East Belfast GP acknowledges abuse of prescription drugs

East Belfast GP and PUP councillor John Kyle. Picture: Colm Lenaghan/Pacemaker.
East Belfast GP and PUP councillor John Kyle. Picture: Colm Lenaghan/Pacemaker.

An inner city GP working in east Belfast has questioned whether society is genuinely experiencing an “epidemic” of chronic pain and depression, or if certain conditions are being over-diagnosed.

John Kyle, who is also a PUP councillor on Belfast City Council, said the level of drugs being prescribed reflects a wider problem within society.

Dr Kyle also said it was “inevitable” that a proportion of medicines would be sold by patients on the black market to those who abuse the drugs.

“This is society’s problem. Doctors on their own can’t solve this. It is a societal problem that needs to be addressed.

“There are genuinely high levels of people who experience chronic pain, and the question is why is that happening? Is it due to the stresses of modern society? Is it due to the food? Is it due to poor sleep patterns and could that be related to overuse of social media?

“There are all these questions about why people are suffering chronic pain and we probably don’t know the answer to that, but that is what the increase in pain-killers reflects,” he said.

“A lot of pain-killers are prescribed and a certain amount of it will inevitably find its way on to the street and be sold on. There a lot of people getting regular pain killers from their GP and the reason why Amitripyline has tripled is because it has pain-killing properties. Whereas it was originally developed as anti-depressant, doctors have become more aware that it is a good neuropathic pain killer.

“So it is often given to people who have got chronic pain conditions. It is very difficult for doctors. The doctor basically takes the patient on trust. If the patient says they’ve got severe pain, it’s very difficult for a doctor to say ‘no you don’t’.”

“Some of the people regularly getting pain medication are almost certainly selling it and view it as a way to supplement their income, but it is almost impossible for a GP to know who is doing that.”

Dr Kyle said the dangers of the tramadol drug are now widely known and doctors are exercising caution.

“It was seen as a safe and good alternative to co-codamol but I think the now the view is that it is probably more dangerous. If taken with alcohol and other drugs it can become part of a rather toxic cocktail,” he added.

“The reason why Citalopram and Sertraline have gone up is probably because, again, depression or chronic low mood is a major problem today in Belfast and many other parts of the UK.

“Patients who used to be given Prozac...sometimes the doctor will, if the Prozac is not working, change the patient to a different anti-depressant to see if that works any better.

“Citalopram and Sertraline have been used more and they are viewed as reasonably safe and relatively inexpensive anti-depressants.”

Dr Kyle said there are two main underlying issues.

“There are two underlying issues here. Why are so many people suffering chronic pain, or reporting to their doctors that they are suffering chronic pain? Why are so many people suffering from depression or low mood?

“Are we over-diagnosing it or is there genuinely an epidemic of depression and low mood, and if there is, what can we as a society do?”

Co-codamol use in Northern Ireland reaches 100 million tablets every year