Prescribing of dependency forming medicines ‘moving in the right direction’ but challenges remain

The number of items of dependency forming medications prescribed in England fell in 2025/2026, continuing a downward trend since 2016/2017, the latest figures from the NHS Business Services Authority have shown.

The figures, published on 30 July 2026, revealed that in 2025/2026, 6.99 million identified patients were prescribed 66.2 million items of dependency forming medicines, which included benzodiazepines, gabapentinoids, opioids and Z-drugs.

Opioids were the most commonly prescribed dependency forming medications in 2025/2026, at 94 patients per 1,000 population, the data showed. The figures also highlighted that the number of prescriptions for opioids in that period totalled 38,626,136 items in all, down 1% from 2024/2025 and down 8% since 2016/2017.

However, between 2024/2025 and 2025/2026, the number of gabapentinoid items prescribed rose by 2%, which continues an upward trend from 2 million items in 2016/2017 to 17 million in 2025/2026, or 28 patients per 1,000 population, the data revealed.

Matthew Ayre, a lecturer in the School of Pharmacy and Pharmaceutical Sciences at the University of Liverpool, commented: “These latest figures suggest prescribing of dependency forming medicines is moving in the right direction, with fewer patients receiving these medicines and a substantial reduction in healthcare spending.”

“These trends highlight the importance of ongoing medication reviews to ensure prescribing remains appropriate and patients receive regular assessment of the benefits and risks of continued treatment,” he continued.

In addition, the data underscored that inequalities in dependency forming prescribing remain, with 59% more identified patients in deprived areas than in the least deprived areas prescribed dependency forming medication in 2025/2026.

Ayre added: “The persistent gap between the most and least deprived communities is particularly concerning. This likely reflects the greater burden of chronic pain and other long-term health conditions in more deprived areas, alongside wider inequalities in access to care and support.

“Overall, these data represent encouraging progress in reducing prescribing of dependency forming medicines, but they also reinforce that reducing medicine dependence is a long-term challenge that requires funding and coordinated action across primary care, secondary care, mental health services and pain management.”

Su-Ann Chew, an emergency department pharmacist specialising in pain management at Imperial College NHS Trust, highlighted that the risk of respiratory depression was higher in opioids, which has lead to a focus on reducing prescribing of these drugs. She also noted specific guidance from the Royal College of Emergency Medicine, published in 2024.

Chew suggested that patients might be less hesitant around gabapentinoids than opiates, adding that “I don’t think they really understand the harm related is just as significant, as in the addiction and the side effects of withdrawal and dependence”.

In addition, Chew said patients might be prescribed pain relief, such as opioids or gabapentinoids, if they present at A&E with an acute issue that does not require surgical intervention.

“The role of the drugs is to enable recoveries so that they can then do the physio and do the rehab and try to make the change they need to actually fix or solve [the issue],” she said.

However Chew emphasised that patients might not understand this, or be unwilling or unable to change their lifestyle in the long-term – particularly those from deprived areas.

“Generally, I have to spend a lot more time counselling these patients around the role of the drugs and that the lifestyle stuff is actually the stuff that will make a meaningful difference and take them out of why they’re actually in pain in the first place,” she said.

Chow suggested that A&E presentations and prescriptions for pain might be influenced by patients being on a waiting list for surgery or being unable to access a GP appointment for long-term management in primary care.