Wednesday, November 11, 2009

Debate on Health: Side Effects of Medication

Parliamentary Debate

The Earl of Sandwich, House of Lords, Tuesday November 3rd, 2009

Health: Side Effects of Medication

Question

2.41 pm

Asked By The Earl of Sandwich

To ask Her Majesty’s Government how they will ensure that doctors and pharmaceutical companies fully recognise the long-term side effects of prescribed tranquillisers and antidepressants, and the nature of withdrawal symptoms.

Baroness Thornton: My Lords, the Government are aware of concerns around prescribing these medicines, particularly after the report of the All-PartyParliamentary Group on Drugs Misuse. The Department of Health is undertaking a review of addiction to medicines which is due to report next year, and of course the Medicines and Healthcare Products Regulatory Agency continuously monitors the safety of medicines on the UK market and issues advice to raise awareness of the potential for side effects.

The Earl of Sandwich: MyLords, I thank the Minister for her reply and I welcome the review. Can she confirm that there are approximately 1.5 million people in the UK who are addicted to prescribed drugs such as benzodiazepines? I declare an interest. A member of my family is confined to his room; he is trying to withdraw from one of these drugs. He cannot work or take the children to school. There is no government benefit or assistance for people in his situation. Can the Government confirm that they are getting on with a proper NHS network of support for these patients?

Baroness Thornton: The noble Earl is, I fear, not alone in direct experience of what can happen to people who suffer from withdrawal reactions to these drugs. There are support services available in some areas of the country which have a good success rate in helping people to withdraw from medicines to which they have become inadvertently addicted, but we recognise that the availability of these services is variable and patchy. Our review will seek to identify what needs to be done to better support people experiencing these problems. We will also review the services that are currently provided in order to gauge the level of support available, and draw on best practice to ensure that we get full cover and support for people in these situations.

Lord Ashley of Stoke: My Lords, have the Government made their own special study of the effects of these tranquillisers? Are they able to impose their views on doctors and pharmaceutical companies? Does the Minister agree that pharmaceutical companies can be far more resistant to pressure from the Government than doctors and that it will require much stronger pressure on the companies than on the medical professions?

Baroness Thornton: My noble friend asks a very pertinent question. Product warnings are kept under close review. One example of this relates to products containing codeine, where new, hard-hitting warnings such as “can cause addiction” and “for three-day use only” on the front of the pack will be introduced next year. Guidance to the healthcare professions will be considered as part of the review that is taking place.

Lord Williamson of Horton: My Lords, I declare an interest as a patron of Rethink, the mental health charity, which does excellent work. There is also the medication helpline of the Maudsley Hospital. Will the Minister consider whether there could be improvements in the information available to those who suffer from mental health problems as the result of withdrawal from prescription drugs? There may be a gap there that we could help to fill.

Baroness Thornton: The noble Lord makes an important point, and the review will be looking at that. There are examples in Liverpool and Bristol of counselling information, education and advice being made available to people, but the noble Lord points to the importance of telling people who are being prescribed these drugs what the side effects might be.

Lord Elton: My Lords, will the inquiry bear in mind the advisability of advising doctors not merely on the dangers of addiction but on the method of keeping in view the condition of people for whom they prescribe these drugs long-term, and who will become addicted without their own knowledge unless they are carefully monitored?

Baroness Thornton: There is a great deal of information available to prescribers of these drugs: the British National Formulary; product information; the National Prescribing Centre, which has an excellent record;

and—for the treatment of depression, for example—NICE 113 Introduction [3 NOVEMBER 2009] Health: Side Effects of Medication 114 [BARONESS THORNTON] guidance talks not only about the effect of prescribing but about the need to provide other therapies to people who are suffering from depression.

Baroness Barker: Does the Minister agree that it would be beneficial if all pharmaceutical companies were required to print information about the half-life of tranquillisers and anti-depressant drugs, so that individuals trying to manage the process of coming off them could do so knowing what the effects were likely to be over a short period?

Baroness Thornton: In answer to a Question put by my honourable friend Jim Dobbin, the Minister said that:

The half-life of a drug intended for use as a sleeping tablet is only one of many factors that influences the safe use of a medicine. Information to aid … safe use … is provided in the product information which consists of the Summary of Product Characteristics…and the Patient Information Leaflet”.—[Official

Report, Commons, 20/5/09; col. 1435W.]

The key point is that those resources are used at the right time.

