Top 10 most abused prescription drugs in the UK

Prescription drug abuse in the UK has reached levels so alarming that it may be appropriate to term the situation a “crisis”. With an estimated 1.5 million people misusing prescriptions medications in 2021 alone according to the NHS, the issue demands urgent attention. When used to alleviate pain and manage health conditions, prescription medication is perfectly okay. When misused, however, devastating consequences await.

It’s important to discuss the misuse of these drugs in order not only to reduce stigma but also to encourage people to seek help and ultimately promote safer prescribing practices among healthcare professionals. If misuse is not adequately handled, it can result in addiction, overdose, and even death. The repercussions extend beyond death, to the family and wider communities as well.

We’ll be exploring the top 10 most abused prescription drugs in the UK, reviewing their effects, risks, and the societal implications of their misuse.

Understanding prescription drug abuse

Prescription drug abuse is when an individual uses medication in a manner that is beyond the dosage bounds of what has been prescribed by their healthcare provider. This misuse can include:

• Taking higher doses than prescribed
• Using someone else’s medication
• Using the drugs for non-medical purposes, such as recreational use

Legitimate use means taking them exactly as directed for the treatment of specific medical conditions. The distinction is very important to avoid potentially fatal consequences.

The scale of prescription drug misuse in the UK is concerning. According to the ONS, the number of drug-related deaths in England and Wales rose to approximately 4,859 in 2021, with a significant proportion linked to prescription medications, particularly opioids and benzodiazepines. Research by DrugWise suggests that about 1 in 5 adults in the UK has misused prescription drugs at some point in their lives. Demographically, misuse is prevalent across various age groups, but it is notably higher among those aged 16 to 24 and older adults who may be prescribed multiple medications.

Why does misuse occur?

Several reasons are dependent on the individual. The following is a list of possible reasons, but it’s important to note that there may be more:

• Pain management: Those with chronic pain may misuse medication to achieve even greater relief.
• Recreation: Seeking the euphoric effects of certain meds, such as opioids and benzodiazepines.
• Dependency: Where individuals feel as though they cannot function normally without the medication, leading to a cycle of misuse.

Additionally, social factors like peer pressure and mental health disturbances can increase rates of prescription drug abuse.

Top 10 most abused prescription drugs

The following is a list of the most commonly abused prescription drugs:

1. Opioids (e.g., Oxycodone, Morphine)

Opioids, including Oxycodone and Morphine, are powerful pain-relieving medications often prescribed for acute pain management, particularly after surgery or for chronic pain conditions.

These drugs work by binding to opioid receptors in the brain, blocking pain signals and producing feelings of euphoria. However, misuse of opioids can lead to severe health risks, including respiratory depression, addiction, and overdose.

In 2021, nearly 3,000 opioid-related deaths were reported in England and Wales, underscoring the critical nature of this issue.

2. Benzodiazepines (e.g., Diazepam, Lorazepam)

Benzodiazepines like Diazepam and Lorazepam are commonly prescribed for anxiety, panic disorders, and sleep disorders due to their sedative effects. These medications enhance the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), resulting in relaxation and reduced anxiety.

However, misuse can lead to dependence, withdrawal symptoms, and an increased risk of overdose, especially when combined with other substances like alcohol.

In 2022, the National Institute for Health and Care Excellence (NICE) reported that nearly 500,000 adults in the UK were prescribed benzodiazepines, with a significant percentage misusing them.

The societal implications include increased healthcare costs, higher rates of accidents, and a need for rehab services to support those struggling with dependence.

3. Stimulants (e.g., Methylphenidate, Dexamphetamine)

Stimulants such as Methylphenidate (commonly known as Ritalin) and Dexamphetamine are primarily used to treat attention deficit hyperactivity disorder (ADHD). These medications enhance focus and concentration by increasing dopamine levels in the brain.

While they can be highly effective for those with ADHD, misuse occurs when individuals take them without a prescription or at higher doses to improve academic performance or for recreational purposes.

This can lead to severe side effects, including anxiety, insomnia, and cardiovascular issues. A study published in The Lancet found that the misuse of stimulant medications in university settings is a growing concern, leading to calls for better regulation and education about their risks.

4. Gabapentinoids (e.g., Gabapentin, Pregabalin)

Gabapentinoids, including Gabapentin and Pregabalin, are often prescribed for neuropathic pain and epilepsy. They work by inhibiting certain calcium channels in the brain, reducing the release of excitatory neurotransmitters.

While effective for their intended uses, these medications can be misused for their sedative effects. Reports indicate that misuse of gabapentinoids is on the rise in the UK, with increased mentions in drug-related deaths.

