Why Sunderland's painkiller use is so high, why experts are concerned - and what the alternatives are

Mood swings, drowsiness and ultimately addiction are among the risks for patients who become dependent on medications to manage long term conditions.

But health bosses are starting to fight back after figures showed Sunderland and County Durham were among the top areas of the country for the rate of prescriptions.

“It’s an issue across the North East,” said Ewan Maule, head of medicines optimisation at NHS Sunderland Clinical Commissioning Group (CCG).

“Although the North East is at the sharp end it’s a national and an international issue.

“There’s been a lot of media coverage of the opioid crisis in America, but we’re not at that stage yet.

“It’s an international problem, closely linked to issues like deprivation and poverty, which is one of the reasons the North East is at the sharp end of things and it’s something which has been building for a number of years.”

According to a study by Formulate Health, a nutrition firm, more than two million prescriptions for pain medications were issued in Sunderland between July 2015 and June 2020 – a rate of 120 per 1,000 patients.

This was only slightly ahead of County Durham, which issued 119 painkillers per 1,000 people over the same period.

All seven of the North East’s CCGs made it into the top 10, although it was Blackpool, in the North West, which took the top spot, just ahead of Sunderland.

According to Maule, a previous history of heavy industry in the region, as well as high levels of poverty and deprivation, is at least partly to blame the number of patients suffering chronic pain.

But doctors have also struggled to get to grips with long term conditions and patients’ needs at times too.

He added: “For a long time a lot of people have suffered with chronic pain and there hasn’t been any effective treatment other than to try and mask the pain through opioids and other medications like them.

“They have been prescribed a lot [in the past] because there weren’t really any alternatives, but also because there is an expectation that people can take something and the pain will go away.”

He said while an immediate short term problem, such as a broken rib or fractured hip, might be dealt with very effectively by medications such as Codeine and Tramadol, use of opioid painkillers for longer than about three months can lead to ‘problematic’ side effects.

But, after managing to slash prescriptions by a third in Sunderland and almost a fifth in County Durham in less than a year, there is hope NHS chiefs in the North East may be on the right path to lowering overall use.

Maule said: “We don’t want people to just stop taking them – have a conversation with your doctor or pharmacist first.

“We’re offering more training for GPs on how to have these conversations and we’re making it a significant focus for general practice that these things should be reviewed.”

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