MPS’ INQUIRY CONCLUDES DEPENDENCE ON LEGAL MEDICINES IS “A SIGNIFICANT PROBLEM”
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.
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.
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,â€ť he commented.
â€ś 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."
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.