MPS' INQUIRY CONCLUDES DEPENDENCE ON LEGAL MEDICINES IS "A SIGNIFICANT PROBLEM"

The All Party Parliamentary Drugs Misuse Group  today publishes the findings of a year-long inquiry into dependence to over-the-counter and prescription-only medicines.

The inquiry, conducted Select Committee-style, took written and oral evidence from the general public, medical and addictions specialists, charities and support groups, pharmaceutical companies and trade and regulatory bodies.  The report details problems faced by individuals who develop dependency problems to a range of prescription and over-the-counter (OTC) medication. 

Prescription-only medicines (POM) implicated include benzodiazepines and some antidepressants; the inquiry also heard about problems with OTCs including some painkillers, particularly those containing codeine.

OVERPRESCRIBING PROBLEMS

The inquiry  heard evidence from individuals who had been taking benzodiazepines for 30 years - despite guidance to doctors saying the drugs should be prescribed for no longer than 4 weeks at a time.  Some people had been incapacitated by the symptoms associated with their dependence on or withdrawal from medication, which included panic attacks, confusion, anxiety, severe joint pain, tremors and stomach ulcers. 

Many people described the lack of support available when discovering they were dependent on medication they had been prescribed by their GP or that they had bought from their pharmacy.  Drug-treatment services are not necessarily geared to help individuals with a dependency on OTC or POM drugs. So small charities, support groups and online forums are often their only source of advice and help.

LACK OF OFFICIAL DATA

APPDMG members were also concerned about the lack of official data recorded which could help determine the scale of the problem of OTC or POM dependency.  While not within the scope of the inquiry to address this directly, it is a key recommendation of the Group that research should be carried out by the Department of Health into the problem as a matter of urgency. 

RECOMMENDATIONS

The APPDMG's wide-ranging recommendations also include:

• medical students and nurses should be trained to recognise the symptoms of OTC and POM dependency;

• the Department of Health should require all Primary Care Trusts to provide appropriate treatment for those with an OTC or POM dependency;

• information and warnings about potential dependence should be included with every sale of products containing codeine;

• the value of small support groups including online fora should be recognised and appropriate government funding allocated to ensure their continued operation.

Dr Brian Iddon, Member of Parliament for Bolton South East, chaired the All Party Parliamentary Drugs Misuse Group. "Our inquiry has only scratched the surface of this problem,” he commented.

“ We have received evidence from individuals and support groups about the extremely distressing effects of dependency to or withdrawal from a range of OTC and POM drugs.  More concerning still is the lack of support available.  Local drug treatment services are often unable to assist and if their GP is unsympathetic. People can be left to deal with their problems alone. 

"Despite clear guidance around the use of benzodiazepines, we heard from many people still in receipt of regular repeat prescriptions, some for years at a time. I was also shocked by evidence suggesting that a considerable number of people in the UK are addicted to OTC products containing codeine.  This issue cannot be ignored any longer.  We must establish the scale of the problem and provide proper diagnosis and treatment for those affected.

"I would like to thank all those organisations and individuals, including members of the APPDMG, who have participated in this inquiry, and express our particular thanks to those members of the public who shared their personal experiences with us." 

MORE DETAILS

Down the recommendations here Download APPGDM Report recommendations-OTC&POM

An Inquiry into Physical Dependence and Addiction to Prescription and Over-the-Counter Medication, can be downloaded here.    

 The All Party Parliamentary Drugs Misuse Group is a cross-party interest group, the purpose of which is 'to educate members of both Houses of Parliament and stimulate debate on issues surrounding drugs misuse. The officers of the APPDMG are: Dr Brian Iddon MP (Chair), Paul Flynn MP, Lord Mancroft, Lord Rea, Baroness Masham of Ilton (Vice Chairs), Dai Davies MP (Treasurer) and David Burrowes MP (Secretary). Gemma Reay is parliamentary researcher to Dr Iddon.

Benzodiazepines are the most commonly prescribed minor tranquilisers.  They are sedative drugs used to relieve anxiety and insomnia.  Dependence can develop with regular use and withdrawal can lead to intense anxiety, nausea, insomnia, irritability and headaches. Sudden withdrawal from very high dosages can be dangerous and result in confusion and convulsions. Many people find it very difficult to give up the drugs and may need a gradually reduced dosage to do so.

