Opioid prescriptions cut by almost half a million in four years as NHS continues crackdown

GPs and pharmacists have helped cut opioid prescriptions in England by 450,000 in under four years, latest data shows, as the NHS today unveils a new action plan to crack down on the overuse of potentially-addictive medicines.

The new framework for local health and care providers aims to further reduce inappropriate prescribing of high-strength painkillers and other addiction-causing medicines, like opioids and benzodiazepines, where they may no longer be the most clinically appropriate treatment for patients – and in some cases can become harmful without intervention.

The plan will support GPs and clinical pharmacists to provide patients with a personalised review of their medicines and make a shared decision about whether a change in treatment is needed, such as moving patients away from potentially-addictive prescribed drugs, especially in cases where the clinical benefit for an individual remaining on a treatment decreases.

Thanks to investment of almost £50 million over the current financial year, the NHS is already making significant progress in this area and the latest data shows that in under three years the number of opioid painkillers prescribed has fallen by 8%, which is estimated to have saved nearly 350 lives and prevented more than 2,100 incidents of patient harm.

The numbers of benzodiazepines and sleeping pills (z-drugs) prescribed in England has also fallen by 170,000 (13.9%) and 95,000 (10.2%) respectively since the NHS led the implementation of key recommendations outlined in a 2019 review by Public Health England.

The review found that in 2017/18 one in four adults in England were prescribed benzodiazepines, z-drugs, gabapentinoids, opioids for chronic non-cancer pain or antidepressants.

Now the NHS is supporting integrated care boards, community health services, public health teams and primary care networks to create personalised and innovative support for patients who have used addictive drugs or suffer from a condition that would have historically seen them prescribed such a drug, to better manage their long-term physical and mental health.

Professor Sir Stephen Powis, National Medical Director for NHS England said: “We know that patients who require prescriptions for potentially addictive drugs can become dependent and struggle with withdrawal, and this new action plan helps NHS services to continue positive work in this space having already slashed opioid prescriptions by almost half a million over the last four years.

“The plan gives clear guidance to support patients who no longer need these drugs to provide them with routine medicine reviews and move them on to other, alternative therapies where appropriate, saving both lives and taxpayer money in the process.”

Professor Tony Avery OBE, National Clinical Director for Prescribing at NHS England said: “Medicines offer a fantastic range of tools for NHS staff to provide patient care and treatment that can be positively life-changing, or even life-saving.

“However, we need to be alert to the risks of some medicines, particularly when used over a long period of time, and the framework we are publishing today empowers local services to work with people to ensure they are being effectively supported when a medicine is no longer providing overall benefit”.

Health Minister Neil O’Brien said: “Tackling the overprescribing of opioids is important, while also ensuring patients have effective alternates.

“Painkillers can help many people manage pain, but they must be treated with caution. Some opioids are highly addictive and have the potential to cause significant harm.”

One example that has already demonstrated the benefits of this step-change is ‘The Living Well with Pain Programme’ in Gloucestershire, which has taken a new approach to supporting people with long-term non-cancer pain by focusing not only on managing the impact of the pain but also people’s mental health – helping to reduce reliance on pharmaceuticals.

An evaluation of the programme over the past four years has shown a significant improvement in the mental health and wellbeing of more than eight in 10 (83%) of the people who participated in the initiative.

Cathy Stannard, clinical lead for NHS Gloucestershire’s Pain Transformation Programme, said: “In Gloucestershire we are working to change the way we think about pain and how we prescribe medications. We have worked extensively with people with lived experience, to better understand the challenges of people living with pain, and to co-design the types of services that are best for them.

“Working across our health and care partnership, including the voluntary, community and social enterprise sector, we have developed new ways to access different types of support, including visual arts, music making, animation and physical movement.

“The aim of our programme is to reduce functional limitations caused by living with persistent pain, as well as to increase mental wellbeing and emotional resilience to live well alongside pain symptoms.”

Harry, a person from Gloucester with lived experience, participates and volunteers at the Music Works, part of the Gloucestershire Creative Health Consortium.

Harry said: “I was referred to the Music Works at a chronic pain meeting, and I had no idea what to expect. I started by attending ‘the Drop’ which is a weekly open access music session, ran as part of the arts on prescription service.

“When I first started to experience pain, getting out of the house became more difficult and I found myself becoming isolated. Discovering the Music Works has really helped with the mental health impact of my pain, it’s something that I enjoy, and it is something that I really look forward to.

“I have been working with the Music Works for a long time now and as I move out of the age groups for the sessions, I am very pleased to have taken on a volunteering role”.

NHS England is encouraging local systems to adopt similar initiatives that are tailored to the needs of their population, giving people flexibility in how to manage their condition.

The framework focuses on five types of medicines, including high-strength painkillers and antidepressants, and sets out steps that local healthcare providers can take to support people who may be taking a prescribed medicine that may no longer be the best treatment for them.

The number of antidepressants prescribed since 2019/20 has increased by 8.4%, though analysis shows that the trajectory of this increase was unaffected by the COVID pandemic. The numbers of gabapentinoids prescribed have also marginally increased over the same period.

Patients should not stop taking their medicines abruptly and should discuss any next steps with their prescriber and/or health professional – this includes seeking advice from their local community pharmacist. More information can be found at