... A first step to supporting patients affected by this urgent public health issue .
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GOVERNMENT LAUNCHES PRESCRIPTION DRUG REVIEW
PUBLIC HEALTH ENGLAND ( PHE ) is launching an independ - ent review into the ‘ growing problem ’ of prescription drug dependency , the government has announced .
Dependence-forming drugs such as opioids , benzodiazepines , GABAergic medicines and ‘ z-drugs ’ like zopiclone were being prescribed to 9 per cent of the population by 2015 , according to figures from NatCen , up from 6 per cent in 2000 . The year-long PHE review will cover sedatives , painkillers , anti-anxiety drugs and antidepressants .
The All-Party Parliamentary Group ( APPG ) for Prescribed Drug Dependence has been calling for a 24- hour helpline for people experiencing dependence on these substances ( DDN , April 2017 , page 4 ). ‘ The APPG is pleased that Public Health England now agrees that prescribed drug dependence is a serious public health issue which needs to be addressed ,’ it said .
‘ Prescribed drug dependence can have devastating consequences for patients , leading to years of unnecessary suffering and disability following withdrawal from medication which has simply been taken as directed by a doctor ,’ said APPG chair Paul Flynn MP . ‘ The APPG welcomes the proposed evidence review of prescribed drug dependence and withdrawal by Public Health England as a first step towards the commissioning of services , including a national helpline , to support patients affected by this urgent public health issue .’
The Royal College of General Practitioners ( RCGP ), meanwhile , welcomed the review but warned that it was important not to ‘ automatically jump to the conclusion that more drugs being prescribed is always a bad thing ’, as advances in research meant a wider choice of medicines for patients .
‘ Many addictive medications , when prescribed and monitored correctly and in line with clinical guidelines , can be very effective in treating a wide range of health condi - tions ,’ said RCGP chair Professor Helen Stokes-Lampard .
‘ But all drugs will have risks and potential side effects . GPs will always prescribe in the best interests of the individual patient in front of us , taking into account the physical , psychological and social factors that might be impacting their health . However , we know most patients would rather not be on long-term medication and where appropriate we will explore nonpharmacological treat - ments , but these – and this is particularly so for psychological therapies – are often scarce at community level .’
Meanwhile the Medicines and Healthcare Regulatory Agency ( MHRA ) has announced a crackdown on the diversion of prescription medicines such as benzodiazepines and other hypnotics onto the illegal market . Up
... A first step to supporting patients affected by this urgent public health issue .
PAul FlYnn MP
to £ 200m worth of medicines were diverted between 2013 and 2016 , the agency says , ‘ putting thousands of vulnerable people at risk ’.
‘ The medicines being sold are potent and should only be taken under medical supervision ,’ said the MHRA ’ s head of enforcement , Alastair Jeffrey . ‘ Criminals involved are ex - ploit ing people when they are at their most vulnerable ; their only objective is to make money . We will continue to concentrate our efforts on identifying the criminals involv - ed and ensure they are prosecuted through the courts .’ areas , while even the best-performing council , Somerset , still achieved less than 50 per cent coverage . Survey results at www . release . org . uk / naloxone
DYSFUNCTIONAL RELATIONSHIPS
POLICE FORCES RISK DAMAGING their relationships with local communities by being unable to demonstrate fair use of stop and search , says a report by Her Majesty ’ s Inspectorate of Constabulary and Fire & Rescue Services ( HMICFRS ). While black people are over eight times more likely to be stopped and searched , drugs searches involving black people were ‘ less likely to result in drugs being found compared with those involving white people or other ethnic groups ’ says the document . ‘ Forces must be able to explain the reasons for any disparity in their stop and search figures if they are to enhance the trust and confidence of all communities ,’ said inspection lead Mike Cunningham . PEEL : Police legitimacy 2017 at www . justiceinspectorates . gov . uk
COPING MECHANISMS
ALMOST 60 PER CENT OF ADULTS who drink are ‘ doing so because it helps them to cope with the pressures of day-to-day life ’, according to a YouGov survey commissioned by industryfunded charity Drinkaware . ‘ Whilst people might think having a drink after a hard day can help them relax , in the long run it can contri - bute to feelings of depression and anxiety and make stress harder to deal with ,’ said Drinkaware chief executive Elaine Hindal . The number of people drinking ‘ when they are already feeling depressed or nervous , and at levels which are harmful to both their physical and mental health ’ was ‘ deeply concerning ’, she added . Survey results at www . drinkaware . co . uk
SORRY STATE
THE TREATMENT SECTOR ’ S ABILITY to absorb funding cuts through efficiency savings and service redesign has been ‘ exhausted ’, according to the latest State of the sector report , with the system ‘ starting to buckle under the pressure ’. A high turnover of commissioners is also causing concerns about loss of expertise and there are ongoing worries about rising caseloads and erosion of service capacity , warns the document , which is published by Adfam on behalf of the Recovery Partnership . While there were ‘ many wonderfully talented and dedicated people ’ working in the sector , funding pressures meant they were ‘ unable to deliver to the gold-standard we ’ d all like
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to see ’, said Adfam chief executive Vivienne Evans . State of the sector 2017 – beyond the tipping point at www . adfam . org . uk
POOR PROVISION
LEVELS OF NALOXONE PROVISION by local authorities are ‘ chronically inadequate ’ and ‘ certainly not sufficient to prevent opioid deaths to any meaningful extent ’, according to research by Release . Although take-home naloxone is now provided by 90 per cent of local authorities ( DDN , September 2017 , page 4 ), FoI requests revealed that just 12 take-home kits were being given out for every 100 people using opiates . Naloxone coverage was found to be between 1 and 20 per cent in more than 70 local authority
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CHANGING MARKETS
THE TOTAL AREA OF OPIUM POPPY CULTIVATION in Myanmar has fallen by 25 per cent from 2015 levels according to UNODC . The drop is in sharp contrast to Afghanistan ’ s 87 per cent increase in opium production last year , which has taken the world into ‘ uncharted territory ’ according to UNODC executive director Yury Fedotov ( DDN , December / January , page 4 ). Myanmar ’ s declining cultivation is likely to be the result of a changing regional drug market in East and Southeast Asia , says the agency , with its shift towards synthetic drugs like methamphet amine . Myanmar opium survey 2017 at www . unodc . org
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We are in ‘ uncharted territory ’
YurY Fedotov
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4 | drinkanddrugsnews | February 2018 www . drinkanddrugsnews . com