Correspondence with the Academy of Medical Sciences

Dear Dr Cope,                                                                                  5 July 2015

I have been given your email address in the reply by Hannah Hobson to my letter (below) to Professor Sir John Tooke on involuntary (iatrogenic) tranquilliser addiction.

I am pleased to have received a positive response and I, and I am sure others, will be happy to contribute to the call for evidence.

However, I do hope that this will lead to effective action. Over a thirty year period MPs, academics and victims of benzodiazepine and z drugs prescribed by their GPs have provided extensive evidence, all of which is on the website www.benzo.org.uk

More recently, evidence has been sent to the Department of Health, the MHRA, the Royal Colleges, the MRC, various professors and a host of other people and organisations responsible for health, through the APPGITA political campaign www.appgita.com

As you will have gathered from my letter, none of this has led to effective action to tackle this problem. I hope that this call for evidence will actually lead somewhere apart from yet another publication or report.

What is required is the enforcement of the 1988 CSM 2 – 4 week tranquilliser prescribing guidelines for new patients. Secondly, the creation of national dedicated tranquilliser withdrawal services based on the Ashton taper, separate from substance misuse services as the treatment requirements are different.  Thirdly, proper drug regulation by the MHRA so that companies do not cause harm by withholding clinical trial data for commercial gain, for example, as Wyeth did with Ativan and GSK did with Seroxat.

Kind regards,

John Perrott

 

On 3 July 2015 at 11:08, Policy <policy@acmedsci.ac.uk> wrote:

Dear Mr Perrott,

Thank you very much for your email to Sir John Tooke concerning our ‘Evaluating Evidence’ project, and I apologise for the delay in responding. We have received a lot of interest in this study, and are currently considering its scope in light of the feedback we have received. Early meetings with stakeholder groups have highlighted to us that industry involvement in research, and the perception of such research by the medical community and citizens, is an important topic. We are currently considering whether this question would be best answered by the ‘Evaluating Evidence’ project, or a separate but parallel work stream. We feel the breadth of issues may be better suited to having multiple focused projects.

Thank you for the information you sent regarding the problems associated with involuntary addiction to benzodiazepine, and the long battle that patients have had to get these problems properly recognised. Clearly this is an important topic and we will carefully consider how best to incorporate it into our project, or parallel projects. We do plan to seek wider input via a call for evidence issued later in the year. Any individual or organisation (including the APPGITA, if they wish) will be able to contribute views via this route, and we will be in touch with information on how you can contribute in due course.

In the meantime, if you have any further questions, please contact Dr Claire Cope, our Senior Policy Officer (claire.cope@acmedsci.ac.uk), who will be working on the ‘Evaluating Evidence’ project over the coming year.

Kind regards,

Hannah Hobson

 

Dear Professor Sir John Tooke,                                                                         27 June 2015

I am writing regarding a BBC news article yesterday in which Prof Dame Sally Davies was reported as having concerns about the use of medicines damaging faith in the way research is carried out and presented, and ‘about a view that doctors and scientists are “untrustworthy”’. The article said that Prof Dame Sally Davies has written to you in your capacity as President of the Academy of Medical Sciences to request an independent review of the safety and efficacy of medicines.http://www.bbc.co.uk/news/health-33127672

I have provided research in an unpaid capacity for an All Party Parliamentary Group on Involuntary Tranquilliser Addiction (APPGITA) for the last 5 years. The APPG campaigned for patients’ rights, who through no fault of their own have become addicted to benzodiazepine and z drug tranquillisers prescribed beyond the 2 – 4 week CSM guidelines issued in 1988.

I wish to contribute to the review being conducted by the Academy of Medical Sciences with the following evidence:

After 30 years of inaction by the Department of Health to help over a million patients who have been abandoned by their GPs on these prescribed drugs (with most likely to be addicted), the All Party Parliamentary Group on Involuntary Tranquilliser Addiction was formed in 2008 and chaired by the late Jim Dobbin MP.

The work of APPGITA and the campaign is documented on this website which I manage  http://www.appgita.com/

APPGITA worked hard to get the Department of Health to take effective action. In July 2009, Gillian Merron, then Public Health minister, announced that the Department of Health would conduct a policy review on addiction to medicines, including tranquillisers.

