The Guardian view on opioids in the the UK: poverty and pain | Editorial

These painkillers don't work against chronic pain. The UK must find alternatives to help sufferers in deprived areas

People in Blackpool are twice as likely as the inhabitants of Wokingham to die before they are 70. A recent paper which measured the distribution of opioids not by the number of prescriptions, but in equivalent units of morphine, found that NHS prescriptions of opioid painkillers have been generally rising in England and Wales, but have risen most in the north of England and more in poorer areas. Blackpool, again, tops the list. In part this is because poverty is correlated with chronic physical pain: both men and women in the lowest income quartile report suffering chronic pain at rates much higher than those in the top quartile. That, in turn, reflects that fact that hard physical labour and unemployment are both bad for health in the long term.

But the prevalence of pain can't entirely account for the pattern of prescription. Many forms of chronic pain do not respond well to opioids. For lower back pain the Nice recommendation is not to treat it at all, except perhaps with ibuprofen, exercise and massage. It will go away on its own, or it will not. Figures suggest that only one opioid prescription in eight was written out for cancer pain in 2014. The others were written for conditions where is it much less obvious that they are the best possible treatment.