England 2016/17 to 2025/26
Published 30 July 2026
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Key findings
In England in 2025/26:
There were 66 million items for dependency-forming medicines prescribed to an estimated 7 million identified patients.
Opioid drugs were the most prescribed dependency-forming medicines, with 39 million items at a cost of £256 million.
The cost of dependency-forming medicines prescribed in England was £325 million – a 57% decrease from 2016/17.
Prescribing of dependency-forming medicines was most prevalent in female patients aged 60 to 84 years, with 2.6 million identified patients across this range.
The most deprived areas in England had 59% more identified patients receiving dependency-forming medications than the least deprived areas.
The decline in cost was mainly driven by reductions in the cost of gabapentinoid and opioid prescribing. The total cost of gabapentinoid prescribing fell by 87% since 2016/17. This was largely due to a steep decline between 2016/17 and 2018/19, when pregabalin came off patent and cheaper generic equivalents became available from August 2017. The total cost of opioid drugs also decreased, falling by 32% since 2016/17. The steepest decline occurred between 2016/17 and 2018/19, after which costs fluctuated while following a gradual overall downward trend.
1. Things you should know
1.1. Background
This publication was developed in response to the Public Health England (PHE) review into the dependence and withdrawal associated with some prescribed medicines.
Known as the prescribed medicines review (PMR), it recommended an increase in the availability and use of data on the prescribing of medicines that can cause dependence.
This publication includes data on 5 categories of medicines overall:
- Antidepressants
- Opioid pain medicine
- Gabapentinoids
- Benzodiazepines
- Z-drugs
Antidepressants are not included in the measures for volume, cost, or demographics. The current National Institute for Health and Care Excellence (NICE) guidance makes the distinction that antidepressants can cause withdrawal symptoms but are historically not dependency-forming. Additionally, the statistics for antidepressants can be found in the Medicines Used in Mental Health publication. Antidepressants are included in the co-prescribing measures in this publication.
1.2. Scope
This publication describes the prescribing of dependency-forming medicines in England that are dispensed in the community. This does not include data on medicines prescribed and dispensed in secondary care, prisons, or issued by a private prescriber.
These statistics detail:
- the total number of prescription items issued for dependency-forming medication
- the total cost of prescription items issued for these drugs
- the number of identified patients that have received prescribing for these drugs
- the number of identified patients receiving more than one dependency-forming medication
- demographic breakdowns of prescribing by age group and gender
- demographic breakdowns by gender
- demographic breakdowns by a measure of deprivation.
1.3. Drug classifications
These statistics use the BNF therapeutic classifications defined in the British National Formulary (BNF) using the classification system prior to BNF edition 70. Each January the NHSBSA updates the classification of drugs within the BNF hierarchy which may involve some drugs changing classification between years of this publication. The categories of dependency-forming drugs do not align to specific sections of the BNF and have been filtered on chemical substance. A complete list can be found in appendix A of the background and methodology note that accompanies this release.
Many drugs have multiple uses, and although classified in the BNF by their primary therapeutic use may be issued to treat a condition outside of this. Due to this, these statistics may not give accurate estimations of prescribing to treat specific conditions.
1.4. Inclusions and exclusions
These statistics do not exclude patients diagnosed with cancer and who are using an opioid to manage the pain that can be associated with malignant diseases, especially as part of end-of-life care. However, the PMR excluded opioids prescribed for cancer, using patient details from the PHE cancer registry. This means that some measures and the data for opioid pain medicines include more patients than the PMR analysis.
To exclude items used to treat an existing drug dependence or substance misuse disorder, drugs prescribed on FP10MDA instalment forms and from BNF Section 4.10 - Drugs used in substance dependence, were excluded from these statistics.
1.5. Key events
| Date | Event |
|---|---|
| June 2015 | All Party Parliamentary Group for Prescribed Drug Dependence launched to address the growing problem of prescribed drug dependence. |
| September 2019 | Public Health England (PHE) prescribed medicines review (PMR) intended to identify the scale, distribution and causes of prescription drug dependence published. |
| August 2021 | Updated Opioid medicines and the risk of addiction Safety leaflet published by Medicines and Healthcare products Regulatory Agency (MHRA). |
| April 2022 | Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults guidance published by NICE. |
| May 2022 | Opioid comparator dashboard to support Primary Care Networks (PCN) and GP practices published by NHSBSA. |
| March 2023 | NHS England published a framework for action on medicines associated with dependence or withdrawal symptoms for integrated care boards (ICBs) and primary care. |
1.6. Definitions
Item
A single unit of medication listed separately on a prescription form. In this publication, an example of an item would be Fluoxetine 20mg tables x56.
NIC
The Net Ingredient Cost (NIC) is the basic price of the medication, and the quantity prescribed. It does not include other fees incurred by dispensing contractors, such as controlled drug fees or the single activity fee. The basic price is determined by the Drug Tariff or by the manufacturer, wholesaler, or supplier of the product.
Patient
A unique NHS number captured from a prescription form or electronic prescription service (EPS) message.
Dependence
The medicines included in these statistics are those that can cause issues with dependence. Dependence is an adaptation to repeated exposure to some drugs and medicines usually characterised by tolerance and withdrawal, though tolerance may not occur with some.
Tolerance
Tolerance is a neuroadaptation arising from repeatedly taking some drugs and medicines, which can mean higher doses are required to achieve the same effect.