5. Antidepressants (e.g., Sertraline, Fluoxetine)

Antidepressants like Sertraline and Fluoxetine are prescribed to treat depression, anxiety disorders, and other mood disorders. While they can significantly improve the quality of life for those who genuinely need them, misuse can occur, particularly among those seeking to self-medicate for emotional distress or to achieve a euphoric effect.

The misuse of antidepressants can lead to adverse effects, including serotonin syndrome, withdrawal symptoms, and worsening of mental health conditions. A study by the Royal College of Psychiatrists found that nearly 1 in 10 individuals in the UK has misused antidepressants at some point.

6. Muscle Relaxants (e.g., Carisoprodol, Cyclobenzaprine)

Muscle relaxants such as Carisoprodol and Cyclobenzaprine are commonly prescribed to alleviate muscle spasms and discomfort. These medications work by depressing the central nervous system, relieving pain and promoting relaxation.

However, misuse can occur, particularly among individuals seeking to enhance the effects of other substances or to achieve sedation. The misuse of muscle relaxants can lead to significant side effects, including dizziness, drowsiness, and respiratory issues.

7. Sleep Aids (e.g., Zolpidem, Zaleplon)

Sleep aids like Zolpidem and Zaleplon are prescribed to treat insomnia and other sleep disorders. These medications are designed to help individuals fall asleep faster and improve overall sleep quality. However, misuse can occur when individuals use these drugs inappropriately, either to self-medicate for stress or to enhance the effects of other substances.

Misuse can result in dangerous side effects, including impaired motor function, memory loss, and increased risk of dependency.

The NHS reported a rise in prescriptions for sleep aids, raising concerns about potential misuse among individuals who are not properly educated about their risks.

8. ADHD Medications (e.g., Adderall, Concerta)

ADHD medications such as Adderall and Concerta are primarily prescribed to treat attention deficit hyperactivity disorder. These stimulant medications improve focus and concentration by altering the levels of certain neurotransmitters in the brain. While they are effective for many individuals with ADHD, misuse occurs when these medications are taken by individuals without ADHD, often to enhance cognitive performance or for recreational purposes.

9. Pain Relievers (e.g., Codeine, Tramadol)

Pain relievers like Codeine and Tramadol are commonly prescribed for moderate to severe pain relief. These medications are effective for managing pain but carry a risk of misuse, particularly among individuals seeking to escape pain or achieve a euphoric effect. Misuse can lead to physical dependence, overdose, and other serious health complications.

In recent years, the misuse of codeine has been highlighted as a significant public health concern, with an increase in reports of addiction and overdose cases. According to NICE, the rising rates of codeine misuse necessitate greater awareness among healthcare providers and patients about the risks associated with these medications and the importance of using them responsibly.

10. Antipsychotics (e.g., Olanzapine, Risperidone)

Antipsychotic medications such as Olanzapine and Risperidone are primarily prescribed to manage psychiatric disorders, including schizophrenia and bipolar disorder. While they can be life-saving for those in need, misuse can occur, particularly among individuals seeking to self-medicate for stress or emotional pain. The misuse of antipsychotics can lead to severe side effects, including weight gain, diabetes, and movement disorders.

The consequences of misuse

Doubtless, the most severe consequence is the potential for addiction, as it leads to more harmful potential consequences. Nearly 21% of individuals prescribed opioids for chronic pain develop an addiction. This dependency is likely to ultimately lead to a vicious cycle of increased dosage and misuse, ultimately resulting in overdose, which accounted for roughly 3000 deaths in England and Wales in 2021.

Outside of physical health, the mental health repercussions are equally delicate. The Royal College of Psychiatrists reports that individuals misusing prescription medication often face higher rates of mood disorders, which further complicates their overall mental health status.

Prevention and support

Preventing the misuse of prescription drugs involves various different considerations. Here is a list of just a few:

• Monitoring prescriptions: Essential for identifying potential misuse early. Tools like prescription drug monitoring programmes (PDMPs) can help providers track patient prescriptions, flagging unusual patterns such as overlapping prescriptions or high dosages.
• NICE guidelines: Guidelines from the National Institute for Health and Care Excellence emphasise the need for healthcare providers to engage in open conversations with patients about the risks associated with prescription drugs.
• Educating patients: Research shows that informed patients are less likely to misuse their medications as they understand the implications of their use and the risks involved.

For individuals already struggling with addiction, various support systems exist to facilitate recovery. UKAT provides a range of services, including counselling, detoxification programmes, and rehab services, specifically designed for those dealing with substance misuse.