From The BMJ Opinion: “For years people trying to reduce their antidepressant medication have reported experiencingĀ withdrawal symptoms. We have also known for some time that prescribing opiate medication for pain isĀ ineffectiveĀ beyond a few months. Despite this, prescriptions for opioids have been on the increase until recently and there has been a substantial rise in antidepressant prescribing. Public Health England (PHE) responded to these concerns by reviewing the evidence we have on a range of prescribed medicines that carry a risk of dependency.
TheĀ reportās publicationĀ made headlines earlier this week for its finding that one in four adults in England were prescribed one of these drugs in the year ending March 2018. Yet itās worth focusing on what the report reveals about antidepressants and opioids, particularly its finding that the highest proportion of patients receiving prescriptions for antidepressants and opioids is located in areas of greatest social deprivation. This wonāt surprise many healthcare workers who meet the individuals behind these statistics every day.
For many patients, clinical depression and pain are more than a solitary psychological or physical problem. Yet as clinicians we can feel as impotent as those we treat to effect a change in the numerous other factors that may influence the course of physical or psychological pain. Depression, for example, can be triggered and maintained by poor housing, unemployment, and grief. None of these medications are cures for social deprivation but they do inoculate against lack of hopeāthey are effective in making you feel different. If youāre in a place physically, psychologically, and socially that you canāt escape and your chances of ever doing so are minimal then feeling different is attractive.”