Addiction
Addiction is the combination of dependence plus compulsive behaviours including patients not having control over doing, taking or using something to the point where it could be harmful to them.
Withdrawal
Withdrawal is the side effects or physiological reactions that a patient experiences when they stop taking a medication.
1.7. Patient identification
When the NHSBSA processes prescriptions it is not always possible to capture the NHS number of the patient. Table 1 shows the proportion of items for which a patient could be identified. This means that the data relating to patient counts represents most, but not all, patients.
Identification rates
Due to an increase in digital prescription processing through the Electronic Prescription Service (EPS) during the COVID-19 pandemic, more patients were identified from 2020/21 onwards. As patient identification rates increased, any increases in the number of identified patients between periods are likely to be an overestimate of the actual increase in patient numbers. This is because the proportion of patients who could be identified has increased. Conversely, any decrease over the same period is likely to be an underestimate of the actual decrease.
Patient age
Where patients are identified, their age is calculated on 30 September of the given financial year to assign them to a single age band. For patients where date of birth has not been captured, they have been included in an unknown category.
Patient gender
Gender information was not available from the Personal Demographic Service (PDS) for a small number of patients in each year, typically fewer than 100. This may be because it was not disclosed by the patient or not recorded by the organisation that collected the data. Further information on PDS is included in 4.2.
Personally identifiable information
These statistics do not include any information that is personally identifiable. You can find more information about how the NHSBSA protect personal information in the confidentiality and access statement.
Table 1: The proportion of items for which an NHS number was recorded for listed drug categories per financial year
| Drug Category | 2021/2022 | 2022/2023 | 2023/2024 | 2024/2025 | 2025/2026 |
|---|---|---|---|---|---|
| Benzodiazepines | 97.16% | 97.10% | 97.04% | 96.98% | 96.99% |
| Gabapentinoids | 99.35% | 99.36% | 99.41% | 99.44% | 99.53% |
| Opioids | 98.94% | 98.92% | 98.94% | 98.99% | 99.07% |
| Z-drugs | 98.32% | 98.29% | 98.27% | 98.20% | 98.28% |
Source: Dependency-forming medicines summary tables - Costs and Items
2. Results and commentary
2.1. Volume and cost
Number of dependency-forming medicine items prescribed and identified patients by financial year
Chart
Figure 1: Both items prescribed and identified patients have been declining since 2016/17
Table
Table 2: Both items prescribed and identified patients have been declining since 2016/17
| Financial Year | Identified patients | Prescription items |
|---|---|---|
| 2016/2017 | 8,130,581 | 69,285,043 |
| 2017/2018 | 7,930,753 | 69,090,062 |
| 2018/2019 | 7,701,902 | 68,558,585 |
| 2019/2020 | 7,456,978 | 68,488,925 |
| 2020/2021 | 7,095,324 | 67,691,439 |
| 2021/2022 | 7,174,596 | 67,661,528 |
| 2022/2023 | 7,118,027 | 67,319,239 |
| 2023/2024 | 7,068,158 | 66,800,526 |
| 2024/2025 | 7,023,845 | 66,685,985 |
| 2025/2026 | 6,986,390 | 66,158,202 |
Source: Dependency-forming medicines summary tables - Costs and Items
In 2025/26:
66 million items for dependency-forming medicines were prescribed.
7 million identified patients were prescribed a dependency-forming item.
The number of items of dependency-forming medicines has been slowly decreasing since 2016/17, decreasing by 5% from 69.3 million in 2016/17 to 66.2 million in 2025/26.
Compared with 2016/17, the number of identified patients prescribed these medicines in 2025/26 has decreased by 14%, from 8.1 million to 7 million.
Between 2024/25 and 2025/26, the number of identified patients fell by 0.5% and the number of items fell by 0.8%, equivalent to decreases of 37,000 patients and 530,000 items, respectively.
Cost of dependency-forming medicines per financial year
Chart
Figure 2: Costs have been declining since 2016/17, with the biggest decline between 2016/17 and 2018/19
Table
Table 3: Costs have been declining since 2016/17, with the biggest decline between 2016/17 and 2018/19
| Financial Year | Total Net Ingredient Cost (GBP) |
|---|---|
| 2016/2017 | 755,979,831 |
| 2017/2018 | 557,337,678 |
| 2018/2019 | 409,901,953 |
| 2019/2020 | 400,468,207 |
| 2020/2021 | 419,383,637 |
| 2021/2022 | 404,983,828 |
| 2022/2023 | 382,847,606 |
| 2023/2024 | 372,495,097 |
| 2024/2025 | 365,892,641 |
| 2025/2026 | 324,890,663 |
Source: Dependency-forming medicines summary tables - Costs and Items
In 2025/26:
The cost of prescribed drugs classed as dependency-forming was £325 million.
The cost of dependency-forming medicines declined by 57% since 2016/17, down from £756 million.
The cost of dependency forming medicines fell by 46% between 2016/17 and 2018/19, from £756 million to £410 million. This reduction was mainly due to changes in the cost of gabapentinoids, as shown in Figure 5. Costs fluctuated somewhat in subsequent years, but have been steadily declining since 2020/21. Between 2024/25 and 2025/26, costs fell by 11%, representing the largest year-on-year decrease since 2018/19.
