Asked by: David Simpson (Democratic Unionist Party - Upper Bann)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he has taken to raise awareness of prescription painkiller addiction.
Answered by Steve Brine
The Government takes seriously the issue of addiction to prescription medicines. People who feel that they might be dependent on either prescribed or over the counter medicines should seek help from a health professional in the first instance (such as a general practitioner or pharmacist). Help and advice is also available from, for example, the 111 helpline or the on-line NHS Choices service.
Public Health England has been involved in a range of work to raise awareness of addiction to medicines, including:
- Providing advice and data for commissioners on treating dependence on prescription and over-the-counter medicines, such as the guide for National Health Service and local authority commissioners available at:
http://www.nta.nhs.uk/uploads/pheatmcommissioningguide.pdf
- Outlining an option for sustainability and transformation partnerships to consider reviewing prescriptions of medicines liable to dependence within primary care, which is available at:
- Supporting the recent update to the drug treatment clinical guidelines, which offers new guidance to clinicians treating people with drug problems including the misuse of prescribed and over-the-counter medicines. The guidelines can be downloaded at:
- Producing advice with NHS England for prescribers on the risks of the misuse of pregabalin and gabapentin. This is available at:
Asked by: Norman Lamb (Liberal Democrat - North Norfolk)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will consider introducing a national 24-hour helpline to support people affected by prescribed drug dependence.
Answered by Steve Brine
The Government has no plans to introduce a national 24-hour helpline to support people affected by prescribed drug dependence. People who feel that they might be dependent on either prescribed or over the counter medicines should seek help from a health professional in the first instance (such as a general practitioner or pharmacist). Help and advice is also available from, for example, the 111 helpline or the on-line NHS Choices service.
Asked by: Roger Godsiff (Labour - Birmingham, Hall Green)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what the NHS guidelines are for rates of withdrawal for prescription drug addiction.
Answered by Steve Brine
There are no specific National Health Service guidelines that cover withdrawal from prescription drugs in general. However the recently-updated National Clinical Guidelines for Drug Misuse and dependence has specific guidance about pharmacological management of dependence on benzodiazepines and z-drugs, including prescribing regimens, detoxification, adjunctive therapies and monitoring. The guidelines are available at the link below:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/628634/clinical_guidelines_2017.pdf (starts at page 119)
Addiction to prescribed and over the counter medicines is a concern and it is essential that people only take these medicines in accordance with advice from a health professional. People who feel that they might be dependent on either prescribed or over the counter medicines should seek help from a health professional in the first instance (such as a general practitioner or pharmacist).
Local authorities are supported by Public Health England to develop tailored responses to existing and emerging drug misuse in their area and, in conjunction with the NHS, to address specific concerns about addiction to prescribed and over the counter medicines.
Asked by: Earl of Sandwich (Crossbench - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what proportion of (1) prisoners, and (2) young offenders, suffer from mental health problems; and of those, how many suffer from (a) illegal drug addiction, and (b) prescribed drug dependence.
Answered by Lord Prior of Brampton
72% of adult male prisoners and 71% of adult female prisoners may have two or more mental disorders including personality disorder, psychosis, anxiety, depression or substance misuse according to the Office for National Statistics (ONS).
According to the cross-government report Healthy Children, Safer Communities (2009), more than one third of people held in the children and young people’s secure estate, including those held in young offender institutions, have diagnosed mental health disorders. A copy of this report is attached.
The ONS also reports that about 55% of individuals entering prison have a drug problem. Data on prescribed drug dependence in prisons is not collected centrally.
Asked by: Roger Godsiff (Labour - Birmingham, Hall Green)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, whether the Government plans to introduce a national helpline for sufferers of prescribed drug dependence.
Answered by Jane Ellison
Anyone who is concerned that they may be dependent on medicines which have been prescribed to them, can get advice from their general practitioner, a community pharmacist, the 111 helpline or the on-line NHS Choices service:
http://www.nhs.uk/pages/home.aspx
In addition, the Government’s drugs information service, Talk to FRANK, also provides advice on how to access specialist drug treatment services, including services which help people who have a dependence on a medicine prescribed to them.
