PHE review prescription medicine dependence

Public Health England (PHE) has announced that it is conducting a review to examine the evidence for dependence on prescribed medicines. According to NHS prescribing data from NatCen Social Research, prescribing of dependence-forming medicines (opioids, benzodiazepines, ‘z-drugs’ used for insomnia and GABA-ergic medicines) in primary care in England is rapidly rising; in the year 2000, 6% of patients were prescribed at least one of these drug types of drug, and this figure increased to 9% in 2015. In addition, antidepressant prescriptions have more than doubled over the past 10 years.

The review, which was launched at the end of January, will investigate commonly prescribed dependence-forming medicines licensed for adults with chronic non-cancer pain, anxiety, insomnia or depression, and will gather the best available evidence on prescribing patterns, the nature and causes of prescription-medicine dependence (or, in the case of antidepressants, discontinuation syndrome), and effective prevention and treatment strategies.

The prescription medicines under review include benzodiazepines, z-drugs (eg zopiclone, zolpidem), GABA-ergic medicines (pregabalin, gabapentin), opioid pain medications and antidepressants. However, the review will not include the use of these drug treatments in cancer or terminal pain.

“We know this is a huge problem in other countries like the United States – and we must absolutely make sure it doesn’t become one here,” said Parliamentary Under Secretary of State for Public Health and Primary Care, Steve Brine MP, who commissioned the review. “While we are world-leading in offering free treatment for addiction, we cannot be complacent – that’s why I’ve asked PHE to conduct this review,” he added.

A full scoping document is currently being developed, and PHE aim to publish the findings of the review in early 2019.

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