Number of dependency-forming medicine items prescribed by drug category per financial year
Chart
Figure 3: Opioids are the most prescribed dependency-forming medicine
Table
Table 4: Opioids are the most prescribed dependency-forming medicine
| Financial Year | Drug Category | Total Items |
|---|---|---|
| 2016/2017 | Benzodiazepines | 8,471,254 |
| 2016/2017 | Gabapentinoids | 12,390,022 |
| 2016/2017 | Opioids | 42,088,837 |
| 2016/2017 | Z-drugs | 6,334,930 |
| 2017/2018 | Benzodiazepines | 8,063,786 |
| 2017/2018 | Gabapentinoids | 13,619,282 |
| 2017/2018 | Opioids | 41,299,394 |
| 2017/2018 | Z-drugs | 6,107,600 |
| 2018/2019 | Benzodiazepines | 7,714,457 |
| 2018/2019 | Gabapentinoids | 14,495,357 |
| 2018/2019 | Opioids | 40,429,878 |
| 2018/2019 | Z-drugs | 5,918,893 |
| 2019/2020 | Benzodiazepines | 7,477,547 |
| 2019/2020 | Gabapentinoids | 14,884,670 |
| 2019/2020 | Opioids | 40,346,917 |
| 2019/2020 | Z-drugs | 5,779,791 |
| 2020/2021 | Benzodiazepines | 7,051,396 |
| 2020/2021 | Gabapentinoids | 15,270,644 |
| 2020/2021 | Opioids | 39,685,897 |
| 2020/2021 | Z-drugs | 5,683,502 |
| 2021/2022 | Benzodiazepines | 6,767,529 |
| 2021/2022 | Gabapentinoids | 15,777,041 |
| 2021/2022 | Opioids | 39,642,598 |
| 2021/2022 | Z-drugs | 5,474,360 |
| 2022/2023 | Benzodiazepines | 6,411,637 |
| 2022/2023 | Gabapentinoids | 16,189,458 |
| 2022/2023 | Opioids | 39,401,517 |
| 2022/2023 | Z-drugs | 5,316,627 |
| 2023/2024 | Benzodiazepines | 6,051,578 |
| 2023/2024 | Gabapentinoids | 16,589,168 |
| 2023/2024 | Opioids | 39,046,206 |
| 2023/2024 | Z-drugs | 5,113,574 |
| 2024/2025 | Benzodiazepines | 5,760,992 |
| 2024/2025 | Gabapentinoids | 17,021,451 |
| 2024/2025 | Opioids | 39,015,441 |
| 2024/2025 | Z-drugs | 4,888,101 |
| 2025/2026 | Benzodiazepines | 5,478,913 |
| 2025/2026 | Gabapentinoids | 17,417,110 |
| 2025/2026 | Opioids | 38,626,136 |
| 2025/2026 | Z-drugs | 4,636,043 |
Source: Dependency-forming medicines summary tables - Costs and Items
In 2025/26:
39 million opioid items were prescribed.
17 million gabapentinoid items were prescribed.
5.5 million benzodiazepine items were prescribed.
The number of dependency-forming medicine items decreased in three of the four drug groups between 2016/17 and 2025/26:
Opioid items decreased by 8%, from 42 million items to 39 million. They remain the most prescribed dependency-forming medicine in 2025/26.
Benzodiazepine items decreased by 35%, from 8.5 million items to 5.5 million.
Z-drugs decreased by 27%, from 6.3 million items to 4.6 million.
There was a 41% increase in gabapentinoid items, from 12 million to 17 million.
Between 2024/25 and 2025/26:
Opioid items fell by 1%, a decrease of 390,000 items.
Benzodiazepine items fell by 5%, a decrease of 280,000 items.
Z-drugs items fell by 5%, a decrease of 250,000 items.
Gabapentinoid items rose by 2%, an increase of 400,000 items.
Number of identified patients per 1,000 population by drug category per financial year
Chart
Figure 4: Opioids are the dependency-forming medicine with the highest identified patients per 1,000 population
Table
Table 5: Opioids are the dependency-forming medicine with the highest identified patients per 1,000 population
| Financial Year | Drug Category | Patients per 1,000 Population |
|---|---|---|
| 2016/2017 | Benzodiazepines | 26.3 |
| 2016/2017 | Gabapentinoids | 25.0 |
| 2016/2017 | Opioids | 116.7 |
| 2016/2017 | Z-drugs | 18.9 |
| 2017/2018 | Benzodiazepines | 25.0 |
| 2017/2018 | Gabapentinoids | 26.4 |
| 2017/2018 | Opioids | 112.4 |
| 2017/2018 | Z-drugs | 18.0 |
| 2018/2019 | Benzodiazepines | 23.8 |
| 2018/2019 | Gabapentinoids | 27.1 |
| 2018/2019 | Opioids | 107.6 |
| 2018/2019 | Z-drugs | 17.1 |
| 2019/2020 | Benzodiazepines | 22.5 |
| 2019/2020 | Gabapentinoids | 26.6 |
| 2019/2020 | Opioids | 103.4 |
| 2019/2020 | Z-drugs | 16.2 |
| 2020/2021 | Benzodiazepines | 19.6 |
| 2020/2021 | Gabapentinoids | 26.3 |
| 2020/2021 | Opioids | 99.1 |
| 2020/2021 | Z-drugs | 15.7 |
| 2021/2022 | Benzodiazepines | 19.3 |
| 2021/2022 | Gabapentinoids | 26.9 |
| 2021/2022 | Opioids | 99.8 |
| 2021/2022 | Z-drugs | 14.7 |
| 2022/2023 | Benzodiazepines | 18.6 |
| 2022/2023 | Gabapentinoids | 27.1 |
| 2022/2023 | Opioids | 97.9 |
| 2022/2023 | Z-drugs | 13.9 |
| 2023/2024 | Benzodiazepines | 17.1 |
| 2023/2024 | Gabapentinoids | 27.2 |
| 2023/2024 | Opioids | 96.0 |
| 2023/2024 | Z-drugs | 13.2 |
| 2024/2025 | Benzodiazepines | 15.6 |
| 2024/2025 | Gabapentinoids | 27.2 |
| 2024/2025 | Opioids | 94.8 |
| 2024/2025 | Z-drugs | 12.3 |
| 2025/2026 | Benzodiazepines | 14.7 |
| 2025/2026 | Gabapentinoids | 27.8 |
| 2025/2026 | Opioids | 94.4 |
| 2025/2026 | Z-drugs | 11.8 |
Source: Dependency-forming medicines summary tables - Costs and Items
In 2025/26:
94 patients per 1,000 population were prescribed an opioid drug.
