Addiction to prescription drugs in Northern Ireland 'at epidemic levels'
Northern Ireland is in the grip of a deadly addiction to prescription medication, it can be revealed today.
More than 193,000 prescriptions were handed out here for the painkiller tramadol in 2016 - a rate of 529 a day - costing almost £2m.
A further 165,759 prescriptions for epilepsy drug gabapentin were written by doctors over the 12-month period, while almost 44,500 prescriptions for Lyrica were given out in 2016, at a cost to the health service of £3.87m.
Alex Bunting from Addiction NI said urgent action was needed to address growing prescription drug abuse, which he said was killing people across Northern Ireland.
According to official figures, there were 842 deaths where prescription drugs were mentioned on the death certificate here between 2006 and 2016 - 56 more than the number of deaths as a result of illegal drugs, including ecstasy and cocaine.
The number of fatalities as a result of prescription drugs rose steadily over the 10-year period, according to the Northern Ireland Statistics and Research Agency (NISRA).
The number of people who overdosed on diazepam tripled between 2006 and 2016 from 20 to 60, while the number of people who died after taking Lyrica, also known as pregablin, increased from zero in 2006 to eight in 2016.
"The fact is, people are dying after becoming addicted to prescription drugs," explained Mr Bunting.
"They are destroying lives, relationships, families.
"All you have to do is look at the figures - you have 461 people with benzodiazepines on their death certificate between 2006 and 2016 and 46 deaths where cocaine was mentioned.
"Some of these prescription drugs are 50 to 100 times stronger than heroin.
"You might have someone starting off taking something like co-codamol and ending up hooked on the likes of heroin.
"We have a guy who uses our services who had a slipped disc in his back and started off on codeine.
Fast-forward a couple of years and he was using morphine patches and smoking heroin.
"This is someone who has moved through the hierarchy of medication from something that appears quite harmless to the other end of the scale."
Dr Lisa Nelligan, a GP at Kingsbridge Private Hospital, said spiralling hospital waiting lists were playing a huge part in the growing number of people taking prescription painkillers.
She said GPs were frequently forced to prescribe medication to patients to manage debilitating conditions as they face waits of up to five years for operations, such as hip replacements.
"These are people who are in so much pain they can't walk, they can't work, they can't do normal, everyday things," she said.
"We're having to manage the patients who are sitting in front of us who have no quality of life, they are perhaps at risk of deep vein thrombosis because of a lack of mobility.
"It is a very fine balancing act for GPs.
"There are alternatives to medication, but access to pain clinics is also difficult, patients are typically waiting six months for an appointment.
"The issue is that people then build up tolerance to pain relief as time goes on and so they have to move on to stronger medication.
"Unless something is done to address our waiting lists, the situation is only going to continue to get worse."
Chief executive of Addiction NI Thelma Abernethy said the charity had seen an increase in the number of people accessing its services for prescription drug misuse over the last 12 months.
"There is an argument that there is an over-reliance on prescription drugs because of the conflict, but it goes deeper than that," she said.
"This is an extremely complex issue and will take concerted action by a number of statutory bodies to address.
"There is also the issue of learned behaviour, so people just assume or expect to be given medication by their GP.
"Then there are issues around the welfare state, where you are more likely to get access to benefits if you are on strong medication.
"There is a lot of hopelessness in our communities, so we need a lot of investment to try and help, we need to educate people to look after themselves, to exercise, to eat properly, to encourage them to make informed choices."
Ms Abernethy also said the street value of prescription drugs was significant, which led people to lie to their GP about medical conditions in order to get drugs to sell.
She added: "When a GP gives a prescription, they are taking into consideration the overall wellbeing of the patient and any other medical conditions they have, but when you are taking these drugs illegally then you have no idea how you might react.
"There needs to be an urgent review of prescribing rates across Northern Ireland to try and establish the extent of the problem and to develop policies to address the situation."
A spokeswoman from the Health & Social Care Board said pain was a very challenging condition to treat.
She said the board continues to work with GP practices to have safeguards in place to ensure the safe and appropriate use of medicines at all stages.
She also said plans to place almost 300 pharmacists in GP practices, who will review patients' medication, by 2020/21 are on target.