Lord Hunt: It’s time government took action on prescribed drug dependency
For far too long, the problem of prescribed medicine dependence has been ignored or hidden away. A National Action Plan is urgently required, writes Lord Hunt
A staggering 15% of us are taking tranquillisers, anti-depressants or other psychotic medicines at any one time. While they can have their benefits, their long-term use can cause dependency and have a hugely damaging impact over months and sometimes even years. Patients can suffer long term disability, adverse physiological and neurological effects and protracted withdrawal with associated complications.
A study published in the British Journal of General Practice in May 2017 into the prevalence of long-term use of benzodiazepines and ‘Z-drugs’, used mostly for the treatment of anxiety and insomnia, found that more than a quarter of a million people in the UK are likely to be taking highly dependency-forming hypnotic medication far beyond the recommended timescales.
The same trend is seen with other drugs. Recent research commissioned by the National Institute for Health Research into prescribing patterns in dependence-forming medicines found that they are widely prescribed in primary care. In 2015, opioids for chronic pain were prescribed to five per cent of all patients on the Clinical Practice Research Datalink.
Worryingly, benzodiazepines, Z-drugs and opioids have tended to be prescribed for longer to people living in the most deprived neighbourhoods, compared with people living in the least deprived neighbourhoods.
Despite this being a serious public health problem, the NHS is woefully ill-prepared to help patients affected. The Council for Evidence Based Psychiatry report that there are little NHS services available. Instead a huge reliance is placed on a small number of underfunded charities to provide these services. But, they cover only a fraction of the UK, and are seeing a significant unmet increase in demand.
The APPG for Prescribed Drug Dependence has warned that many doctors respond inappropriately to prescribed drug dependence and withdrawal symptoms, due to a lack of awareness and training. The result is that large numbers of patients are suffering alone at home, unable to work, with no NHS support, relying on peer-to-peer support via the internet.
The NHS needs to step up its response. Dedicated support services as called for by the BMA are required to help these patients. The APPG is also calling for a national helpline to counsel this group of patients, alongside a withdrawal resources website for both doctors and patients. This would be of huge help to patients and their families who often feel isolated and could be introduced relatively quickly.
As a sufferer told the APPG: “There are crisis points when you’re hanging on to life by the tiniest thread. It would be good to talk to someone who knows that it is actually the drug wrecking me.”
The recently-updated National Clinical Guidelines for Drug Misuse and dependence has specific guidance about pharmacological management of dependence on benzodiazepines and z-drugs, including prescribing regimens, detoxification, and therapies and monitoring. But this doesn’t go far enough.
What is also needed is NHS guidelines on withdrawal for prescription drug addiction. But, ministers have not commissioned them and while they have readily acknowledged the problem, seem powerless to make NHS England establish support service. Instead they park the problem at the door of cash strapped local authorities. Ministers won’t even agree to collect data nationally on benzodiazepine dependence.
I shall be arguing in Lords oral questions that a National Action Plan is urgently required, supported by the Government and made a key priority in the NHS Mandate. For far too long, this problem had been ignored or hidden away. For the sake of those who have suffered the hugely damaging impact of prescribed medicine dependence, we must act.
Lord Hunt of Kings Heath is a Labour peer and spokesperson for Health, Further and Higher Education and Cabinet Office. His question is on Monday 19 March