Around four times as many high-dose opioid painkillers are prescribed in the North East and Yorkshire compared to London, amid reports highlighting a "North-South Divide" in use of the addictive pills.
The figures come from the Open Prescribing website - and show that the North East and North Cumbria (NENC) NHS area has seen among the highest levels of opioid prescribing in the country. Opioids include drugs like morphine and tramadol, with illegal opioids including heroin. This comes as health experts highlight the link between deprivation and chronic pain.
According to the site, while the practice has fallen since 2017, the area covered by the NENC Integrated Care Board remains among the worst 10% of areas for prescribing opiates. And there are also worryingly high levels of prescribing of an alternative - pregabalin - which "can produce feelings of euphoria, relaxation and calmness" and exacerbate the effects of opioids, according to advice website Talk To Frank.
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In the North East and Yorkshire, according to Open Prescribing there are 1.421 "high dose opioids" prescribed per 1,000 patients. In London, the equivalent figure is 0.347. In County Durham, the 14th highest 'sub Integrated Care Board' area, the figure is 1.698.
By "high dose opioids" the data refers to "Opioids with likely daily dose of ≥120mg morphine equivalence per 1000 patients". This is based on the fact that, according to the Opioids Aware safety campaign, "the risk of harm increases significantly above 120mg morphine (or equivalent) per day, without much increase in benefit".
In a Sky News investigation which has highlighted the scale of the problem, two County Durham women - Justine Grant and Cheryl Parker - housed by the charity Positive Directions in County Durham revealed how they had become addicted to the drugs. Justine even turned to drug dealers to top up her prescriptions. Representatives from the charity, which works to help house vulnerable people, warned the problem was a "time bomb" exerting a heavy toll on the region.
According to the report, Ms Grant beat a heroin addiction and had been clean for 12 years - but said she had found prescription drugs even harder to kick. She said: "I said I need something like ibuprofen but maybe a bit stronger, and that's when they prescribed us the pregabalin. It's very, very addictive. More addictive than anything I've taken in my lifetime."
"I immediately got addicted to one of those a day, and then two and then three and then four. Up until I was taking ten a day. I don't know how I'm alive."
Ms Parker said at one stage she had been prescribed 100 codeine pills every three days, and added: "I used to have an inhaler down the side of my bed every night. I used to just be panicking. What would I do if I don't wake up? My little girl's there, what's she going to do?"
High levels of opioid prescribing have long been a cause for concern in the North East. The Academic Health Sciences Network in the North East and North Cumbria runs the Campaign to Reduce Opioid Prescribing, while the region's senior NHS pharmacist Ewan Maule told Sky there was a link between poverty and chronic pain, though doctors and pharmacists needed to "re-educate themselves" about the issue.
Professor Julia Newton, from the Newcastle Hospitals NHS Trust, said: "We need to take notice that we're an outlier in this area and begin to look at why that might be. Primary care is overwhelmed at the moment, time is very precious in short GP consultations. And I think sometimes it might just be easier when a patient wants a tablet, for a GP to prescribe or to continue to prescribe a medication."
In December 2020, research from the University of Manchester published in the journal Epidemiology and Communality Health found "Prescribing in the most deprived areas in North England was 1.2 times higher than the national average for areas with similar deprivation levels and 3.3 times higher than the most deprived areas in London."
In the North East, according to research from the Heath Foundation, chronic pain, alcohol problems, COPD and cardiovascular disease are the key conditions which account for the huge inequality which makes the North East the least healthy region in England.
Mr Maule told Sky News: "The conversation is changing and we are starting to talk about non-drug treatments, non-medicines for treatment of chronic pain, because we know the harm that can be done by opioids certainly long-term, outweighs the benefits.
"We all need to re-educate ourselves. People like me, who were educated 20 years ago, need to change the way we think about things."
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