Codeine is an opioid analgesic (painkiller).  It may be prescribed on its own for pain relief.  Some OTC preparations contain codeine in combination with other analgesics such as paracetamol, ibuprofen or aspirin.  Dependence on these medications containing a combination of codeine and other painkillers can develop (but it should be remembered that other analgesics such as paracetamol or aspirin may also produce a form of dependence with chronic use).  Withdrawal from codeine may induce joint pain, restlessness, irritability or flu-like symptoms.  Long term use of the other analgesics in OTC preparations can have serious health effects, impacting on the liver or the stomach.

Comments

[pain pill addiction]

Legal medicine is the branch of medicine that deals with the application of medical knowledge to legal problems and legal proceedings. Legal medicine is also called forensic medicine.

-jomie-

[Bob Dunkley]

As a practicing community pharmacist I see prescriptions for HUGE amounts of opiate based painkillers. Most of the people who are taking these month after month, year afyer year, are surely dependent. A call to the prescriber, because Mr Smith has just been dispensed 400 co-codamol 30/500, 200 tramadol 50mg, and 300ml of morphine solution (as happended to me today) elicits the reply " what do you want me to do?"
My thoughts are stop prescribing the b****y things, but the prescriber has the welfare (we hope) of the patient in mind, and whilst the obvious track is to wean the patient off, or at least bring some control to their drug use, he is not likely to do anything - anything means a bit of thought, and GPs are well beyond rational thought at the end of a busy surgery.
Meanwhile we see the drug companies promoting really strong opioids for seemingly trivial complaints: a few years ago, anyone prescribed fentanyl or oxycodone, were on their way out via cancer. No Longer, if you have a bad back, then whack on that fentanyl patch; morphine solution is the almost universal panacea to any pain that you care to name. Opioids have moved from terminal care into the realms of non-life threatening conditions, and this movement has "downgraded" the status of strong opioids - they are now as ubiquitous as paracetamol.
The result: we are growing up in an atmosphere of universal opioid use. Because you can bet Mrs Smith will tell Mrs Jones that "...them patches/liquid/pills I got from t'doctor - eeh they really give you a buzz"
And so it goes on. GPs must learn to asses pain in a better way.
Regards
Bob Dunkley

[Jane Hallett]

I have a career in the medical profession and became addicted to codeine related products, originally counter preparations and subsequently the stronger POMs. You could argue that I should know better but after having had the fortune of rehab treatment I now realise that addiction is an illness of which some of the symptoms are dishonesty, secrecy and fear of rejection...the stigma attached to addiction is one of horror and immorality the victim being weak willed and living on the park bench!
I would gladly share any other information which you may find of value but I agree with increasing the awareness of the free availabilty of some of these drigs which are open to abuse even when the patient is oblivious to the life threatening consequences. Maybe the prescribers and suppliers should be more informed/special licenses should be given?
Perhaps I could be of some service to your campaign?

[Benzodiazepine Addiction]

enzodiazepine addiction has grown as the use of these drugs has largely replaced the more dangerous barbiturates. Benzodiazepines are tranquilizers, designed and developed to treat a variety of conditions and with a range of both toxicity and sedative potential. They are sold under various names, by prescription, to treat anxiety, insomnia and a host of other similar medical conditions. Taken in therapeutic doses, and even when adhering to the prescribed dose, these drugs can cause addiction. Used as an illegal recreational drug almost guarantees addiction after a short while.

[Benzodiazepine Addiction]

nice blos.i like your blogs. thanks for posting here.

[Colin Young]

This problem of benzodiazepines being prescribed wrong is massive and has went on for 40 years. I work with a specialist tranquilliser organisation who has done tireless amounts of work since 1985 in the Bristol area. Still they are mismanaged and harder to withdraw from than any other drug with devastating consequences for some people and many of whom aren't addicted to any other drug or ever been an elicit drug user, the problems these people face are dreadful. At least illicit drug users are used to cold turkeys and managing withdrawals these poor sods have their world turned upside down by mismanagement of gp prescribing as well as this they can also be arrogant to self help groups actually knowing alot more than they ever will.

[Deborah]

I am a nurse who became addicted to Benzodiazepines.
I was prescribed them for anxiety, then my GP, following Govt. guidelines started to rapidly reduce them, I could not cope and began helping myself at work.
I know now how stupid and wrong that was.
Now, although the case has been dealt with by the NMC and I am allowed to practise unrestricted, I cannot get a job in nursing.
I was a good nurse with a 30 year unblemished career, now because of anxiety caused by work and the consequences, I cannot practise