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Drugs: Prescribed Drug Addiction and Withdrawal

Volume 728: debated on Thursday 23 June 2011

Question

Asked By

To ask Her Majesty’s Government what action they propose following the latest two reports from the National Addiction Centre and National Treatment Agency on prescribed drug addiction and withdrawal.

My Lords, my honourable friend the Minister for Public Health, Anne Milton, has discussed the findings of the reports with the All-Party Parliamentary Group on Drug Misuse and the All-Party Parliamentary Group on Involuntary Tranquiliser Addiction at a meeting chaired by my noble friend Lord Mancroft on 14 June. She wrote to my noble friend yesterday setting out the collaborative action that she will be taking in the light of that helpful discussion. She will be convening a round table meeting to discuss the key issues.

My Lords, I thank the Minister for that information. Does he accept that this is an emergency for the victims of withdrawal from prescribed drugs and their families? Cannot the Government recognise the good practice that is already out there, set up withdrawal clinics and spread the word that no longer are these prescribed drugs but that they are turning into dangerous substances which can cost lives? These people cannot wait for further reports and consultation.

Earl Howe: My Lords, dependence on prescription or over-the-counter-drugs can be every bit as distressing and debilitating as dependence on illegal drugs and clearly has an impact on not only those suffering from dependence but their families and their communities. It is an important issue which we have clearly resolved to address as part of the national drug strategy by focusing on all drugs of dependence, including prescription and over-the-counter medicines. Many NHS and voluntary organisations provide support to people in relation to prescription and over-the-counter medicine use and support is available to people who develop problems in relation to those issues in most local areas. However, it is clear that there is variation in the levels of support provided between local areas and we need to address that problem.

My Lords, how much advice is now being given to GPs over the prescribing of psychoactive substances? In the revisions of the NHS as proposed by the Government, will the pricing bureau which monitors GP prescriptions still have the same levers as it currently has in providing GPs with benchmarking of their prescribing of psychoactive substances?

My Lords, I am not sure that I can answer the latter part of the noble Baroness’s question but GPs are clearly in an important position in this context. They are responsible for identifying patients who need help and for supporting them. I do not think that there is any reliable evidence that doctors are failing to comply with guidelines on the prescribing of benzodiazepines but I am aware that the Royal College of General Practitioners is updating its guidance at the moment. It is working hard to produce that very shortly.

My Lords, given the importance of making visible the number of people who are addicted in this way, when will the Government calculate the true number of people addicted to and withdrawing from legally prescribed drugs? That information could be made available from GP computer records. Does the Minster agree that both the NAC and the NTA reports confuse the number of patients taking legal prescriptions with the number of users of illegal drugs?

I agree with the noble Lord that it would be very nice to have a better handle on the numbers here, but the two reports found that nationally available data do not actually provide a definitive prevalence estimate of dependence on prescription and over-the-counter medicines, much as we would wish otherwise. The reports, not unreasonably, consider the full spectrum of need in relation to the issue of addiction. The key point here is that, while different people might start taking these medicines for different reasons and may present with a different range of needs, no one at all should be excluded from the treatment and support that they require. The reports distinguish between the two groups of patients, not just those who are dependent on prescription and over-the-counter medicines but also those who are dependent on illegal drug use. That enables us to make some useful comparisons.

Cognitive behaviour therapy is often considered as an alternative to benzodiazepines. Does the Minister believe that that low-risk alternative might be available more readily through the proposed clinical commissioning groups?

My Lords, my noble friend will know that we have set aside a very considerable sum of money over the spending review period to expand the availability of talking therapies. I entirely agree that it is an important avenue of treatment.

Following on from the noble Earl’s supplementary question on how to ensure that good practice becomes standard practice, how will that sit with the dismantling of strategic health authorities, PCTs and other levers that might be used to ensure progress? Who or which organisations in the proposed restructuring of the NHS will be able to ensure that patients who have an addiction to prescription drugs receive the support that they desperately need? I agree with the noble Earl that this is an emergency; it is not the first time that we have discussed this on the Floor of the House.

My Lords, the responsibility for commissioning these services in future will lie with local authorities, supported by Public Health England. The noble Baroness will be aware that it is our proposal to ring-fence the public health budget. Local authorities will be informed by the joint strategic needs assessment that they carry out and will work in partnership with local delivery organisations and with local GPs, who, as I have mentioned, will be even better informed than they are at the moment thanks to the Royal College guidance.

My Lords, how much research into the problem of prescribed drug addiction is being supported by the National Institute for Health Research?

My Lords, I am afraid that I do not have that figure in my brief, but I shall write to the noble Lord if it is available.

My Lords, as this is a UK-wide problem, how do you link with the devolved Administrations in Wales, Scotland and Northern Ireland to make sure that the guidelines that we get here for England are shared with those in the other Administrations?

My noble friend will know, as his question certainly made clear, that health is a devolved matter. However, we work very closely with our counterparts in the devolved Administrations on a basis of mutual information. I am sure that, for example, the Royal College of General Practitioners will wish to make certain that the devolved Administrations are every bit as well informed about their work as we are in the department in London.