Addiction to medicine: an investigation into the configuration and commissioning of treatment services to support those who develop problems with prescription-only or over-the-counter medicine

Document type
Corporate author(s)
NHS National Treatment Agency for Substance Misuse
NHS National Treatment Agency for Substance Misuse
Date of publication
11 May 2011
Substance Misuse
Social welfare
Material type

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This report was commissioned from the National Treatment Agency for Substance Misuse (NTA) by the Department of Health and covers England only. The NTA has no remit over clinical prescribing decisions by GPs or the regulation of pharmaceutical products. However, its oversight of national drug treatment provision and access to commissioners, practitioners and providers of addiction and recovery services make it well placed to investigate the potential extent of misuse of both prescription only-medicines (POM) and over-the-counter medicines (OTC), and the current availability of services to help people addicted to them. There were three main aspects of this work: an analysis of relevant National Drug Treatment Monitoring System (NDTMS) data and prescription data to investigate prevalence and trends; structured interviews with targeted primary care trusts and partnerships to better understand the commissioning, governance and provision of drug treatment services; surveys and structured interviews with specialist drug treatment providers and dedicated providers of treatment for POM/OTC medicines dependency to determine what is being provided and how local services are configured. This report considers the problems encountered by the use of psychotropic and opioid analgesic medication, such as diazepam and tramadol, in the general population, including that encountered by people reporting problems with illegal drugs, and the role of health services, including specialist addiction, pain and primary care services in order to address these issues. Despite detailed analysis of the treatment and prescription data available at a national level, and extensive consultation with the field, it has not been possible to establish a definite prevalence of POM/OTC medicines addiction or dependency in the general population. However this report does find that a level of need in relation to the problematic use of POM/OTC medicines is recognised by local areas and that people who access treatment services find the support they need to achieve recovery. In 2009-10, just 2% (3,735) of those in drug treatment services reported their primary problem was with POM/OTC medicines. A further 14% (28,775) whose primary dependency was illegal drugs reported additional problems with POM/OTC medicines. This means that overall 16% (32,510) of people in drug treatment services reported problems with their use of POM/OTC medicines out of a treatment population of 206,889. Despite some variation in the overall proportion of people entering treatment in relation to POM/OTC between local areas, data indicates that there are people accessing treatment in almost every local area. Importantly the national drug treatment data shows that those who develop problems in relation to POM/OTC medicines, without problematic illegal drug use, do not suffer long waits and can access local treatment services that support them to achieve recovery.

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