Abstract: Opioid medicines provide relief from acute pain; however, long-term use (in non-cancer pain) carries risk of dependence and addiction. An opioid epidemic has been well documented in the USA, causing huge numbers of deaths annually and hundreds of billions of dollars in economic losses. In light of the US experience, increasing rates of opioid usage in the UK are raising considerable concerns; a recent study of primary care electronic health records found that codeine prescriptions have increased fivefold from 2006 to 2017 and that 14.6% of people given opioids for the first time became long-term opioid users within a year.