Now let’s give anxiety pill addicts the help they need
After the Mail’s stunning victory for thousands hooked on prescription medicine . . . Save the prescription pill victims
LUCY FERNANDES, a 31-year-old who lives in London, is one of countless thousands of Britons who’ve become dependent on their prescription medicines through no fault of their own.
Lucy became trapped on three drugs prescribed to her for severe anxiety. She started taking them in 2009 after seeing a psychiatrist because she was breaking down under the pressure of doing a master’s in Renaissance art history.
‘Looking back, I realise now that I was too young to have taken on such a huge challenge,’ she says. ‘I’d begun the master’s straight after finishing university.’
She was prescribed the benzodiazepine tranquillisers diazepam (formerly known as Valium) and clonazepam, plus lamotrigine, an anti-convulsant drug that is used as a mood stabiliser.
But her body developed an increasing tolerance to the drugs and she needed greater doses. However, the longer she was taking the pills, the worse the side-effects became. ‘The mood stabiliser disrupted my sleep as it made me more alert at night, while the benzodiazepines made me withdrawn,’ she says.
‘I was just not myself. Things were fuzzy. It was hard for me to understand what was going on.’
At the end of 2014, the sideeffects were so debilitating that Lucy decided to stop taking her medication. But the withdrawal only made her feel worse and she had to give up her job as a gallery shop assistant and move back home.
Meanwhile, the effects of withdrawing from the drugs worsened so that for months she didn’t sleep at all.
Lucy has since managed to overcome her dependency — thanks to one of the tiny handful of organisations that offer help to patients hooked on their prescription pills.
But the NHS has now said it will no longer fund that service, leaving others with nowhere to turn for help.
The problem of prescription pill dependency is one that campaigners have long fought to have recognised, with growing concerns about patients left dependent on medication prescribed by their doctors — and then abandoned to their fate.
Concerns centre on drugs commonly prescribed for anxiety, depression, insomnia and pain.
They include benzodiazepines (such as diazepam and lorazepam); Z-drugs (such as zolpidem and zopiclone used for sleep problems), opioid painkillers (such as codeine and tramadol), and the gab a pentinoids (GABA) for nerve pain.
Antidepressants, although not traditionally regarded as addictive, can also cause withdrawal problems for some patients. These pills can, and do, help some people — and many do not become dependent on them, while others do.
Last year, a committee of concerned MPs, the All-Party Parliamentary Group on Prescribed Drug Dependence (APPG), warned that more than a million patients in England alone are taking dependency forming drugs unnecessarily. The overprescription of these drugs — and failure to provide help to patients to get off them — prompted calls from the APPG, along with the British Medical Association and other leading medical organisations and patient groups, for the Government to acknowledge the problem and set up a national helpline. The calls have been backed by the Mail.
AND now it appears campaigners have been vindicated, with Steve Brine, the Public Health Minister, announcing last week that Public Health England will undertake an inquiry into the scale of the problem, including harm caused by dependency and withdrawal from tranquillisers, antidepressants and painkillers.
It is due to report in 2019 but what worries observers is whether this will come to anything — as for years ministers have been making grand statements, then doing nothing.
In 2013, Anna Soubry, then Public Health Minister, declared on BBC Radio 4 that the issue of prescribed-drug dependence ‘has not been sexy. The time has now come for us to put it up the agenda.’
Instead, it was parked in the long grass, where it had been left by David Cameron, who’d said in 2011: ‘Tranquilliser addiction is an extreme problem in our country... We must deal with the problem at source.’
Since then, tranquilliser prescriptions have spiralled. Back in 1994, David Blunkett, then Labour’s Shadow Secretary of State for Health, called benzodiazepine over-prescription ‘a national scandal’ and pledged to ensure justice for victims. When Labour won the 1997 election, it did no such thing.
And in 1993, the Tories had announced that GPs should be given local targets for reducing benzodiazepine prescriptions. Nothing came of this.
Announcing lengthy inquiries is a well-worn strategy for ‘kicking the can down the road’. Indeed, there is already a wealth of evidence to show the extent of the problem in Britain without yet another investigation.
The BMA reacted to the new announcement by urging prompt action. Dr Andrew Green, the GP Committee clinical and prescribing lead, welcomed the inquiry but also pointed out that it called for a national 24-hour helpline nearly two years ago.