Asked by: Earl of Sandwich (Crossbench - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is the cost to the NHS of prescribed drugs for the treatment of mental health during each of the last five years; and what assessment they have made of whether those drugs are being over-prescribed.
Answered by Lord Prior of Brampton
Information about the cost of prescribed drugs for the treatment of mental health during the last five years is given in the following table. No assessment has been made of whether the drugs are being over-prescribed.
National Health Service cost (£) of drugs used to treat mental health in primary care and secondary care in England, 2010/11 to 2014/15
| 2010/11 | 2011/12 | 2012/13 | 2013/14 | 2014/15 |
Primary care | £875,627 | £895,885 | £705,325 | £755,679 | £683,102 |
Secondary care | £93,717 | £95,311 | £88,981 | £91,170 | £95,565 |
Total | £969,344 | £991,196 | £794,306 | £846,849 | £778,667 |
Information on why a drug has been prescribed is not available. Many of the drugs can be prescribed to treat a number of conditions. Therefore, it is possible that other medicines, not included in this response, have been prescribed for mental health. Also, the medicines included may have been prescribed to treat other conditions.
Notes:
4.1 - hypnotics and anxiolytics
4.2 - drugs used in psychoses
4.3 - antidepressant drugs
4.4 - drugs for Attention Deficit Hyperactivity Disorder
4.5 - drugs used in substance dependence
4.6 - drugs for dementia
Asked by: Lord Patel of Bradford (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, in the light of the findings in the <i>Evaluation of the Drugs and Alcohol Recovery Payment by Results Pilot Programme </i>(Interim Summary Report June 2014, National Drug Evidence Centre, University of Manchester) in respect of the impact of payment by results on practitioners and service users (1) what is their policy on reducing the number of service users prescribed opioid substitution medication; (2) what advice they give to local authority public health directorates on the use of the payment-by-result target for successful completions of drug treatment; (3) what regulatory framework covers local authority public health directorates' drug and alcohol commissioning and service delivery; and (4) who is responsible for regulation of the local authority commissioning of drug and alcohol provision.
Answered by Earl Howe - Deputy Leader of the House of Lords
The Drug and Alcohol Recovery Payment by Results (PbR) pilots ran from April 2012 to March 2014. Their purpose was to develop and test the PbR approach to contracting for drug and alcohol services.
As with services in other parts of the country, providers in the eight PbR pilot sites were expected to take account of the United Kingdom guidelines on the Clinical Management of Drug Misuse and Dependence and the relevant guidance from the National Institute for Health and Care Excellence. Services that prescribe opioid substitute treatment must be registered with the regulator, the Care Quality Commission.
The Government’s 2010 Drug Strategy is ambitious to support more people to recover from dependence on drugs and alcohol, acknowledging that all treatments with a sound evidence base, including opioid substitution medication, have a role to play depending on the clinical circumstances of individual cases.
Pending the publication in 2015 of the independent evaluation of the pilot programme, in August 2014 the Department published a note on lessons learnt. This document was intended for commissioners and providers who are considering using a PbR method and highlights the key areas where additional attention may need to be focussed to optimise the PbR approach.
Local Authority Circular LAC(DH)(2014)2, Public Health Ring-fenced Grant Conditions – 2015-16, dated 17 December 2014, stipulates at paragraph 20 that “in commissioning services using funds from this grant, local authorities should also ensure that appropriate clinical governance arrangements are put in place.” The circular contains a link to a public health commissioning template which emphasises the importance of good clinical practice.
The structures for coordinating local Joint Strategic Needs Assessments and the provision of services are set out in the Health and Social Care Act 2012. Should there be a complaint which cannot be resolved locally about a local authority’s discharge of its functions, an individual can refer the matter to the Local Government Ombudsman.
Asked by: Eric Ollerenshaw (Conservative - Lancaster and Fleetwood)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what data his Department collects on prescriptions dispensed to prisoners.
Answered by Norman Lamb
Information on the number of prisoners who are prescribed a particular medicine or class of medicine is not collected centrally, nor are data held relating to prescription items dispensed in prisons.