28 patients per 1,000 population were prescribed a gabapentinoid.
15 patients per 1,000 population were prescribed a benzodiazepine.
The patients per 1,000 population are calculated using the Office for National Statistics (ONS) population estimates. The ONS had not yet published updated population estimates for 2025/26 at the time of reporting. As a result, population rates for 2025/26 were calculated using the same mid-year population estimate as 2024/25, and should be considered provisional.
The rate of patients prescribed dependency-forming medicine items also decreased in three of the four drug groups between 2016/17 and 2025/26:
Opioid prescribing decreased from 117 to 94 patients per 1,000 population.
Benzodiazepines decreased from 26 patients to 15 per 1,000 population.
Z-drugs decreased from 19 patients to 12 per 1,000 population.
Gabapentinoids increased from 25 patients to 28 patients per 1,000 population.
Changes in prescribing rates between 2024/25 and 2025/26 followed a similar pattern. Opioid prescribing rates decreased by 0.4 patients per 1,000 population, benzodiazepine prescribing rates decreased by 0.9 patients per 1,000 population, and Z-drug prescribing rates decreased by 0.5 patients per 1,000 population. In contrast, gabapentinoid prescribing rates increased by 0.6 patients per 1,000 population.
Cost of dependency-forming medicines prescribed by drug category per financial year
Chart
Figure 5: Opioids are the dependency-forming medicine with the highest costs
Table
Table 6: Opioids are the dependency-forming medicine with the highest costs
| Financial Year | Drug Category | Total Net Ingredient Cost (GBP) |
|---|---|---|
| 2016/2017 | Benzodiazepines | 23,468,433 |
| 2016/2017 | Gabapentinoids | 349,314,811 |
| 2016/2017 | Opioids | 377,522,126 |
| 2016/2017 | Z-drugs | 5,674,461 |
| 2017/2018 | Benzodiazepines | 22,271,530 |
| 2017/2018 | Gabapentinoids | 196,333,878 |
| 2017/2018 | Opioids | 334,382,742 |
| 2017/2018 | Z-drugs | 4,349,528 |
| 2018/2019 | Benzodiazepines | 18,992,531 |
| 2018/2019 | Gabapentinoids | 78,506,142 |
| 2018/2019 | Opioids | 308,836,412 |
| 2018/2019 | Z-drugs | 3,566,868 |
| 2019/2020 | Benzodiazepines | 20,691,728 |
| 2019/2020 | Gabapentinoids | 61,750,196 |
| 2019/2020 | Opioids | 313,501,880 |
| 2019/2020 | Z-drugs | 4,524,403 |
| 2020/2021 | Benzodiazepines | 24,156,141 |
| 2020/2021 | Gabapentinoids | 68,219,779 |
| 2020/2021 | Opioids | 321,815,860 |
| 2020/2021 | Z-drugs | 5,191,858 |
| 2021/2022 | Benzodiazepines | 25,174,727 |
| 2021/2022 | Gabapentinoids | 68,530,782 |
| 2021/2022 | Opioids | 306,761,734 |
| 2021/2022 | Z-drugs | 4,516,585 |
| 2022/2023 | Benzodiazepines | 31,426,920 |
| 2022/2023 | Gabapentinoids | 64,766,535 |
| 2022/2023 | Opioids | 282,504,452 |
| 2022/2023 | Z-drugs | 4,149,699 |
| 2023/2024 | Benzodiazepines | 27,421,369 |
| 2023/2024 | Gabapentinoids | 62,008,113 |
| 2023/2024 | Opioids | 277,599,054 |
| 2023/2024 | Z-drugs | 5,466,561 |
| 2024/2025 | Benzodiazepines | 24,288,941 |
| 2024/2025 | Gabapentinoids | 67,856,764 |
| 2024/2025 | Opioids | 269,466,667 |
| 2024/2025 | Z-drugs | 4,280,270 |
| 2025/2026 | Benzodiazepines | 22,146,552 |
| 2025/2026 | Gabapentinoids | 43,755,885 |
| 2025/2026 | Opioids | 256,189,392 |
| 2025/2026 | Z-drugs | 2,798,834 |
Source: Dependency-forming medicines summary tables - Costs and Items
In 2025/26:
Opioid drugs had the highest cost of £256 million.
Gabapentinoids had a cost of £44 million.
The cost of benzodiazepines was £22 million.
