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


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

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