NHS address prescription drug addiction

A GP summit today examined how to address addiction to prescription and over-the-counter drugs following publication of two new reports into the scale of the issue commissioned by the Department of Health.

The two studies, which were conducted by the National Addiction Centre and National Treatment Agency for Substance Misuse, provide important insights into the issue of addiction to medicines. They will inform future guidance and policy such as the development of new Royal College of GPs guidelines for the use of benzodiazepine and similar drugs in general practice.

People can become dependent on tranquilisers, sleeping pills and opiate based painkillers, such as codeine, particularly if taken at high doses for prolonged periods. Long-term dependence on substances such as benzodiazepines has been identified as a particular issue. Today’s reports reveal that the overall prescribing of benzodiazepines is falling but that prescription of benzodiazepines to treat anxiety continues to increase as do the sale and prescription of opioid painkillers.

The findings suggest:

most prescribing falls within current guidelines;
long-term prescribing increases the likelihood of dependency but this is not inevitable;
dependence may be overcome if individuals are supported to reduce gradually their medication;
of the 32,510 people in drug treatment who reported problems with prescription or over-the-counter medicines only 3,735 were not also using illegal drugs; and
over the last 19 years dispensing of benzodiazepines has decreased but there has been an increase in the prescribing of anxiolytic benzodiazepines and the sale and prescription of opioid painkillers;
most local areas provide some treatment for people who develop problems in relation to medicines.

GPs at the Substance Misuse Management in General Practice conference will now consider what the implications of these two studies are for local practice and how best to prevent and manage addiction to medicines.

What the experts say

Public Health Minister Anne Milton said: “Addiction to prescription drugs can be every bit as damaging and distressing as addiction to illegal drugs.

“For the first time we have a national picture of what is happening in the community and how we can address addiction to painkillers and tranquillisers.

"Most areas in the country have services in place to support people who develop problems but there is regional variation coupled with a paucity of knowledge on the issue. We want local health professionals to pay close attention to the report so that they meet the needs of their populations.”

A National Addiction Centre spokesperson said: "The National Addiction Centre in collaboration with colleagues from the University of Bristol, has conducted a review on the changing use of prescribed benzodiazepines and z-drugs and of over-the-counter codeine-containing products in England.

“This structured review of published English and international evidence and available data informs consideration of the extent of dependence and harm. The review is published online from today, 11th May 2011, and may be updated or revised by the National Addiction Centre and collaborators as new data and new evidence become available."

GP's are responding

RCGP Chair Dr Clare Gerada said:

“GPs are all too aware of the damage that addiction to drugs – prescription and non-prescription – can do to the lives of an addicted person and their family, and the RCGP welcomes this renewed focus from the Department of Health.

“GP prescribing is guided by good standards, as laid out, for example, by the British National Formulary and DH National Clinical Guidelines on Substance Misuse. GPs are aware of the importance of not creating dependence on prescription drugs, and make sure they prescribe responsibly and according to good practice guidelines.

“The RCGP has worked for over two decades to improve GPs’ knowledge and skills in the management of substance misuse and much of this work as been led our own RCGP Substance Misuse Unit. We are pleased with how well GPs have responded to the advice issued by the RCGP over the years.