Prescribing rates for benzodiazepines and Z-drugs far higher in deprived areas

Prescriptions for drugs to treat anxiety, alcohol withdrawal and sleep problems are highest in the most deprived areas in England, a study has revealed.

Researchers at Warwick Medical School found that the rate of prescribing of benzodiazepines and Z-drugs was on average 45% higher in the most deprived GP practice populations compared to areas that are the least deprived.

Poorer areas averaged 288 prescriptions of these drugs per 1,000 patients in 2017, compared to 198 prescriptions in areas that were least deprived. The study authors said the trend persisted even after accounting for age and sex demographic differences between GP practices populations.

Meanwhile, a large geographical variation was found across the country, with a tendency for higher prescribing rates in coastal regions, such as Cornwall, Devon and Kent.

GP prescribing

The study, which compared prescribing rates and levels of socioeconomic deprivation at practices using data from NHS Digital, found that over 1.6m prescriptions for benzodiazepines and Z-drugs were written in England during 2017.

Rates of benzodiazepine prescribing were highest in the east of England and coastal regions dispersed around the UK. But the researchers said it was ‘notable' that the latter locations tended to have a higher proportion of elderly people.

Researchers added that very few CCGs had both a high IMD score - indicating better socioeconomic status - and high prescribing rates. But the study concluded that social status alone could not explain the geographic variation found and suggested that cultural influences could also play a part in prescription rates.

Higher prescribing rates in coastal areas match up with analysis by GPonline that suggests these parts of the country are among those most likely to face a shortage of GPs.

Long-term use

The latest findings come just a month after a Public Health England (PHE) report found that hundreds of thousands of patients are being prescribed addictive medication over long periods, often against clinical guidelines.

Lead author of the Warwick Medical School report Dr Saran Shantikumar encouraged GPs to ‘actively think’ whether 'alternative strategies' were available. He said: ‘From my experience and others' in clinical practice we know that there are people who have been taking these drugs for a long time, who are struggling to get off them.

‘Ideally, GPs would be supported to identify long-term users systematically and to provide alternative management options to reduce their risk of side effects and dependence.’

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