Opioid analgesics

(Note: For Tramadol information specifically please the DrugWatch Tramadol factsheet)
DrugWatch are an informal online professional network established by a group of professionals working in the UK and Irish drugs sector, including DrugWise.)

An analgesic is a pain-killing drug. There are three main types:

  • non-opioid medications such as aspirin, paracetamol and nonsteroidal anti-inflammatory agents like ibuprofen. These are over the counter medicines for mild to moderate pain.
  • Compound analgesics such as co-codamol. Some of the milder forms can be obtained over the counter but stronger types are available on prescription only.
  • Opioid analgesics such as codeine, tramadol, morphine, buprenorphine, fentanyl, oxycodone and dihydrocodeine. These strong painkillers are for moderate to severe pain and are prescription only medicines. They work by mimicking the effects of the body’s natural painkillers – endorphins – namely by blocking the pain signals sent from the nerves to the brain.

Problems relating to opioid analgesics

Opioid analgesics are now the most commonly prescribed drugs in the United States. According to statistics from the National Institute on Drug Abuse (NIDA), in 2014 U.S. pharmacies dispensed 245 million prescriptions for these drugs.

In recent years misuse of prescribed opioids has become a major problem in the US. Opioid analgesics are diverted from medical supplies and their widespread use has resulted in a national epidemic of opioid overdose deaths and addictions. 37% of the 44,000 drug-overdose deaths that were reported in 2013 in the US were attributable to pharmaceutical opioids – compared with 19% for heroin.

At the same time, according to the SAMHSA’s National Survey on Drug Use there has been a parallel increase in the rate of opioid addiction, affecting approximately 2.5 million adults in 2014.

In March 2016 the US Food and Drug Administration announced new safety warnings were to be added to all prescription opioid analgesics to help inform doctors and patients of the dependence risks of these drugs.

UK situation

In September 2019, PHE published a report on the evidence for dependence on, and withdrawal from, prescribed medicines, including opioid analgesics.

PHE’s analysis shows that, in 2017 to 2018, 5.6 million people (13% of the population) received a prescription for an opioid pain medicine. After a long increasing trend, the annual number of prescriptions for opioid pain medicines has slightly decreased since 2016 in the UK.

Recreational use

In addition, there appears be a growing cohort of users taking these drugs for recreational purposes. The 2015/16 Home Office survey of drug use estimated that in the last year 7.5% of adults aged 16 to 59 had taken a prescription-only painkiller not prescribed to them: 7.4% (around 2.4 million adults) said they had taken the painkillers purely for medical reasons, while a small proportion (0.2%, or 33,000 adults) said it was just for the feeling or experience it gave them. A further very small number of adults said it was for both. This tendency was also true for young adults aged 16 to 24.

For more information on this topic please see our page on prescribed & OTC drug dependence




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