Should we, can we, halt the rise in prescribing for pain and distress?

INTRODUCTION. Awareness of prescribed opioid dependence is now reaching the general population along with concerns about levels of antidepressant prescribing and the potential for withdrawal symptoms. Gabapentinoids have become controlled drugs and Public Health England have published their report on prescribed drugs and dependence detailing extensive long-term prescribing. Family doctors will not have failed to notice both the increasing numbers of patients being prescribed multiple drugs for pain and distress, and the change in tone in consultations as we start to worry about their effects and wonder whether adding more, or another, or just switching drugs is the right action. What is the nature of the problem? What can we do instead?