Background: Trends of opioid prescribing in the NHS has been well published, yet trends by private prescribers has not been established. Aim: To assess trends and geographical variation of controlled opioids dispensed by private prescribers in England. Design and setting: A retrospective observational study in English primary care. Methods: Data on schedule II and III controlled opioids was obtained from the NHS Business Services Authority (BSA) using freedom of information (FOI) requests between 01 January 2014 and 30 November 2021. Absolute counts and rates of the number of items dispensed per cumulative number of registered private prescribers and stratified over time, by opioid type, and geographical region. Results: 128,341 items of controlled opioids were dispensed by private prescribers in England between January 2014 and November 2021, which decreased by 50% from 23,339 items (4.09 items/prescriber) in 2014 to 11,573 items (1.49 items/prescriber) in 2020. Methadone (36%) was the most common controlled opioid dispensed privately, followed by morphine (18%), buprenorphine (16%), and oxycodone (12%). Prescriptions were highest in London (74%), followed by the South-East of England (7%). A proportion of items (n=462, 0.35%) were prescribed by unidentified doctors. Conclusions: Controlled opioids dispensed by private prescribers in England decreased and were primarily dispensed in London. To ensure patient safety, the monitoring and surveillance of controlled opioids dispensed privately should continue and items linked to unidentified doctors should be further investigated.

IEM has no conflicts to declare. BMK declares that in addition to his role at the Bennett Instititue, BMK is employed by NHS England as a specialist pharmacist. All past declarations for BMK are openly available at https://www.whopaysthisdoctor.org/doctor/491/active. GCR is the Director of a limited company that is independently contracted to work as an Epidemiologist and teach at the University of Oxford. GCR received scholarships from NIHR SPCR, the Naji Foundation, and the Rotary Foundation between 2017-2021 to study for a Doctor of Philosophy (DPhil/PhD).

https://doi.org/10.17605/OSF.IO/HCKPU

No funding was obtained for this study

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All study materials and data is openly available via online repositories (https://doi.org/10.17605/OSF.IO/HFKDQ(27). The study protocol was preregistered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/HCKPU)(21). Data were obtained from the NHSBSA through freedom of information requests; ePACT2, NHSBSA Copyright 2022. This information is licensed under the terms of the Open Government Licence.

https://doi.org/10.17605/OSF.IO/HFKDQ