Data on UK prescribing patterns of drugs associated with dependence (antidepressants, benzodiazepines, Z-drugs and opioids) show that:
- antidepressant prescribing more than doubled over the last decade, and over 75 million prescriptions were dispensed in 2016 at a cost of over £340 million
- there were 12 million benzodiazepine prescriptions in 2015, costing over £50 million
- there were 28 million opioid prescriptions in 2016, costing over £340 million.
There are limited data on the number of people affected by dependence and withdrawal. Data published by NatCen (National Centre for Social Research) in September 2017 show that potentially dependence forming medicines (benzodiazepines, opioids, Z-drugs and GABAergic medicines) are widely prescribed in primary care. Opioids were prescribed to 5% of all patients on the CPRD, while benzodiazepines and z-drugs were prescribed to around 2%.
The study of 50,000 patients on the CPRD (clinical practice research datalink) show that:
- there has been an upward trend in the length of continuous prescribing, especially for opioids which increased from 64 days in 2000, to a peak of 102 days in 2014
- there has been an increase in very long-term (over 100 days) benzodiazepine prescribing, but no change (or a slight decline) in the proportion of benzodiazepine prescribing periods that were just over 30 days.
There are some data projecting the level of dependence from specific drug groups (benzodiazepines and Z-drugs). A recent survey of 100,000 patients registered in Bradford, UK, show that: the number of 16-80 year olds patients taking benzodiazepines and Z-drugs over the long-term (more than one year) is 0.69% - when applied to nationwide patient numbers this projects that there are between 265,000 and 295,000 patients taking benzodiazepines and Z-drugs over the long-term in the UK. 35% of all patients taking benzodiazepines or Z-drugs are taking these drugs long term – at least 12 times longer than the BNF (British National Formulary) recommendation of 2-4 weeks.
NHS Digital (2017) Prescriptions dispensed in the community, statistics for England – 2006-2016. Leeds: NHS Digital;
NHS National Services Scotland (2017) Prescription Cost Analysis 2017. Edinburgh: NHS National Services Scotland;
NHS Wales Shared Services Partnership (2017) Prescriptions dispensed in the community – Wales. Cardiff: NHS Wales Shared Services Partnership.
Cartagena Farias J, Porter L, McManus S et al (2017) Prescribing patterns in dependence forming medicines. London: NatCen.
Davies J, Rae T C and Montagu L (2017) Long-term benzodiazepine and Z-drugs use in the UK: a survey of general research. British Journal of General Practice 67(662): e:609-e613.