Prescription painkillers are killing more people in the UK than cocaine, ecstasy and heroin, with an average of more than one death linked to either tramadol or codeine each day in 2015.
Doctors and drug support workers also say around two Nottingham people a week are coming forward for help with addictions to drugs they first got from their GPs or pharmacists – and most are middle-aged women.
In the first of a three-part investigation, Jamie Barlow talks to a former Nottingham City Hospital midwife who was fired and arrested after stealing NHS painkillers to feed her crippling addiction.
Sarah Mann had been a midwife for 16 years, delivering hundreds of babies, and worked her way up to ward manager at Nottingham City Hospital.
But her life began to spiral out of control because of a few chance moments when she badly injured her back while helping during a birth.
The incident left her racked with pain – and then her nightmare began.
Sarah, of Bagnall Road, Basford, was initially prescribed tramadol by her GP, an opioid painkiller, to enable her to work and live life with as much normality as possible.
Sarah took small doses for a few months, but says she then noticed, when she didn’t take the painkiller, she was becoming feverish, getting cold sweats and body cramps.
The 43-year-old put the symptoms down to her back pain and took more tramadol to mitigate the agony.
Her partner at the time was also prescribed tramadol to treat his Rheumatoid Arthritis, and Sarah says she thought nothing of consuming his 200 monthly tablets – eight a day, the maximum NHS recommended dosage – all to herself.
Sarah did not know at the time, but she had become a full-blown addict, hooked on the prescription drugs which were meant to help her.
She had become a part of a wider problem which has been described by an all-party parliamentary group as a ‘public health disaster’ which has caused a level of addiction almost impossible to measure but which has led to a 666 per cent increase in tramadol prescriptions in 13 years.
Fatal pharmacy?: Opiate-related deaths in the UK
- There were 1,989 fatal opiate poisonings in the UK in 2015, an increase from 1,786 in 2014, 1,592 in 2013 and 1,290 in 2012.
- The opioids include: Illegal heroin but also prescription morphine, methadone, tramadol, codeine and dihydrocodeine.
- There were 1,990 opiate “misuse” deaths in the UK in 2015, an increase from 1,791 in 2014, 1,598 in 2013 and 1,288 in 2012.
- In 2015, there were 1,061 deaths in the UK where a specific opioid was mentioned on the death certificate, a rise from 938 in 2014, 881 in 2013 and 684 in 2012.
- The main age bracket of people, who died in cases where opioids were mentioned on the death certificate, were aged between 40 and 49.
Figures supplied by the Office for National Statistics.
She was devoted to nursing and midwifery and would take the tablets straight after work.
She said: “I increasingly started taking more tablets. I was eventually taking eight a day and then it started creeping up and I started taking above well what I should’ve been taking.”
Sarah qualified as a nurse in 1994 and, throughout her career, treated recreational drug addicts, alcoholics and patients hooked on over-the-counter medication.
She stresses addiction is involuntary.
“No-one wakes up in the morning and says: ‘I want to be a drug addict’.”
As Sarah’s tolerance for tramadol grew, she needed more than eight daily tablets for the drug to have the same painkilling effects, and she started to suffer from withdrawal symptoms.
Her resting heart rate would soar to 150 beats per minute, well above the average of between 60 and 100, and she would become paranoid and frightened.
“I felt as if something horrific was going to happen. The symptoms were so dominating that I knew people around me would be able to tell what they were,” she admits.
Before her addiction was discovered by a colleague, Sarah began taking codeine, a potent painkiller, because tramadol became a ‘controlled’ drug and harder to get hold of from her GP.
Codeine is prescription drug and, when pharmacists and doctors dispense it, they are obliged to warn patients of its highly addictive side effects.
However, weaker versions of the drug mixed with paracetamol can be purchased over-the-counter, such as Nurofen Plus.
Sarah says she never dabbled in illicit street drugs – and wasn’t tempted at the height of her addiction – but she was hooked on tramadol for 18 months in total.
Eventually the gruelling pain took hold and her yearning for drugs to quell it was uncontrollable, provoking her to steal medication from the hospital.
She resorted to stealing two to four boxes of codeine, and three or four ampoules of diamorphine, each day for several months, amassing 364 thefts worth a combined total of £5,456.
“I thought to myself, ‘Oh my god, Sarah, what are you doing?’ I eventually went to one of my work colleagues and told them I had a problem and asked if they could go and speak to a matron with me.
“I couldn’t escape that, I just thought ‘What have I done? What the hell’s happened?’”
She went home that evening planning to tell her then-partner and daughter Olivia, then aged 16, what had happened.
“I went to get in the shower and my heart was racing – I thought ‘I’ve got to tell them, I’ve got to tell them’.
“As soon as I stepped into the shower, I heard this almighty bang on the door and the deputy had phoned the police and that’s how it all came out.
“It turned into that I was an addict, who was a thief, and it was awful what happened then. My life just spiralled out of control then.”
After a hospital investigation Sarah was sacked.
She pleaded guilty in court to all the thefts and was sentenced to 16 weeks’ imprisonment, suspended for 12 months, and ordered to pay compensation to the hospital.
Today she speaks out about a problem which she believes is still largely hidden, and is working again part-time as a receptionist.
In 2015, the year after Sarah’s addiction came to light, 208 people’s deaths in England and Wales were linked to tramadol.
The all party parliamentary group is still working to recognise and reduce the harm caused by prescribed drug dependence and recommend changes to services provided to people who face addictions.
Read the second part of Prescription Addiction on nottstv.com on Friday, March 24.