Lord Crisp: My Lords, in setting up the review, will the Minister ensure that it takes full account of implementation? She will know as well as I do that there is a difference between policy and implementation. Does she have any thoughts about how to ensure that this policy, which needs to be a very personal one to every member of the primary care team, is disseminated so that people are not only aware of it but follow it in practice in all the individual cases that we are talking about?

Baroness Thornton: The review will be completed next year, with a report published later in the spring. We are doing a counting exercise, reviewing evidence of the prevalence of addiction, effective treatment and the long-term effects of the use of a range of antidepressants, sleeping pills and codeine-based painkillers. That will influence future policy. The noble Lord is right, though, that the policy leadership within the department has to address how to ensure that this is rolled out and how to use the machinery and levers that we have to ensure that it is implemented.

Baroness Gardner of Parkes: My Lords, does the Minister agree that these drugs are obviously very complicated and must be of benefit to a number of patients or they would not be in such common use? Does she have any figures on the percentage of people who become addicted?

Baroness Thornton: I do not have any figures on the percentage of people who become addicted. That is part of the exercise that we are undergoing. The noble Baroness is right that we must not forget the impact of depression, for example, on sufferers, and that depressive illness is a debilitating condition. One in four women and one in 10 men in the UK is likely to suffer from depression at some point in their lives, and these drugs will help to transform their lives and enable them to cope and recover.

Lord Acton: My Lords, does my noble friend agree that “next year” is a rather long and elastic time? Could the review not be tightened up a bit?

Baroness Thornton: We are moving with all speed because we know that this is important, but I promise my noble friend that I will take his views back to the department and see if there is any way that we can hurry up.


Parliamentary Copyright House of Lords 2009


Thursday, October 29, 2009

Announcement

There will be a short debate on tranquillisers in the House of Lords on Tuesday 3 November at 2.30 pm. It may be televised on the parliament channel or parliament website.

Early Day Motion

EDM 2164

WITHDRAWAL FROM PRESCRIPTION DRUGS
27.10.2009


Dobbin, Jim

That this House congratulates Pam Armstrong of the Council for Information on Tranquilliser and Anti-depressants and Doctor Ghosh Arun and the nursing staff at the Sefton Suite of the Aintree Hospital in Liverpool for setting up the first in-patient withdrawal facility for patients involuntarily addicted to prescription medication; congratulates Sandwell Primary Care Trust, Birmingham for partly funding this facility; further congratulates the Department of Health for undertaking a review of its policy on addiction to prescription medication; and urges the Department of Health to establish a national network of specialist out-patient clinics to treat those addicted to tranquillisers and other prescription medications, and regional in-patient clinics like the Sefton Suite for those too addicted to withdraw at home.

Wednesday, October 28, 2009

Letter to A Grosskurth, Dept. of Health

All Party Political Group on Involuntary Tranquilliser Addiction


21 October 2009


Dear Ms. Grosskurth,


I understand that you are conducting a Department of Health policy review on addiction to prescription drugs. A large part of this problem is Involuntary tranquilliser addiction. I am chair of the APPG on Involuntary Tranquiliser Addiction, which was set up specifically to deal with this problem. We are campaigning, amongst other things ,for specialized tranquilliser withdrawal clinics and services designed to give involuntary tranquilliser addicts the opportunity to become drug free.


I would be very grateful if you would meet with me to discuss this issue. My diary secretary will be able to offer you some dates so that we can arrange a mutually convenient appointment. The telephone number is 0207 219 4530. I look forward to hearing from you.


Yours sincerely

Jim Dobbin MP

Letter to Gillian Merron

APPG for Involuntary Tranquilliser Addiction

Gillian Merron MP
Department of Health

20 October 2009


Dear Gillian,

I would like to thank you on behalf of the APPGITA for your visit to the Oldham tranquilliser clinic and for the encouragement you gave to the patients and staff. I would like to meet with you to discuss the current review of Department of Health policy on addiction to prescription drugs. Involuntary tranquilliser addiction is a large part of the subject matter under review. This APPG was set up to deal specifically with the problem of ITA and we have access to experience and expertise on this subject.

Our campaign has been for specialist withdrawal clinics and services to be provided to deal with this problem and provide people with the opportunity to become drug free. I would like to be consulted at the political level on this subject and to be included in all consultations.


Kind Regards,
Jim Dobbin MP.

c.c.Phil Woolas MP.

Tuesday, September 22, 2009

Health Minister's Visit to Oldham

The following is a news article from the Oldham Evening Chronicle:

‘Rebuilding lives’

Reporter: JANICE BARKER
Date online: 22/09/2009

Drugs help service is leading the way

A model of good practice — that’s the verdict of health minister Gillian Merron after visiting Oldham’s specialist service for prescription drug addicts . . . and it could be copied in other parts of the country.

