PRESCRIBING OF PAIN medications in Ireland has risen significantly over the past decade, with usage rates now outpacing those in England, new research from RCSI reveals.

In Ireland, the use of opioids increased by approximately 25% between 2014 and 2022, while prescriptions for paracetamol rose by 50%.

Specific medicines like codeine and stronger opioids increased by even higher percentages. Tapentadol prescriptions rose by 389%, for example.

By contrast, England experienced declining use across most classes of pain medications during the same timeframe.

The findings are based on a comparison between prescribing data of medical card holders in Ireland – about a third of the population – and all patients at general practices in England. This may contribute to the notable disparity in figures, as older populations are over-represented among medical card holders here.

However, it was still found that the Irish and English health systems take markedly different approaches to managing pain issues.

Dr Molly Mattsson, who is the first author of the study and a postdoctoral fellow at the RCSI School of Pharmacy and Biomolecular Sciences, said the results show a growing reliance on prescribing pharmacological treatments for pain in Ireland

“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,” she said.

The study says that in England there is “broad access” to healthcare services including pain clinics and non-pharmacological interventions such as physical therapy through the NHS.

These services are less accessible in Ireland, possibly contributing to a greater reliance on medication. 

In order to reduce the worrying trend, researchers say waiting lists need to be addressed.

Orthopaedics currently has the highest number of individuals on outpatient waiting lists, with over 63 000 awaiting an appointment as of March 2024.

Some patients with severe degenerative-related chronic pain wait years to be considered for joint replacement surgery, so they need strong analgesics in the meantime, the study says. 

“Many of these medications carry risks such as dependency which can be worsened by overprescribing”, said Professor Frank Moriarty, a senior author of the study.

“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.”

Moriarty added that access to data is equally vital to track how prescribing patterns evolve over time.