Campaigners, some of whom had been bringing this issue to successive governments’ attention for nearly thirty years, welcomed Gillian Merron’s statement. However, it was not long before it was apparent that the process was developing into a sham for the following reasons:

1. The Department of Health and the Royal Colleges continually and consistently persisted to incorrectly treat the issue as substance abuse by the patients. This continued throughout the Department of Health’s Policy review processes. In reality, patients were not warned regarding the addictive nature of benzodiazepines. One benzodiazepine widely used, Ativan, had no warnings regarding dependence from Wyeth the manufacturer receiving a licence in 1972 until 1988,by which time a benzodiazepine addict population had been created. Wyeth knew that it was addictive in 1972 through the De Buck trials yet the regulatory authority at the time took no action. Evidence has been presented to Dr June Raine, Director, Vigilance and Risk Management of Medicines at the MHRA showing that Wyeth knew about Ativan by comparing drug data sheets from different countries yet, to this day, no action has ensued. I wish to point out that there are still patients being prescribed Ativan (lorazepam) today who became addicted in the 1970s. I personally suffered a 32 year addiction to Ativan and a protracted withdrawal with no NHS support because there are no NHS tranquilliser withdrawal services. The only support available is provided by a handful of specialist charities which have been supporting those iatrogenically addicted since the 1980s.

You may read more about this here –  http://www.benzo.org.uk/behan2.htm

The MHRA routinely destroys clinical trial data after 5 years making accountability of drug companies almost impossible. Not one drug company has been prosecuted for withholding data and the MHRA appears to be the first line of defence for the industry. Not one of the recommendations which would benefit patients made by the Health Select Committee’s 2004/5 report on the Influence of the Pharmaceutical Industry was implemented. The enquiry found that the MHRA is far too close to the industry and operates a revolving door system.

2. As part of its policy review, the Department of Health commissioned two reports, one from the National Addiction Centre at Kings College London, the other from the National Treatment Agency (now PHE). Professor John Strang who co-authored the National Addiction Centre (KCL) report informing the review had undeclared interests with manufacturers of the drugs which were the subject of the review, including Genus/Brittania which manufactures Ativan and Clonmel Healthcare whichmanufactures diazepam zopiclone and zolpidem.

Professor Strang also had a financial relationship with Napp Pharmaceuticals, Reckitt Benckiser all of whom manufacture codeine containing over the counter products which were also part of the subject matter of the DH policy review. These conflicts of interest were not declared by Professor Strang at tendering or publication.

Despite the fact that the NAC report was supposed to be a literature review it “missed” 129 papers documenting the harms caused by long-term use including correlation with early death; long-term use causing dementia; that 40 – 80% of users become dependent; the withdrawal syndrome being much longer than for other drugs of dependence; no mention of the post-withdrawal syndrome (PWS); that symptoms may persist for up to 5 years or more; withdrawal taking up to a year or more; social deterioration including failure in achievement and professional decline , divorce, bankruptcy; suicidal ideation, suicide attempts, suicides caused by addiction/withdrawal symptoms; depression; long-term illness being caused which is much worse than the original condition benzos prescribed for; long-term use causing agoraphobia, depersonalisation and perceptual distortions; benzo babies (floppy infant syndrome); and toxic poisoning.

None of these known harms were mentioned in the NAC report yet the scientific papers were all easily accessible from websiteshttp://www.benzo.org.uk/amisc/rpeart.pdf

http://www.benzo.org.uk/vot4.htm

Most notably Professor Ashton’s voluminous work on tranquillisers and tranquilliser withdrawal was virtually ignored. Professor Ashton is a world recognised expert on benzodiazepines and has written over 70 papers on the subject. Professor Ashton wrote a manual on benzodiazepines http://www.benzo.org.uk/manual/ which underpins the successful slow taper method of withdrawal and also ran a tranquilliser withdrawal clinic in the 1980s.

The evidence of benzodiazepine related brain damage by another benzodiazepine expert, Professor Lader, was dismissed in one sentence. http://www.benzo.org.uk/lader2.htm

The late Jim Dobbin MP wrote to the Department of Health and Andrew Lansley regarding Professor Strang’s undeclared pharmaceutical interest but no action was taken.

I have written to the authors of the NAC report asking for an explanation but they do not reply.