Drug costs decreased overall for all four drug groups between 2016/17 and 2025/26:
The cost of opioids decreased by 32%, from £378 million to £256 million.
The cost of benzodiazepines decreased by 6%, from £23 million to £22 million.
The cost of Z-drugs decreased by 51%, from £5.7 million to £2.8 million.
The cost of gabapentinoids decreased by 87%, from £349 million to £44 million.
With the exception of benzodiazepines, these percentage-decreases are greater than the corresponding decreases in item counts, shown in Figure 3.
Between 2016/17 and 2025/26, the five opioid drugs with the biggest drop in cost were fentanyl, tramadol, oxycodone, buprenorphine, and co-codamol. Their combined cost fell by £102 million, from £288 million to £186 million.
The cost of gabapentinoids decreased substantially between 2016/17 and 2018/19, due to pregabalin coming off patent and entering Category M of the drug tariff, meaning cheaper generic equivalents could be prescribed from August 2017. The cost of gabapentinoids decreased by 36% between 2024/25 and 2025/26, from £68 million to £44 million. This was driven by reductions in spending on both pregabalin and gabapentin, which fell by 40% and 30%, respectively.
Drug costs may be impacted by a complex mix of factors, including prescribing practices, market forces, patents, policy, and changes to prescribing guidance.
Average number of dependency-forming medicine items per patient by financial year
Chart
Figure 6: The average number of dependency-forming items per patient increased between 2016/17 and 2025/26
Table
Table 7: The average number of dependency-forming items per patient increased between 2016/17 and 2025/26
| Financial Year | Total Items | Total Identified Patients | Items Per Patient |
|---|---|---|---|
| 2016/2017 | 66,210,227 | 8,130,581 | 8.1 |
| 2017/2018 | 66,568,968 | 7,930,753 | 8.4 |
| 2018/2019 | 66,289,591 | 7,701,902 | 8.6 |
| 2019/2020 | 66,893,850 | 7,456,978 | 9.0 |
| 2020/2021 | 66,829,855 | 7,095,324 | 9.4 |
| 2021/2022 | 66,854,210 | 7,174,596 | 9.3 |
| 2022/2023 | 66,511,831 | 7,118,027 | 9.3 |
| 2023/2024 | 66,020,870 | 7,068,158 | 9.3 |
| 2024/2025 | 65,933,289 | 7,023,845 | 9.4 |
| 2025/2026 | 65,473,365 | 6,986,390 | 9.4 |
Source: Dependency-forming medicines summary tables - Costs and Items
The average number of dependency-forming medicine items per patient increased from 8.14 in 2016/17 to 9.37 per patient in 2025/26, though fell slightly from 9.39 in 2024/25.
2.2. Patient demographics
Number of identified patients receiving dependency-forming medicine prescribing by gender and financial year
Chart
Figure 7: The overall split of male and female patients has remained consistent between 2016/17 and 2025/26
Table
Table 8: The overall split of male and female patients has remained consistent between 2015/16 and 2025/26
| Financial Year | Patient Gender | Total Identified Patients |
|---|---|---|
| 2016/2017 | Female | 4,916,586 |
| 2016/2017 | Male | 3,199,350 |
| 2017/2018 | Female | 4,796,381 |
| 2017/2018 | Male | 3,124,659 |
| 2018/2019 | Female | 4,660,225 |
| 2018/2019 | Male | 3,032,697 |
| 2019/2020 | Female | 4,517,608 |
| 2019/2020 | Male | 2,932,807 |
| 2020/2021 | Female | 4,319,464 |
| 2020/2021 | Male | 2,773,661 |
| 2021/2022 | Female | 4,376,791 |
| 2021/2022 | Male | 2,795,528 |
| 2022/2023 | Female | 4,348,387 |
| 2022/2023 | Male | 2,767,085 |
| 2023/2024 | Female | 4,321,510 |
| 2023/2024 | Male | 2,744,220 |
| 2024/2025 | Female | 4,296,511 |
| 2024/2025 | Male | 2,724,802 |
| 2025/2026 | Female | 4,274,888 |
| 2025/2026 | Male | 2,709,041 |
Source: Dependency-forming medicines summary tables - Costs and Items
In 2025/26, 61% of identified patients who were prescribed a dependency-forming item were female.
In 2025/26, 39% of identified patients who were prescribed a dependency-forming item were male.
Although the total number of identified patients prescribed dependency-forming medicines decreased between 2016/17 and 2025/26, the gender split remains consistent, at approximately 60% female and 40% male in both years. However, in 2025/26, there were 642,000 fewer female identified patients and 490,000 fewer male identified patients than in 2016/17.
Identified patients whose gender was unknown or indeterminate have been grouped together and can be found in the summary tables that accompany this release.
