Risks of prescription medication including addiction and overdose are higher for women and people in deprived areas, a Fife-based study has shown.
Research by NHS Fife and Stirling University has identified potential major risk factors, leading to overdose in patients taking opioids.
In partnership with St Andrews University and Glasgow Caledonian University, the research teams have been studying data from GP practices across Fife.
The research looked into more than 42,000 patients who have been prescribed opioids over the last six months and found that around a third of patients (14,079) have been prescribed a strong opioid.
Strong opioid is a variety of pain-relieving medication for acute pain, cancer pain, chronic pain, palliative care or to manage dependence around substance abuse from illegal drugs.
Dangers of opioids prescriptions
Patients studied were prescribed opioids as part of treatment for two or more diseases.
As well as the risk of overdose, there was a 67% risk the medication could increase pain.
The study also showed a 43% risk of cardiovascular disease. There was also a higher chance of mental health problems (39.3%) and respiratory disease (25.6%).
People living in deprived areas are also more likely to be prescribed opioids, the research showed.
Joe Schofield, of the University of Stirling and a researcher on the project, said: “Our work shows there is likely to be a large population of people prescribed strong opioids across Scotland, many of whom will be at increased risk of overdose, especially those prescribed multiple medications and who have other health conditions.
“We found those at risk tended to be older, female, and living in areas of high social deprivation.
“There is a need to explore practical interventions to reduce the risk of overdose within this group and clinical practice may need to be tightened to minimise overdose risk for individuals prescribed strong opioids.”
The study was funded by a research and development bursary from NHS Fife.
It is hoped its findings will be used to help the health board improve policy on prescription medication.
Deborah Steven, lead pharmacist for pain management in Fife and the co-investigator for the project, said opioids can cause a variety of issues for some people.
She said: “We know that opioids can be useful for some people, but for others can cause issues in the short and long-term.
“These can include side effects, such as dependency, risk of overdose and, in some circumstances, a worsening of their pain.
“It’s vital these types of medicines are being used safely and effectively and this research has allowed us to better understand current prescribing of opioids to patients locally.
“Furthermore, the research is also helping individual medical practices to support their patients currently prescribed these medicines, while reducing the risk of accidental harm in patients benefiting from taking opioid medications.
“In the longer term, the research has provided us with a firm, evidence-based grounding to move forward with wider proposals around pain medicines safety here in Fife.”
Overdose in Scotland
Scotland has one of the highest rates of opioid-related overdose deaths in Europe, with rates continuing to rise each year.
Overdoses mainly occur through the use of illegal opioids such as heroin.
Those prescribed opioids for clinical reasons can also have increased Prescription Opioid Overdose Risk (POOR).
There were 1,264 drug-related deaths in Scotland in 2019, with opioids being connected to 1,092 of those deaths, including prescription opioids such as methadone, buprenorphine, and codeine/dihydrocodeine.
Those living in the most deprived areas were found to be highly associated with the proportion prescribed a strong opioid.
