Recent NHS figures reveal that spending on dependency-forming medicines in England continues to fall, offering a clearer picture of progress in managing the use and cost of these drugs. NHS Business Services Authority’s (NHSBSA) latest quarterly data covering October to December 2024 show not only a further reduction in overall spend but also ongoing changes in prescription patterns for opioid pain medicine and related medications. Here’s a comprehensive look at what the latest findings mean for patients, practitioners, and public health.

Dependency-Forming Medicines and NHS Costs: A Downward Trend

The cost of dependency-forming medicines—including opioid pain medicine, benzodiazepines, and gabapentinoids—is showing a consistent decline. The NHS report indicates that in the last quarter of 2024 alone, spending dropped by £2 million, bringing the total to £91.1 million. That’s a 2.6% decrease compared to £93.5 million during the previous three months.

This reduction is part of a much larger trend. Since 2015/16, the NHS in England has reduced its outlay on these potentially addictive medicines by 52%. Such long-term change reflects both increased awareness and targeted action by health professionals.

Opioid Pain Medicine Remains the Most Prescribed

Despite the overall drop in costs, opioid pain medicine remains the most commonly prescribed dependency-forming medicine in England. During the last quarter of 2024, NHS clinicians prescribed 9.86 million items of opioid pain treatments, accounting for £67.3 million of the total spend.

Who Receives Dependency-Forming Medicines?

The latest NHS data identified 4.39 million patients who received prescriptions for dependency-forming medicines during this quarter. While the reduction from the previous quarter (4.40 million) is modest at 0.16%, it marks a continued move in the right direction.

The report reveals that 288,000 female patients aged 60 to 64 are the group most likely to receive these medicines. It tracks opioids, benzodiazepines, gabapentinoids, and Z-drugs, explicitly excluding antidepressants.

Health Inequality in Usage Persists

One concerning aspect of dependency-forming medicines is the clear divide between different communities. NHS data reveals that patients in the most deprived areas are 78.5% more likely to receive prescriptions for these drugs than those in the least deprived parts of England.

This disparity suggests deep-rooted health inequalities, as well as wider issues around chronic pain, mental health, and access to non-drug therapies. It’s a reminder that, while overall dependency-forming medicines use is falling, targeted work remains essential.

Why Is NHS Tracking Dependency-Forming Medicines?

Since a significant 2019 Public Health England review revealed that one in four adults were being prescribed medicines with addiction risks, including opioids, NHSBSA has monitored these medications in primary care. They aim to better understand changing prescription patterns and identify where interventions succeed or where new steps are necessary.

Shifts in Prescribing Policy and Alternative Treatments

Following the 2019 review, NHS England urged GPs to explore alternative therapies—including psychotherapy, sleep clinics, and community-based activities—for conditions like chronic pain and insomnia before prescribing opioids or other dependency-forming medicines.

Efforts are showing results. By 2023, opioid prescription numbers had already dropped by 450,000 within four years, helping prevent over 2,100 potential cases of patient harm. These changes reflect an important cultural shift in clinical practice.

Innovative Approaches Making a Difference

A notable example comes from GP-led trials in the North East and Midlands, where a programme combining dose tapering, group meetings, and alternative pain management therapies helped one in five patients quit opioid prescriptions in just one year. These results showcase that with proper support, many individuals can transition away from long-term reliance on dependency-forming medicines.

Guidance on Safe Prescribing and Withdrawal Management

The National Institute for Health and Care Excellence (NICE) has also played a role in shaping safer prescribing practices. Their guidance now clearly defines which drugs are considered dependency-forming and recommends that GPs regularly review patients on long-term opioids or similar drugs. While not classed as dependency-forming, NICE emphasizes managing antidepressant withdrawal carefully, as these medicines can still cause withdrawal symptoms for some patients.

New Research Highlights Patterns and Concerns

Research published in late 2023 concluded that more than three-quarters of new opioid pain medicine prescriptions for non-cancer pain are for musculoskeletal conditions. This is despite limited evidence that opioids offer long-term relief for such problems.

The findings highlight a need for continued education and more robust guidelines to support prescribers and patients making informed choices, especially when safer or more effective alternatives may exist.

Source: Pulse Today