Number of identified patients receiving dependency-forming medicine prescribing by age and gender
Chart
Figure 8: Female patients aged 60 to 64 were the largest prescribing group for dependency-forming medicines in 2025/26
Table
Table 9: Female patients aged 60 to 64 were the largest prescribing group for dependency-forming medicines in 2025/26
| Financial Year | Age Band | Patient Gender | Total Identified Patients |
|---|---|---|---|
| 2025/2026 | 00-04 | Female | 406 |
| 2025/2026 | 00-04 | Male | 505 |
| 2025/2026 | 05-09 | Female | 817 |
| 2025/2026 | 05-09 | Male | 985 |
| 2025/2026 | 10-14 | Female | 4,858 |
| 2025/2026 | 10-14 | Male | 3,266 |
| 2025/2026 | 15-19 | Female | 34,694 |
| 2025/2026 | 15-19 | Male | 16,090 |
| 2025/2026 | 20-24 | Female | 84,299 |
| 2025/2026 | 20-24 | Male | 37,849 |
| 2025/2026 | 25-29 | Female | 134,538 |
| 2025/2026 | 25-29 | Male | 63,516 |
| 2025/2026 | 30-34 | Female | 192,199 |
| 2025/2026 | 30-34 | Male | 99,575 |
| 2025/2026 | 35-39 | Female | 241,088 |
| 2025/2026 | 35-39 | Male | 133,384 |
| 2025/2026 | 40-44 | Female | 267,796 |
| 2025/2026 | 40-44 | Male | 156,276 |
| 2025/2026 | 45-49 | Female | 281,185 |
| 2025/2026 | 45-49 | Male | 173,986 |
| 2025/2026 | 50-54 | Female | 344,431 |
| 2025/2026 | 50-54 | Male | 220,240 |
| 2025/2026 | 55-59 | Female | 399,820 |
| 2025/2026 | 55-59 | Male | 272,514 |
| 2025/2026 | 60-64 | Female | 428,747 |
| 2025/2026 | 60-64 | Male | 310,903 |
| 2025/2026 | 65-69 | Female | 383,085 |
| 2025/2026 | 65-69 | Male | 287,171 |
| 2025/2026 | 70-74 | Female | 354,731 |
| 2025/2026 | 70-74 | Male | 255,296 |
| 2025/2026 | 75-79 | Female | 394,965 |
| 2025/2026 | 75-79 | Male | 266,228 |
| 2025/2026 | 80-84 | Female | 314,017 |
| 2025/2026 | 80-84 | Male | 192,375 |
| 2025/2026 | 85-89 | Female | 227,840 |
| 2025/2026 | 85-89 | Male | 123,495 |
| 2025/2026 | 90+ | Female | 172,255 |
| 2025/2026 | 90+ | Male | 70,230 |
Source: Dependency-forming medicines summary tables - Costs and Items
In 2025/26, 429,000 female patients aged 60 to 64 were prescribed a dependency-forming item.
In 2025/26, 311,000 male patients aged 60 to 64 were prescribed a dependency-forming item.
Prescribing of dependency forming medicines peaks for both females and males age 60 to 64 years. In 2025/26, this group accounted for 11% of all identified patients who received a dependency-forming item.
Across almost all age groups, the number of female patients receiving dependency-forming medicines was consistently higher than that of males. Only the age bands 0 to 4 years and 5 to 9 years saw more male prescribing, though less than 0.1% of identified patients that received a dependency-forming item fell into this age range.
Number of identified patients receiving dependency-forming medicines prescribing by IMD quintile
Chart
Figure 9: In 2025/26, more people were prescribed dependency-forming medicines in more deprived areas
Table
Table 10: In 2025/26, more people were prescribed dependency-forming medicines in more deprived areas
| Financial Year | IMD Quintile | Total Identified Patients |
|---|---|---|
| 2025/2026 | 1 - Most Deprived | 1,794,138 |
| 2025/2026 | 2 | 1,560,735 |
| 2025/2026 | 3 | 1,395,164 |
| 2025/2026 | 4 | 1,288,129 |
| 2025/2026 | 5 - Least Deprived | 1,129,744 |
Source: Dependency-forming medicines summary tables - Costs and Items
In 2025/26, 1.8 million patients from the 20% most deprived areas in England were prescribed a dependency-forming item.
In 2025/26, 1.1 million patients from the 20% least deprived areas in England were prescribed a dependency-forming item.
In 2025/26, the number of identified patients prescribed dependency-forming medicines was 59% higher in the most deprived areas of England compared to the least deprived. This trend of higher prescribing in more deprived areas has remained consistent since 2016/17.
There have also consistently been more items prescribed per patient in the most deprived areas than in the least deprived areas. In 2025/26, there were on average 10.8 items per patient prescribed in the most deprived areas compared to 7.4 items per patient in the least deprived areas.
In 2025/26, this difference was greatest for benzodiazepines, with 81% more items per patient in the most deprived areas compared to the least, at 8.1 items per patient compared with 4.5 in the least deprived areas.
2.3. Co-prescribing of drug categories
Co-prescribing is where a patient is receiving drugs from more than one category of dependency-forming medicine in the same month. Antidepressants which have been excluded from the previous sections have been included here because of the increased risk factors when combined with dependency-forming medicines. It is not possible to distinguish whether multiple prescriptions which have been reported for the same month were given consecutively or concurrently. As such, some activity will show as co-prescribing when in fact the individual was prescribed one medicine and another separately, and both were reported in the same month. March 2026 has been used for this analysis as the most recent month of available data and as it was representative of the recent trends in co-prescribing.
Number of identified patients receiving more than one category of dependency-forming medicines in the same month prescribing by number of categories
Chart
Figure 10: Almost a quarter of patients who received a prescription for dependency-forming medicines were prescribed drugs from more than one category in March 2026
Table
Table 11: Almost a quarter of patients who received a prescription for dependency-forming medicines were prescribed drugs from more than one category in March 2026
| Year Month | Number of Categories | Total Identified Patients |
|---|---|---|
| 202603 | 1 | 5,215,718 |
| 202603 | 2 | 1,236,480 |
| 202603 | 3 | 324,377 |
| 202603 | 4 | 40,950 |
| 202603 | 5 | 4,670 |
Source: Dependency-forming medicines summary tables - Co-prescribing
In March 2026, 24% of patients who received a prescription for dependency-forming medicines were prescribed drugs from more than one category.