‘A helpline could be set up relatively quickly,’ Dr Green said. ‘It would give individuals suffering with dependence to drugs like benzodiazepines vital, timely support and advice.’
Yet instead of promptly increasing support for these innocent victims, just as the review was announced, the NHS was quietly pulling the plug on one of the few such services that exists.
For 30 years, the REST (Recovery Experience Sleeping Tablets and Tranquillisers) service at the mental health charity Mind in Camden has helped people achieve the gruelling task of weaning themselves from benzodiazepines and other addictive prescription drugs. It is the only such service for London and one
of only six in the whole country. Mind in Camden says standard clinics for people hooked on illegal substances are not suitable as they are geared to get clients off drugs as quickly as possible.
Yet experts say the only way to get off prescribed tranquillisers, painkillers and antidepressants without horrific side-effects is by cutting the dose slowly and carefully — known as tapering. This, says the charity, needs intense specialist support.
Lucy discovered REST on the internet at the end of 2014 and joined its patient support group, which meets weekly, with around eight to ten people.
She’s convinced this is the only thing that could have saved her: ‘You need the experience and wisdom of people who know how to come off these drugs.’
Previously her doctor had not taken her seriously, putting her symptoms down to anxiety.
‘He seemed to view all psychiatric drugs as fairly harmless in terms of side-effects and dependency,’ she explains.
With the help of REST, she started cutting her dose by 1mg a month. ‘It took me about 18 months to taper off,’ she says. ‘I was tired a lot of the time, but it was so much better than trying to go cold turkey.’
Today, 14 months on, she says her life is ‘back on track’. ‘I’m just starting a job, working to develop services in mental health, and I’m living independently.’
REST, which sees around 130 people at any one time, has successfully helped thousands. Each is supported for a year or more through the arduous process of weaning off their medications.
Much of this is done through peer support from people like Lucy who have already escaped dependency on prescribed drugs.
But the local health authority, Camden Clinical Commissioning Group, says it will no longer pay REST’s annual £45,000 funding.
Instead, it plans to ‘improve’ services by telling patients dependent on prescription drugs to attend GP services and community centres.
The CCG has not answered our questions about how much money would be saved by the move, and whether the alternative services will be shared with people using illegal drugs.
But the move has been condemned by the APPG, which points out that REST costs only around £372 per client each year.
Paul Flynn MP, chair of the APPG, told us: ‘Closing the REST project is short-sighted, and will lead to unnecessary suffering and uncertainty for clients.’
Brian Dawn, chief executive of Mind in Camden says: ‘It is a false economy. Admissions to more expensive A&E, hospital, rehabilitation and other services will be the inevitable result.’
BIzARRELY, only last week the NHS’s own National Institute for Health Research announced that it is to fund a clinical trial at Warwick University for treating people trapped on long-term strong painkillers — using the same group-therapy approach pioneered by Mind in Camden.
Observers fear this doesn’t bode well for the new inquiry: if it’s to have any effect, it will have to ensure the NHS takes a consistent approach to the problem.
One expert close to the inquiry, who wishes to remain anonymous, adds another concern: that ‘organisations with a vested interest in keeping things denied — such as people involved with drug companies — may sit on the inquiry group and try to bury the issue. We have seen this happen before,’ he told Good Health.
Meanwhile Barry Haslam, a retired accountant from Oldham, Lancs, who has long campaigned for prescribed drug-dependent victims following his own experience of ten years trapped on benzodiazepines, welcomes the review as a significant step.
‘But we have no idea yet about what issues it will cover,’ he said.
He runs Tranx, a withdrawal support service for people dependent on long-term prescriptions. It is England’s only NHS-funded facility — Haslam says patients need a network of such clinics across the country. But he fears that the review will fail to recommend this.
He adds: ‘From my 20 years in this area, I fear that there could be just another fudge.’
However, Oliver Letwin MP, the vice-chair of the APPG, remains cautiously optimistic. ‘We are hoping the inquiry will enable Public Health England to persuade itself, and the Department of Health and the NHS, that the need for national help for victims of prescription-drug addiction is well evidenced,’ he says.
‘The proof of the pudding is in the eating — but I am optimistic.’