pain. This slow-release opioid was vigorously promoted to doctors and, amid lax regulation and slick sales tactics, people were assured it was safe. But the drug was akin to luxury morphine, doled out like super aspirin, and highly addictive. What resulted was a commercial triumph and a public health tragedy. Belated efforts to rein in distribution fueled a resurgence of heroin and the emergence of a deadly, black market version of the synthetic opioid fentanyl. The crisis is so deep because it affects all races, regions and incomes

They are also potentially dangerous. Luke Mordecai, a pain research fellow at University College London Hospital and the lead author of the study, is calling for a register of all those who are taking the equivalent of more than 120mg of morphine a day. “There should be a national database to keep track of these people,” he said. “There is very high morbidity and mortality [among them], a lot of it avoidable.”

The gold standard, he said, was treatment by a multi-disciplinary team of pain experts, including a specialist consultant, nurse, psychologist and physiotherapist. Yet that is rare: only 40% of pain consultants provide it. Many people could come off opioids altogether with the best care.

Chronic pain is very common. As many as one in seven people have complained of moderate to severely disabling pain and the numbers rise with age. Opioids do not work, but, says the study, many GPs prescribe them because they think it is unethical to refuse their patients painkillers.

The study looks at the total amount prescribed in grams of each of eight common opioid drugs and finds a rise in six of them. Mordecai talked of “a steady increase” but declined to quantify it in percentage terms because of the relatively short time period.

The most prescribed opioid drug in England over the 43 months of the study, from August 2010 to February 2014, was tramadol. It is stronger than over-the-counter codeine but does not have the stigma of the powerful morphine.

“It is not seen as a strong opiate although actually I think it really is,” said Mordecai. “It is the first port of call for troublesome pain but it can become quite addictive.”

Tramadol is implicated in a rising number of deaths due to drug misuse – in Northern Ireland up from 9% to 40% in 2011. In England it was found responsible for 132 deaths in 2010 but 240 in 2014. In that year, it was reclassified as schedule 3 and prescription was limited to one month’s supply at a time. But, the study’s authors note, that failed to work with codeine in Australia. Prescriptions of buprenorphine, oxycodone, codeine and morphine also rose, the study finds. There was a small rise in fentanyl prescription, while prescribing of methadone and dihydrocodeine dropped.

Mordecai said more studies would be needed to find out why prescriptions were highest in more deprived areas and in the north. “We know that chronic pain affects more people of low socio-economic status,” he said. The paper notes that an association has also been found between unemployment and poor outcomes in chronic pain.

“It is something that needs a great deal more work. People of higher socio-economic status might have access to better facilities and ask more questions or want the best treatment possible,” he said.

“This study exposes increasing rates of prescription of a class of drugs whose use for chronic pain is controversial, with potential for abuse, and an association with serious adverse effects and premature death,” concludes the paper. “The authors call on policymakers to identify the reasons for this variation to enable avoidable harm to be addressed.”

Prescription of opioid drugs continues to rise in England

Doctors give patients drugs such as tramadol despite risks of addiction and ineffectiveness when treating chronic pain

Tramadol packet


Tramadol was the most commonly prescribed opioid in England from August 2010 to February 2014. Photograph: Jeremy Durkin/Rex Features

The prescription of opioid drugs by GPs in England is steadily rising, especially in more deprived communities, even though they are potentially dangerous and do not work for chronic pain, a new study reveals.

The study shines an alarming new light on the legal use of opioids in England; potentially inappropriate yet sanctioned by doctors. It also reveals a north-south divide. Nine out of 10 of the highest-prescribing regions were in the north. Prescriptions of painkillers were higher in areas of socio-economic deprivation.

Opioids have hit the headlines mainly because of their abuse in the United States. The authors of the study in the British Journal of General Practice, which uses official government data, say opioids are rightly given to people to cope with cancer pain and short-lived acute pain. But as the authors also point out, the widespread prescribing of opioids for people with long-term pain is controversial because “opioids are ineffective in much chronic pain beyond modest effects in the short term”.

Q&A

Why is there an opioid crisis in America?

Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. The majority of these fatalities reveal widespread addiction to powerful prescription painkillers. The crisis unfolded in the mid-90s when the US pharmaceutical industry began marketing legal narcotics, particularly OxyContin, to treat everyday pain. This slow-release opioid was vigorously promoted to doctors and, amid lax regulation and slick sales tactics, people were assured it was safe. But the drug was akin to luxury morphine, doled out like super aspirin, and highly addictive. What resulted was a commercial triumph and a public health tragedy. Belated efforts to rein in distribution fueled a resurgence of heroin and the emergence of a deadly, black market version of the synthetic opioid fentanyl. The crisis is so deep because it affects all races, regions and incomes

They are also potentially dangerous. Luke Mordecai, a pain research fellow at University College London Hospital and the lead author of the study, is calling for a register of all those who are taking the equivalent of more than 120mg of morphine a day. “There should be a national database to keep track of these people,” he said. “There is very high morbidity and mortality [among them], a lot of it avoidable.”

The gold standard, he said, was treatment by a multi-disciplinary team of pain experts, including a specialist consultant, nurse, psychologist and physiotherapist. Yet that is rare: only 40% of pain consultants provide it. Many people could come off opioids altogether with the best care.

Chronic pain is very common. As many as one in seven people have complained of moderate to severely disabling pain and the numbers rise with age. Opioids do not work, but, says the study, many GPs prescribe them because they think it is unethical to refuse their patients painkillers.

The study looks at the total amount prescribed in grams of each of eight common opioid drugs and finds a rise in six of them. Mordecai talked of “a steady increase” but declined to quantify it in percentage terms because of the relatively short time period.

The most prescribed opioid drug in England over the 43 months of the study, from August 2010 to February 2014, was tramadol. It is stronger than over-the-counter codeine but does not have the stigma of the powerful morphine.

“It is not seen as a strong opiate although actually I think it really is,” said Mordecai. “It is the first port of call for troublesome pain but it can become quite addictive.”

Tramadol is implicated in a rising number of deaths due to drug misuse – in Northern Ireland up from 9% to 40% in 2011. In England it was found responsible for 132 deaths in 2010 but 240 in 2014. In that year, it was reclassified as schedule 3 and prescription was limited to one month’s supply at a time. But, the study’s authors note, that failed to work with codeine in Australia. Prescriptions of buprenorphine, oxycodone, codeine and morphine also rose, the study finds. There was a small rise in fentanyl prescription, while prescribing of methadone and dihydrocodeine dropped.

Mordecai said more studies would be needed to find out why prescriptions were highest in more deprived areas and in the north. “We know that chronic pain affects more people of low socio-economic status,” he said. The paper notes that an association has also been found between unemployment and poor outcomes in chronic pain.

“It is something that needs a great deal more work. People of higher socio-economic status might have access to better facilities and ask more questions or want the best treatment possible,” he said.

“This study exposes increasing rates of prescription of a class of drugs whose use for chronic pain is controversial, with potential for abuse, and an association with serious adverse effects and premature death,” concludes the paper. “The authors call on policymakers to identify the reasons for this variation to enable avoidable harm to be addressed.”