In March 2026, less than 0.1% of patients who received a prescription for dependency-forming medicines were prescribed drugs from all 5 categories, at around 4,700 individuals.
In total, an estimated 6.8 million identified patients received a prescription for dependency-forming medicines in March 2026. Of these, 1.2 million received prescriptions in two categories, representing 18% of patients.
Number of identified patients receiving prescribing of a combination of two dependency-forming medicines
Chart
Figure 11: In March 2026, opioids and antidepressants were the most popular combination of drugs for patients receiving items from two categories of dependency-forming medicines.
Table
Table 12: In March 2026, opioids and antidepressants were the most popular combination of drugs for patients receiving items from two categories of dependency-forming medicines.
| Year Month | Drug Combination | Total Identified Patients |
|---|---|---|
| 202603 | Opioids and Antidepressants | 654,801 |
| 202603 | Gabapentinoids and Antidepressants | 248,492 |
| 202603 | Opioids and Gabapentinoids | 148,372 |
| 202603 | Benzodiazepines and Antidepressants | 65,333 |
| 202603 | Z-Drugs and Antidepressants | 60,615 |
| 202603 | Opioids and Benzodiazepines | 24,633 |
| 202603 | Opioids and Z-Drugs | 18,000 |
| 202603 | Benzodiazepines and Gabapentinoids | 5,987 |
| 202603 | Z-Drugs and Gabapentinoids | 5,251 |
| 202603 | Benzodiazepines and Z-Drugs | 4,996 |
Source: Dependency-forming medicines summary tables - Co-prescribing
In March 2026, the most popular combination of drugs for patients receiving items from two categories of dependency-forming medicines was opioids and antidepressants, with 650,000 patients. This accounted for 53% of patients who received prescribing in two categories of dependency-forming medicines.
This was followed by gabapentinoids and antidepressants, with 250,000 patients. This represented 20% of patients who received prescribing in two categories of dependency-forming medicines.
3. Background
3.1. Opioid pain medicine
Opioids provide pain relief by acting on areas in the spinal cord and brain to block the transmission of pain signals.
Most opioids are schedule 2 controlled drugs, unless very low strength which may be schedule 5, and are available in a wide variety of medication forms.
Opioids should only be considered for the short-to-medium-term treatment of chronic non-malignant pain, when other therapies have been insufficient and the benefits of use are considered to outweigh the risks of harm.
Opioid analgesics are usually used for palliative care, where potential for dependence is not a deterrent, and chronic (lasting more than 12 weeks) moderate-to-severe pain exists where other treatments have been insufficient due to the potential for dependence.
You can find out more information on opioid analgesics on the NICE website. Resources for the prescribing of opioids have been produced by the Faculty of Pain Medicine in partnership with PHE.
3.2. Gabapentinoids
Gabapentinoids is the combined name for gabapentin and pregabalin which are antiepileptic drugs also used in the treatment of neuropathic pain and in the case of pregabalin, anxiety.
In epilepsy, gabapentinoids stop seizures by reducing the abnormal electrical activity in the brain.
With nerve pain, they block pain by affecting the pain messages travelling through the brain and down the spine.
When pregabalin is used to treat anxiety, it prevents the brain from releasing the chemicals that cause anxiety.
Both gabapentinoids are schedule 3 controlled drugs and are available as capsules, tablets, or a liquid.
You can find out more about gabapentin and pregabalin on the NHS website.
3.3. Benzodiazepines
Benzodiazepines are a commonly used hypnotic and anxiolytic medicine. Hypnotics and anxiolytics are used to treat insomnia and anxiety respectively. Benzodiazepines work by increasing the effects of a calming chemical in the brain called gamma-aminobutyric acid (GABA).
Benzodiazepines are indicated for the short-term relief of severe anxiety. Long-term use should be avoided and should also only be used to treat insomnia only when it is severe, disabling, or causing the patient extreme distress
The majority of benzodiazepines are schedule 4 controlled drugs with some belonging to schedule 3, and are available as capsules, tablets, injectables, suppositories or a liquid.
Insomnia is difficulty getting to sleep or staying asleep for long enough to feel refreshed in the morning, despite there being enough opportunity to sleep. An insomniac may also experience:
- waking in the night
- not feeling refreshed after sleep and not being able to function normally during the day
- feeling irritable and tired and finding it difficult to concentrate
- waking when they have been disturbed from sleep by pain or noise
- waking early in the morning
Anxiety is a feeling of unease, such as worry or fear, which can be mild or severe. Everyone experiences feelings of anxiety at some point in their life and feeling anxious is sometimes perfectly normal. However, people with generalised anxiety disorder (GAD) find it hard to control their worries. Their feelings of anxiety are more constant and often affect their daily life. There are several conditions for which anxiety is the main symptom. Panic disorder, phobias and post-traumatic stress disorder can all cause severe anxiety.
You can find more information about insomnia and anxiety from the NHS website, and further information about hypnotics and anxiolytics at the NICE website, though this includes drugs other than benzodiazepines.
