For this reason, she feels that a large part of the responsibility for preventing abuse falls upon prescribers.“Every prescriber should tell their patients four things,” she says.
“How to take the drug properly, to beware of people asking them to share, to control and count their pills, and to dispose of them correctly.
Weaker regulatory restrictions, higher patient demand for ‘effective treatment’, and a more pronounced for-profit organisation of healthcare in North America, particularly the United States, may have exacerbated the problem in this region.
In contrast, tighter control and surveillance over prescriptions in the UK’s NHS has probably kept the problem from reaching the same level, says Stannard.
These are electronic systems that can show doctors, pharmacists and law enforcement officials what a patient has been prescribed over the past three to six months, who prescribed it, how many times a prescription has been refilled and other data.
There is some patchy evidence from the United States that such systems can reduce overprescribing, but getting doctors on board is tricky.
Regulations, according to Boyd, run up against “a quality of life issue”.
She says: “I would never want patients to not have access to these medications.”Governments can also help doctors prescribe more wisely by setting up prescription drug monitoring programmes, says Rebecca Haffajee, a pharmaceutical policy researcher at Harvard Medical School, Boston, Massachusetts.
Others who start using these drugs therapeutically can go on to become addicted. In the United States, drug overdoses are the leading cause of accidental deaths, eclipsing even car accidents.
And the UK joins the United States in the grim statistic that overdose deaths from prescription opioids outnumber those from heroin and cocaine combined.