The number of powerful painkillers, also known as opioids, being prescribed in England has skyrocketed in the last ten years, according to a new investigation by the BBC.
Analysis reveals that the number of prescriptions in England has nearly doubled in the last ten years, with the North East of the country reporting the highest prescription rates in the country.
The steep rise in drugs such as morphine, codeine and tramadol has prompted doctors to warn that people could become addicted.
So just how prevalent are opioids and who is most at risk?
Here are the answers to key questions:
What are opioids?
Opioids are primarily used for pain relief in medicine, and they work by imitating the body’s natural pain relievers. Examples of weaker opioids include codeine, dihydrocodeine and tramadol.
Morphine is a stronger opioid drug, as are diamorphine, oxycodone, fentanyl, methadone and buprenorphine.
Opioids can come in many forms, including capsules, liquids, injections and skin patches.
How many opioids are being prescribed?
According to the BBC investigation, GPs in England prescribed 23.8 million opioid-based painkillers in 2017. This breaks down to the equivalent of 2,700 items every hour.
In 2007 there were 10 million fewer prescriptions.
What age group is most at risk?
About 2.3 million people aged between 16 and 59 in England took a prescription painkiller that had not been prescribed to them in 2016-17, BBC analysis suggested.
Experts warned that there had been a rise in the number of patients seeking help for opioid prescription addictions.
“There is definitely a link between rising numbers of prescriptions and an increase in the number of opioid addicts and related deaths,” Professor Jonathan Chick from rehabilitation Castle Craig Hospital told the BBC.
According to the England and Wales crime survey 2016/17, in the last year 7.6% of adults aged 16 to 59 had taken a prescription-only painkiller not prescribed to them for medical reasons.
0.2% of respondents to the 2016/17 survey said that they had taken a prescription-only painkiller not prescribed to them solely for the feeling or experience it gave them.
The data shows that use of non-prescribed prescription-only painkillers for medical reasons was higher among men (8.3%) than women (6.9%).
There was very little difference in the use of non-prescribed prescription-only painkillers across age groups - 8.0% of those aged 16 to 24, compared with 7.5% of those aged 25 to 59.
Where is over prescription most prevalent?
Prescription rates for opioid drugs in Cumbria and the North East were four times higher than in London, the BBC investigation found.
After Cumbria and the North East, Lancashire and South Cumbria had the second highest number of opioids prescribed in 2017, according to the BBC.
The number of people dying from opioid-related drug misuse has reached a record high in England and Wales.
According to figures from the ONS, more than 2,000 of the 3,700 drug-related deaths in England and Wales in 2016 involved an opioid.
ONS data shows that the North East had the highest drug misuse mortality rate in England in 2016.
According to figures, the mortality rate from drug misuse has been increasing year-on-year across England since 2012.
Wales now has a higher rate of deaths from drug misuse than eight of the regions of England, the report states.
The government has commissioned Public Health England to review the evidence for dependence on, and withdrawal from, prescribed medicines.