Citation

Giraudon I, Lowitz K, Dargan PI, Wood DM, Dart RC. Br. J. Clin. Pharmacol. 2013; 76(5): 823-824.

Affiliation

Health consequences Prevalence, consequences and data management unit, European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Cais do Sodré, 1249-289, Lisbon, Portugal.

Copyright

(Copyright © 2013, John Wiley and Sons)

DOI

10.1111/bcp.12133

PMID

23594290

Abstract

The United States (US) is considered the center of prescription drug abuse. Since drug abuse is a worldwide phenomenon, it would be valuable to determine if the trend of increasing prescription opioid misuse and abuse seen in the US is developing in the United Kingdom (UK). To compare trends in deaths associated with prescription opioid drugs, mortality data was obtained online for England, Wales, and Scotland from the Office for National Statistics and the General Register Office and for the US from The National Vital Statistics System (NVSS). Mortality trends in the US show a relentless increase of deaths from unintentional drug poisoning with opioid analgesics in the last decade. In 2010, the number of deaths related to opioid analgesics was over 16,500, more than double the number of 2002 and more than twice the number of deaths from heroin and cocaine deaths combined [1]. Although the number of deaths related to drug poisoning reviewed from England and Wales is not as high as the US, the overall trends are remarkably similar (Figure 1). The prominent role of methadone in UK opioid deaths also is striking. In Scotland, methadone-related deaths increased from 71 in 2001 to 275 in 2011 [2] and they currently represent over half of all reported opioid deaths. However, this should be viewed in the context of a considerable increase in the availability of opioid substitution treatment in the UK [3]. In the US, most cases relate to opioid analgesics, and the number of oxycodone deaths slightly exceeds the number of methadone deaths. Tramadol presents interesting data in the UK: in 1996, England and Wales reported one death with the drug mentioned, but by 2011 there were 154 deaths [4]. In Scotland, tramadol-related deaths increased from 8 in 2001 to 34 deaths in 2011 [2]. The increase in tramadol-related deaths may reflect a rise in tramadol prescriptions, therefore availability, but also points to the need to monitor closely any increase in deaths caused by opioid analgesics as it may signal an emerging problem in the UK similar to the issue that is now well-established in the US.

Language: en