Dear Mr Jarrett
Thank you for your recent letters to David Cameron about benzodiazepines. As your letter is about concerns regarding medication, it has been passed to the Department of Health. I have been asked to reply, and I apologise for the delay in doing so.
I was very sorry to read of your health problems, and I can appreciate that this is an extremely distressing situation for you, and would like to assure you that the safety of benzodiazepines remains under close review.
I was sorry to read that you were dissappointed about the membership of the round table on 15 September. The Department will be releasing a note of the agreed action points.
I hope it will reassure you if I explain the Department’s current policies. The Department has commissioned evidence-gathering reports looking at the problem of addiction to prescription and over-the-counter medicines for two organisations: the National Treatment Agency for Substance Misuse and the National Addiction Centre at King’s College London.
- The National Addiction Centre was asked to conduct a literature review to bring together the published evidence on the scale of the problem and how best to respond to dependencies on medicines; and
- The National Treatment Agency for Substance Misuse was asked to contact local commissioners and treatment providers to investigate prescribing patterns and the help that is currently offered to people who develop problems.
The reports were published in a Written Ministerial Statement from Anne Milton, the Parliamentary Under Secretary for Public Health, on 11 May 2011.
While the reports do suggest that benzodiazepines have long-term effects on memory, they found no convincing evidence of lasting anatomical or functional changes in the brain. They also suggested that there is no evidence the benzodiazepines cause long-term cognitive decline.
The review of current published evidence found that cognitive effects start to improve soon after long-term cognitive decline.
The review of current published evidence found that cognitive effects start to improve soon after long-term treatment with benzodiazepines is stopped, and continue to improve thereafter.
The Department is now engaging widely with interested parties, including expert representatives from dedicated benzodiazepine withdrawal services, to determine future policy and service planning.
It may also be helpful to clarify that the Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for the regulation of medicines and medical devices and equipment. The aim of the MHRA is to enhance and safeguard the public’s health by ensuring that medicines and medical devices work and are acceptably safe. No product is risk free. The MHRA makes robust and fact-based judgements to ensure that the benefits to patients and the public justify the risks. Information to aid the safe use of medicines is defined within the terms of the individual product licence and provided within the product information.
There is clear guidance on the issue of prescription and usage of drugs by GPs and psychiatrists. The Committee on the Safety of Medicines emphasises that benzodiazepines should only be used for short-term relief (two to four weeks) of severe or disabling anxiety. Benzodiazepines should not be used for longer-term treatment, or for the treatment of mild anxiety. This is reiterated in the advice in the British National Formulary.
Support for people who are dependent on benzodiazepines is provided by a variety of services across a range of settings including the community, the voluntary sector and local GP surgeries. It is the responsibility of local organisations to plan, develop and improve health services according to the healthcare needs of the local population. Ministers believe that local bodies, with their greater knowledge and understanding of local health needs, are best placed to assess the need for services, including rehabilitation and support services, within their areas. In some areas, organisations will have to make difficult decisions about the services that can be offered. It would not be appropriate for either ministers of the Department to intervene in local commissioning decisions.
It is important to note that the long period of tapering dose required to support recovery from benzodiazepine dependency means that residential service provision is often not appropriate.
I realise that this reply will be disappointing, but I hope it clarifies the Department’s position on this matter.
Yours sincerely,
Tim Morgan
Customer Service Centre