Why codeine deaths have reached a record high

Rise of the ‘dark web’ and demography of addicts may explain surge

Opioids such as codeine were prescribed at a rate of 2,700 packs an hour last year in the UK
(Image credit: Fred Tanneau/AFP/Getty Images)

Codeine-related deaths have increased by almost 25% in the past year to a record high, according to data from the Office for National Statistics (ONS).

Analysis shows that 212 people died of drug poisoning from codeine in 2020, up from 167 in 2019, 169 in 2018 and 156 in 2017. The latest figure is the highest number of deaths from the drug in a calendar year since records began in 1993, and more than double the number from ten years ago, when 91 people died from codeine.

Of the 115,000 prescriptions that are written for opioids in the UK every day, five are thought to result in a death, according to the Priory Group.

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Several theories have been put forward for the surge in codeine deaths. Ian Hamilton, a senior lecturer in addiction and mental health at the University of York, tells The Telegraph that the internet and unregulated dark web marketplaces have made the illegal sale of codeine simpler and more accessible.

He says the dark web “makes it relatively easy for people to source drugs like codeine without having to leave their house” and points out that suppliers “won’t place any limits on how many pills an individual orders, providing they can pay for them”.

He adds that this trend has “undoubtedly contributed to the rising problem many people are having with use of non-medical prescription drugs”.

The ONS points out that there is also an ageing group of long-term addicts are who “increasingly susceptible to a fatal overdose” as they get older.

James Nicholls, the chief executive of Transform Drug Policy Foundation, said the “grim drug death statistics” are a “clear signal that an urgent change of course is needed in UK drug policy”.

Earlier this year, The Times said experts in the UK were working to “stave off a US-style addiction crisis”, referring to the American epidemic in which deaths from opioid overdoses have exceeded those from HIV or Aids. The newspaper said there had been warnings that a year of lockdowns might have led to “more ‘stopgap’ pain relief prescriptions while sufferers wait longer to see specialists”.

The Independent reported earlier this week that drug-related deaths in Scotland rose to a record 1,339 last year, with 1,192 of them related to use of opioids including codeine. England and Wales has also seen a record number of overall drug-related deaths, with 4,561 deaths related to drug poisoning registered in England and Wales in 2020.

Codeine works by stopping pain signals from travelling along the nerves to the brain. The NHS warns that codeine is addictive and those who take it for a long time can become tolerant to it, meaning they need higher doses to control pain over time.

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