Call for a National Helpline in the UK for Prescribed Drug Dependence
House of Commons
There was a scheduled meeting at the House of Commons (the meeting was initially scheduled for July 11, but was rescheduled due to the election/political chaos) on the question of a 24-hour national helpline in the UK for prescribed drug (including benzodiazepine) dependent patients.
Information on the Proposed Hotline
A. The BMA has issued a document which details the agreed areas for action concerning benzodiazepines (and other prescribed dependence-causing drugs). These include:
- Calling for a national helpline for prescribed drug dependence
- Writing to NICE proposing a review of the effects of withdrawal from psychoactive prescribed drugs
- Establishing a working group with the aim of establishing a multidisciplinary quality standard guideline for prescribing
- Undertaking a pilot of the best way to fund and commission local specialist prescribed drug withdrawal services
- Lobbying for changes to the Prescribing Safety Assessment, part of the Year 1 medical curriculum
- Incorporating patient experiences within relevant training programs
- Proposing areas of additional research to funding organizations, to include research on withdrawal and the harms associated with prescribed drug dependence
B. The All Party Parliamentary Group for Prescribed Drug Dependence (APPG) for Prescribed Drug Dependence published a Declaration of Support on 01/04/2017 for a national 24-hour helpline and accompanying website. The declaration is signed by numerous medical bodies and charities, including:
- The BMA
- The Royal College of Psychiatrists
- The Royal College of GPs
- The Royal College of Physicians
- The Royal Society for Public Health
- The Medical Schools Council
- The British Psychological Society
A copy of the declaration can be viewed here.
Note: Physicians in the US may contact George Roycroft, BMA Head of Science and Public Health Policy, Policy Directorate
C. The APPG for Prescribed Drug Dependence published on 03/28/17 its proposal for a national helpline to help patients affected by prescribed drug dependence.The Council for Evidence-Based Psychiatry (CEP) provides the Secretariat for the APPG, and some of its members authored the report.
The full report can be viewed at this link.
Update to BMA stakeholder group: Summary note – meeting with DH/PHE on prescribed drug dependence/withdrawal (22.6.17) from George Roycroft
Dear all
You may recall that we wrote to the then Public Health Minister, Nicola Blackwood, last year following the launch of our recommendations on ways to better support those affected by prescribed drug dependence/withdrawal. In response, the Minister asked that we initially meet with her senior civil servants from the Department of Health (DH) and Public Health England (PHE) to discuss this further.
Representatives of the BMA (including Professor Parveen Kumar and Dr Andrew Green) met with Tim Baxter (Deputy Director, Public Health Development Unit, DH) and Rosanna O’Connor (Director of Alcohol, Drugs & Tobacco, Health and Wellbeing Directorate, PHE) on 22 June.
I’ve copied below a brief summary of the meeting and the agreed action points.
- Following the 2017 General Election, a new Public Health Minister, Steve Brine MP, had been very recently appointed. As he was currently appraising himself of his new ministerial responsibilities, the DH were not able to provide any commitments on actions that may be taken on this matter, but would be raising this subject with the new Minister in due course.
- Professor Kumar and Dr Green summarised the BMA’s recent work and our specific concerns, including the need for a national helpline. DH/PHE highlighted that ongoing funding constraints and a lack of data on the number of people affected by prescribed drug dependence/withdrawal were significant barriers to taking forward a proposal for a national helpline. In particular, was difficult to estimate the potential number of people who would benefit from the service, as well as its potential cost effectiveness. We asked what plans there were to assess the level of need and collate data on the extent of the problem, and the DH agreed to look at what research can be done to establish the epidemiology of prescribed drug dependence/withdrawal.
- In relation to existing support services, we highlighted our concerns that NHS 111 and NHS Choices do not provide appropriate support – the former is a protocol-based telephone service that is not designed to manage the complexity of issues around prescribed drug dependence/withdrawal, and the latter only provides basic information on the potential for dependence and withdrawal. Neither service provide immediate and accessible support and counselling at a time of crisis, which is what patients have indicated is required. DH/PHE noted these concerns and suggested that they be raised with NHS England, which has responsibility for both services.
- In light of our recommendation on the need for clear guidance on tapering and withdrawal management, it was noted that NICE had received a referral to develop some guidance on safe prescribing and withdrawal management, and that this was currently due to be commissioned in December 2017. As the specific timelines are still to be confirmed, the DH agreed to seek an update on its progress. Dr Andrew Green updated on the work the RCGP are leading to promote best practice through the development of a readily accessible, practical and compact online resource for prescribers and other clinicians, which would be published in the next few months. PHE suggested that they may be able to support its publication.
- We raised the issue of the lack of appropriate specialised services available for prescribed drug dependence/withdrawal, and the concerns patients have with using existing services that are predominantly focused on illicit drug users. PHE noted that there is appropriate guidance for commissioners on assessing the level of local need, and the requirement to provide necessary services. We raised the concern that this assessment is not being taken forward, and that consequently there remains a lack of specialised support services. PHE also noted that they have highlighted this as an area to consider in the ongoing development of Sustainability and Transformation Plans (STPs), including circulating evidence of the cost-effectiveness of providing these services. PHE agreed to share details of this advice, as well as information on which STPs had taken action in this area.
- We concluded the meeting by requesting that this issue be considered as a priority by the DH and PHE, and that we would be willing to support this and liaise with our network of stakeholders in doing so.
As a follow up to the meeting, we will be writing to the new Public Health Minister in due course; writing to NHS England to highlight our concerns about the adequacy of NHS 111 and NHS Choices in providing appropriate support; and will seek updates from the DH and PHE on the actions they have agreed to take forward.
Please let me know if you have any questions.
Best wishes
George
George Roycroft
Head of Science and Public Health Policy
Public Health and Healthcare
Policy Directorate
British Medical AssociationT: 020 7383 6064 | M: 07990006072| E: groycroft@bma.org.uk