The public health minister talked to addicts who are getting their lives back after being helped to come off benzodiazepines and other prescribed drugs at the Addiction Dependency Solutions centre in Greaves Street.

Ms Merron has already set up a review of the problems of addiction to legal drugs. And a health specialist has visited Oldham campaigner Barry Haslam, who fought his own addiction to Ativan, for his views.

After meeting health professionals, ADS staff and clients yesterday, the minister said: “This is a model of good practice which is why I was very keen to look at it as part of the review.” Asked if the Oldham model could be repeated, Ms Merron added: “I am very interested in seeing if we can.

“It is the kind of thing we can look at. Clearly, they do an excellent job in Oldham and the whole team is to be congratulated.

“Individuals have been generous in their honesty in telling me their experiences. They are very positive about rebuilding their lives with the help of this service.”

Care is given by Suzanne Atreides and Angela Rankin, benzodiazepine withdrawal support workers.

They are invited by GPs to help patients to reduce their addiction.

One client, a 34-year-old single Oldham woman, said: “Without Suzanne and the support of the group, I would never have known that when I was angry or crying, it was not me it was the drugs.” Wendy Kay, area director of ADS, said the service — paid for by NHS Oldham, the primary care trust — is putting a business case to the trust to double the service from one full-time and one part-time worker to three full-time workers.

She added: “If we had three workers we could go into every GP surgery in Oldham — we only do a third at the moment.”

After talking to the minister, Barry Haslam said: “I have been waiting at least 20 years for this — I am delighted.”

(PHOTO . . . (from left) Suzanne Atreides, Gillian Merron, Barry Haslam and Immigration Minister and local MP Phil Woolas)

DIRECT LINK TO ARTICLE

Saturday, September 12, 2009

Public Health Minister to visit Oldham Tranq. Clinic

Gillian Merron MP, the Public Health Minister, is to visit the Oldham Tranquilliser Clinic on 21 September. Also visiting will be Phil Woolas MP and Jim Dobbin MP.

Tuesday, August 25, 2009

Michael Jackson

Press Release
25 August 2009
from Jim Dobbin M.P., Chair of the All Party Parliamentary Group on Involuntary Tranquilliser Addiction.


Sky News and the Times are reporting today that Michael Jackson's death has been ruled to be a homicide and that the drugs found in his body included the anaesthetic Propofol but also the benzodiazepine tranquillisers Ativan (Lorazepam),Valium and Midazolam.

I would like to comment on the dangers of the benzodiazepine tranquillisers involved. In 2004 the Canadian Ativan data sheet contained the warning that "Use of benzodiazepines,including lorazepam may lead to potentially fatal respiratory depression." It also contained a seven day addiction warning and suicide warning ,for lorazepam.

Phil Woolas M.P. wrote to Sir Alastair Breckenbridge, Chair of the U.K. drug licensing authority the MHRA,in 2004 asking for similar warnings to be introduced into the U.K. product information.The warnings were never introduced and in fact no product information sheet for lorazepam tablets was published at all in the U.K. in 2009, despite the increased number of licenses issued.

Tranquilliser related deaths in the U.K. are running at some 300 per year, in some years they have exceeded the total number of deaths for all class A drugs added together, according to Home Office figures. In answer to a Parliamentary question the Department of Health reported that in 2008 over 17 million tranquilliser prescriptions were issued in the U.K., an increase on 2007. My question is how many people have died a Michael Jackson type death in the U.K. and elsewhere, but with no homicide investigation or any other kind of investigation.

Tranquillisers are highly addictive yet the Department of Health provides no withdrawal treatment at all except for one worker in Belfast and two in Oldham. The All Party Parliamentary Group on Involuntary Tranquilliser Addiction (APPGITA) is campaigning for the introduction of specialized tranquilliser withdrawal services by the Department of Health.We are also campaigning for medical research into the damage caused by tranquillisers, a review of the benzodiazepine product licenses which were issued with no assessment of safety or efficacy and a no-fault drug compensation scheme for patients who suffer drug injuries.

Jim Dobbin M.P.

Thursday, August 20, 2009

DoH Review

The Department of Health has undertaken a review of policy on addiction to prescribed and over-the-counter medication with the intention of producing a report in December 2009.

The review manager is Anne Grosskurth and her address is:

Department of Health
133-135 Waterloo Road, 616
LONDON
SE1 8UG

Letter from Home Office re ACMD

Please click on image for larger view.