3.4. Z-drugs
Z drugs are are non-benzodiazepine hypnotics made up of zaleplon, zolpidem and zopiclone. As hypnotics they are also used to treat insomnia. Z drugs work by affecting a calming chemical in the brain called gamma-aminobutyric acid (GABA).
Zolpidem is a schedule 4 controlled drug and is available as tablets or a powder. Zaleplon is not a controlled drug and is available as a capsule and zopiclone is not a controlled drug and is available as capsules, tablets, or a liquid.
You can find more information about insomnia on the NHS website and further information about hypnotics and anxiolytics at the NICE website.
3.5. Antidepressants
Antidepressant drugs are licensed to treat major depression. Health professionals use the words depression, depressive illness or clinical depression to refer to depression. It is a serious illness and very different from the common experience of feeling unhappy or fed up for a short period of time. Depressed people may have feelings of extreme sadness that can last for a long time. These feelings are severe enough to interfere with daily life, and can last for weeks, months or years, rather than days.
It should be noted that antidepressant drugs are used for indications other than depression. For example, they can used for migraine, chronic pain, Myalgic Encephalomyelitis (ME), or a range of other conditions. Clinical indication is not captured by the NHSBSA. Therefore, the statistics on these drugs do not relate solely to prescribing for depression.
You can find more information about depression on the NHS website.
4. About these statistics
Further information on the methodology used in this publication and further background information is available in our Background Information and Methodology supporting document.
4.1. Patient counts
The patient counts shown in these statistics should only be analysed at the level at which they are presented. Adding together any patient counts is likely to result in an overestimate of the number of patients. A person will be included, or counted, in each category or time period in which they received relevant prescriptions. For example, if a patient received a prescription item for a dependency-forming medicine product in 2018/19 and another in 2019/20, then adding together those totals would count that patient twice. For the same reason, data on patient counts for different drug categories should not be added together.
4.2. Patient age and gender
The age and gender of patients used in these statistics is derived from data provided by the NHS PDS for NHS numbers that have been successfully verified by them. A patient’s age, used to assign them to an age group, has been calculated on 30 September for the given financial year. It is possible that a patient’s PDS information may change over the course of the year, in these cases patients may be subject to multiple counting in these analyses.
4.3. Index of deprivation
The English Indices of Deprivation 2025 have been used to provide a measure of patient deprivation. The English Indices of Deprivation are an official national measure of deprivation that follows an established methodological framework to capture a wide range of individuals living conditions.
The reported IMD quintile, is derived from the postcode of the patient an item has been prescribed to. Quintile 1 represents the 20% most deprived areas and quintile 5 is the 20% least deprived areas. There are a small number of items each year that we have reported as having an unknown IMD quintile. These are items where we have been unable to match the patient postcode to a postcode in the National Statistics Postcode Lookup (NSPL) - February 2026.
IMD deciles are calculated by ranking census lower-layer super output areas (LSOA) from most deprived to least deprived and dividing them into 10 equal groups. These range from the most deprived 10% (decile 1) of small areas nationally to the least deprived 10% (decile 10) of small areas nationally. We have aggregated these deciles into quintiles in this publication, for use alongside the NHS Core20PLUS5 approach.
4.4. Geographies included in this publication
The patient deprivation measures in these statistics are based on the patient’s postcode. Each postcode is linked to a Lower Layer Super Output Area (LSOA) using the February 2026 National Statistics Postcode Lookup (NSPL) file for 2021 census LSOAs. This allows deprivation to be measured using standard geographical boundaries.
Unlike LSOAs, the higher-level geographies shown in the statistical summary tables, such as Integrated Care Boards (ICBs), are based on NHS Business Services Authority (NHSBSA) administrative records rather than geographical boundaries. This approach better reflects how GP practices are organised and managed in practice, rather than strictly following geographical definitions.
4.5. Co-prescribing measures
In these statistics, co-prescribing refers to the reporting of 2 or more drug categories of medicine for the same identified patient in the same month. Co-prescribing is reported based on the number of categories, up to 5, that were reported in the same month, with greater than one deemed to be co-prescribing. The main limitation is that it is not possible to distinguish whether multiple prescriptions that have been reported for the same month were given consecutively or concurrently. As such, some activity will be flagged in this analysis as co-prescribing, implying they were received at the same time, when in fact the individual was prescribed one medicine and then another separately, and both were reported in the same month.
5. Rounding
The high-level figures in this statistical summary have been rounded as per the table below:
| From | To | Round to nearest |
|---|---|---|
| 0 | 1,000 | 1 |
| 1,001 | 10,000 | 100 |
| 10,001 | 100,000 | 1,000 |
| 100,001 | 1,000,000 | 10,000 |
| 1,000,001 | 10,000,000 | 100,000 |
| 10,000,001 | 100,000,000 | 1,000,000 |
| 100,000,001 | 100,000,000,000 | 10,000,000 |
All changes and totals are calculated prior to rounding. Percentage changes are calculated prior to rounding and then are rounded to the nearest whole number. As all figures within this statistical summary have been rounded, they may not match totals elsewhere when aggregated.
The summary tables released with this publication allow users to investigate this data at lower levels of granularity. Figures in the supplementary tables have not been rounded.
6. Statistical disclosure control
Statistical disclosure control has been applied to these statistics. Patient count, items, and net ingredient cost (NIC) have been redacted in the supporting summary tables if they relate to fewer than 5 patients. Further information about our statistical disclosure control protocol can be found on our website.
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