NHS England commissions all pharmacy services in prisons in England. It is responsible for the quality of service and for ensuring that good practice guidelines are followed in relation to the prescribing, safe use and treatment following withdrawal of psychotropic drugs treatments, including benzodiapines and Z-drugs. Where healthcare professionals have concerns about prescribing decisions in relation to psychotropic drug treatment in prisons, they should record these as medication safety incidents and report them to the local medicines management committee for possible further investigation. NHS England commissioners also require healthcare providers to report these incidents in patient safety contract monitoring.
Prison pharmacy services currently follow guidelines set out in A Pharmacy Service for Prisoners, issued by the Department in 2003. NHS England is currently reviewing this guidance, and updated guidance will be published in due course. A copy of the current guidance has already been placed in the Library.
Detailed guidance on benzodiazepine detoxification for prisoners is included in Clinical Management of Drug Dependence in the Adult Prison Setting, published by the Department in 2006. A copy has already been placed in the Library. Clinicians are expected to follow this and other relevant guidance such as that published by the Royal College of General Practitioners' Secure Environments Group on Safer Prescribing in Prisons.
Asked by: Eric Ollerenshaw (Conservative - Lancaster and Fleetwood)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps his Department is taking to prevent over-prescribing or mis-prescribing of psychotropic drugs to prisoners.
Answered by Norman Lamb
Information on the number of prisoners who are prescribed a particular medicine or class of medicine is not collected centrally, nor are data held relating to prescription items dispensed in prisons.
NHS England commissions all pharmacy services in prisons in England. It is responsible for the quality of service and for ensuring that good practice guidelines are followed in relation to the prescribing, safe use and treatment following withdrawal of psychotropic drugs treatments, including benzodiapines and Z-drugs. Where healthcare professionals have concerns about prescribing decisions in relation to psychotropic drug treatment in prisons, they should record these as medication safety incidents and report them to the local medicines management committee for possible further investigation. NHS England commissioners also require healthcare providers to report these incidents in patient safety contract monitoring.
Prison pharmacy services currently follow guidelines set out in A Pharmacy Service for Prisoners, issued by the Department in 2003. NHS England is currently reviewing this guidance, and updated guidance will be published in due course. A copy of the current guidance has already been placed in the Library.
Detailed guidance on benzodiazepine detoxification for prisoners is included in Clinical Management of Drug Dependence in the Adult Prison Setting, published by the Department in 2006. A copy has already been placed in the Library. Clinicians are expected to follow this and other relevant guidance such as that published by the Royal College of General Practitioners' Secure Environments Group on Safer Prescribing in Prisons.
Asked by: Eric Ollerenshaw (Conservative - Lancaster and Fleetwood)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, which protocols are used in prisons for withdrawal of treatment following long and short-term use of benzodiazepines and Z-drugs.
Answered by Norman Lamb
Information on the number of prisoners who are prescribed a particular medicine or class of medicine is not collected centrally, nor are data held relating to prescription items dispensed in prisons.
NHS England commissions all pharmacy services in prisons in England. It is responsible for the quality of service and for ensuring that good practice guidelines are followed in relation to the prescribing, safe use and treatment following withdrawal of psychotropic drugs treatments, including benzodiapines and Z-drugs. Where healthcare professionals have concerns about prescribing decisions in relation to psychotropic drug treatment in prisons, they should record these as medication safety incidents and report them to the local medicines management committee for possible further investigation. NHS England commissioners also require healthcare providers to report these incidents in patient safety contract monitoring.
Prison pharmacy services currently follow guidelines set out in A Pharmacy Service for Prisoners, issued by the Department in 2003. NHS England is currently reviewing this guidance, and updated guidance will be published in due course. A copy of the current guidance has already been placed in the Library.
Detailed guidance on benzodiazepine detoxification for prisoners is included in Clinical Management of Drug Dependence in the Adult Prison Setting, published by the Department in 2006. A copy has already been placed in the Library. Clinicians are expected to follow this and other relevant guidance such as that published by the Royal College of General Practitioners' Secure Environments Group on Safer Prescribing in Prisons.