Experts have warned of addiction risks as they report a significant increase in painkiller use in Ireland, including a 25% rise in opioid use and a 50% surge in prescriptions for medication containing oxycodone.
The study also revealed that Irish patients consume considerably more pain medication than their counterparts in England, prompting calls for improved access to alternative treatment options.
Lengthy waiting lists for orthopaedic procedures, such as knee replacements, can trap individuals in severe chronic pain, potentially “waiting several years to be considered for joint replacement surgery,” forcing them to rely on medication in the interim, the study authors cautioned.
Researchers, including Emma Wallace from University College Cork, examined medication dispensing data for medical card holders in Ireland from 2014 to 2022.
The study found that opioid use in Ireland increased by approximately 25% during the study period, alongside a 50% increase in paracetamol prescriptions.
Notably, the use of tapentadol, found in brand-name drugs like Palexia and prescribed for severe chronic pain unresponsive to other painkillers, saw a relative increase of 389% over the same period.
Researchers also observed a 104% rise in the use of amitriptyline (10mg), a medication sometimes prescribed for pain management, including migraines and rheumatic conditions.
Medication containing oxycodone, which is typically reserved for cases where other painkillers prove ineffective, experienced a 50% increase in usage.
The data further indicated a 59% increase in the use of non-steroidal anti-inflammatory drugs (NSAIDs).
This category includes topical formulations such as creams, sprays, and gels marketed under brand names like Voltaren and Solaraze.
In contrast, analysis of general practice patients in England revealed significantly lower rates of pain medication use. For instance, the dispensing rate for tapentadol was found to be 26 times higher in Ireland.
While acknowledging that medical card holders in Ireland, who tend to be older and have lower incomes, generally require more support, the researchers stated, “The discrepancy is likely too large to be fully accounted for by this.”
The analysis also highlighted that prescribing levels in Ireland, compared to England, were twice as high for opioids, four times higher for anti-inflammatories, and nearly five times higher for paracetamol.
Frank Moriarty, senior author and associate professor at the RCSI School of Pharmacy and Biomolecular Sciences, expressed concern over the potential risks associated with such high usage, stating:
“While medication can play an important role in treating pain, we must address issues like orthopaedic surgery waiting times and ensure Irish patients also have access to safe, evidence-based alternatives to medications.”
Professor Moriarty also emphasized the need for improved data access to facilitate better analysis of these trends.
The research team emphasized that patients in England benefit from greater access to pain clinics and alternative therapies like physical therapy.
Molly Mattsson, lead author and a postdoctoral fellow at the RCSI School of Pharmacy and Biomolecular Sciences, underscored the “growing trend” towards reliance on pain medication.
“The trends raise important questions about healthcare access and the availability of non-drug options to manage pain, particularly for medical card holders who avail of public services,” said Dr. Mattsson.
The study team, which included representatives from the HSE’s Quality and Patient Safety Directorate, the University of Oxford, and University College Dublin, recommended “further research to understand the drivers for this high volume of use is required.”
• The study is published in the British Journal of Clinical Pharmacology.
