Health: Addiction to Prescribed Drugs

Lord Mancroft Excerpts

Wednesday 6th October 2010 Lords Chamber

[Lord Mancroft]

My Lords, your Lordships will be grateful to the noble Earl, Lord Sandwich, for initiating this important debate. I commend the noble Earl on his courage in describing through the example of his own family the particular and peculiar degree of suffering as the result of addiction to benzodiazepines and other prescription drugs. I declare an interest as chairman of the All-Party Group on the Misuse of Drugs. My predecessor, Dr Brian Iddon, who retired at the last election and to whom I pay tribute for his commitment to and tireless work for the group, set up an inquiry and produced in January 2009 a report on addiction to prescription and over the counter medication. I would suggest that the report is required reading for anyone with an interest in this subject. It is by no means perfect, and I am aware that the All-Party Group on Involuntary Tranquilliser Addiction did not agree with all the recommendations, and consequently produced its own report. Having read both reports, I see little of substance to separate them. More important is that it appears that there has been little reaction to either report from those responsible for this appalling situation.

And this is an appalling situation. It is now pretty clear that a very large group of patients, through no fault of their own, are suffering debilitating physical and psychological symptoms to the point where many are incapable of leading remotely normal or happy lives. It is not clear exactly how many people are in this position, but it seems likely to be well over 1 million. That is significantly more than the 350,000 chronic and chaotic illegal drug addicts who clog up our criminal justice system and take up so much of our time and money.

Interestingly, I have had more briefing for this debate than for almost any other that I have taken part in. For example, I was intrigued to learn from Professor Hamid Ghodse’s recent annual report on drug related deaths in the UK that out of a total 2,182 deaths last year, 20 per cent were caused by heroin or opiates, which is perhaps not particularly surprising. However, 10 per cent were as a result of prescription drug overdose. More significant is the number where a mixture of illegal, prescription, over the counter drugs and alcohol are the cause of death. I shall return to this point at the end of my remarks. Whichever way you look at it, this is an unacceptable situation. What is clear is that responsibility for researching it in order to fill the very real gaps in our knowledge, and for producing a plan to tackle the problem, lies fair and square with the Department of Health, the royal colleges—in particular those for general practitioners and psychiatrists—and the pharmaceutical industry, which produces and profits from these drugs. It is clear that all three have been guilty of a quite staggering degree of complacency, which amounts to a gross dereliction of duty.

The problems we are discussing have been known about since the 1980s, if not earlier. I wonder, too, how much of this is the result of the cosy relationship between doctors, the drug companies and the department. The previous Government are to be congratulated on setting up last year the review which is the subject of this evening’s debate. From correspondence I have seen, it appears that the terms of that review may have been amended and reduced by officials—quietly, I suspect, while one Government went and another came. I hope, when he comes to reply, that my noble friend will be able to reassure the House that the review will be thorough, all-encompassing, and that it will be completed in a reasonable time. I hope, too, that this Government will publish the report, that it will include recommendations—a point made by another speaker earlier in the debate—and that those recommendations will be subject to consultation among the relevant stakeholders. We should also remember that the Government are currently reviewing their drug and alcohol strategy, for which the consultation period will shortly draw to a close, but I hope that my noble friend will be able to reassure the House that the issue of addiction to prescription drugs that we are discussing tonight will form a significant part of the review and be included in the Government’s proposals when the strategy comes out.

In respect of this, I should like to make two final points. I referred earlier to the number of deaths caused by a mixture of different drugs and alcohol. Increasingly, whether we like it or not, we live in the age of the poly-addict—the addict who will take any or all sorts of drugs. I know that some seek to differentiate between involuntary addiction to prescription drugs and the use of illegal or street drugs. Having said that, I have never met a voluntary drug addict, whatever drug they were taking. But the resulting health problem is that of addiction. It does not much matter whether you break your leg ballroom dancing, playing cricket or falling over outside the pub, having had a glass too many. What matters is that you have a broken leg and it needs to be fixed. That is the key point.

The noble Earl said clearly that he does not believe that the National Treatment Agency has the expertise to provide the specialist withdrawal services that benzodiazepine addicts need. He is certainly correct in that, and indeed I wonder who does have that expertise. I could argue that the National Treatment Agency’s main area of expertise lies in prescribing drugs such as methadone rather than in helping patients off drugs altogether, which could suggest that it is part of the problem rather than part of the solution. What matters is that the solution is one of appropriate healthcare, which currently is not being provided either for involuntary tranquilliser addicts or voluntary street drug addicts. Both need to be provided with appropriate care, and ultimately the NHS must provide that care, whether via the National Treatment Agency or any new body to be set up as part of the public health reforms.

That brings me to my last point. Whatever happens, the solution to this problem lies in proper regulation of prescribing, better training of doctors and other healthcare professionals, the provision of high quality detoxification and treatment for all addicts that gets them off rather than keeps them on drugs, and assistance back into the work place. In other words, it is a health solution, not a criminal justice one, and that is why it is so welcome that the Minister responding to tonight’s debate is a Minister from the Department of Health, not one from the Home Office. That, at least, is progress.