The report provided by the National Treatment Agency (NTA) informing the review was incorrectly on substance misuse. It contained incorrect information quoted by Earl Howe, Health spokesman in the House of Lords, more than once in Parliamentary debates, including the claim that most local areas had tranquilliser withdrawal services when a survey I conducted proved that 83% of local areas did not. Survey of PCTs in England recording provision of services for involuntary tranquilliser addiction by John Perrott

In 2014 the Department of Health figures for drug hospital admissions showed that prescription drugs dwarf those for illegal drugs with a total for heroin and cocaine combined at 4684 yet admissions for prescription drugs (benzodiazepines, z drugs and antidepressants) combined total 54,474. You would think the Department of Health would act on this yet inaction yet again prevails.

3. Further undeclared conflicts of interest in the benzo campaign included Professor Nutt. A submission was made to the ACMD in 2003 on the harms associated with benzodiazepine tranquillisers. On the advice of the ACMD Technical Committee chaired by Professor Nutt the ACMD concluded that the reclassifying and/or rescheduling of benzodiazepines would be likely to be ineffective. Professor Nutt had serious undeclared conflicts of interest at the time with benzodiazepine tranquilliser manufacturers, including Wyeth which manufactures Ativan. You may read more about this hereOmand Review of the ACMD

Professor Nutt has been a strong advocate of the use of drugs including benzodiazepines and antidepressants. He has financial links with many drug companies which he often does not declare.  The credibility of the 2003 government inquiry into anti-depressant drugs on which he sat was questionable with most of the inquiry members, including Professor Nutt, having shareholdings or other links to the manufacturers. GSK’s Seroxat was known to cause suicidal behaviour amongst other ADRs. Professor Nutt and Professor David Baldwin, who also has many pharmaceutical interests, jointly fronted the promotional press launch of Seroxat.

I also point out that the half-dozen tranquilliser withdrawal charities, including BDTP http://www.btpinfo.org.uk/ and CITAhttp://www.citawithdrawal.org.uk/ report that antidepressants now outnumber benzodiazepines in calls from patients needing help withdrawing from psychiatric medication.

I have reported both Professor Strang and Professor Nutt to the GMC but the GMC does not understand what a conflict of interest is or that it includes a bias or a perception of bias and does not necessarily mean a direct financial reward to either the professor concerned or the drug companies involved. I also reported Professor Strang to Kings College London which conducted a whitewash inquiry and found him not guilty. It is impossible as a damaged patient to challenge powerful institutions or for that matter government bodies and exact any fairness as they are all self-serving and protect themselves.

4. Doctors continue to ignore the 1988 CSM 2 – 4 week prescribing guidelines which remain unenforced after 27 years of non-compliance which caused the problem in the first place.Patients we are in contact with verify this and prescriptions for tranquillisers have remained at around 16 million for a decade.

What is the point of guidelines if doctors ignore them?

Many doctors do not understand ADRs because they do not receive training in pharmacology.

Patients are left on medication, especially psychiatric medication, for years with no review. Adverse drug reactions are mis-diagnosed as new symptoms leading to polypharmacy, patients are withdrawn too rapidly and withdrawal symptoms are often mis-diagnosed.

All of these issues have been reported through voluminous correspondence with the Department of Health, PHE, the Care Quality Commission, the Royal Colleges and numerous other agencies and organisations over nearly three decades and still no effective action has been taken.

My MP, Eric Ollerenshaw, a member of APPGITA, requested a meeting with Prof Dame Sally Davies on the issue of involuntary tranquilliser addiction in July last year but her office informed him that she was too busy to meet him.

I suggest you look at the APPGITA website post 25 years of “taking it seriously” by the Department of Health – a trail of false promises

It is no wonder that patients are mistrustful. The various comments by Department of Health officials and ministers are typical of the formulaic responses, pretending to care, and obfuscation received in correspondence over the years.

Prof Dame Sally Davies says that “I have, therefore, reluctantly come to the conclusion that we do need an authoritative independent report looking at how society should judge the safety and efficacy of drugs as an intervention”.

The CQC is supposed to protect patients and I appreciate they are under pressure. Professor Steve Field who is Chief Inspector knows all about this issue through correspondence with me and a meeting with the late Jim Dobbin MP. He was also past Chair of the RCGP and is aware of the addictive nature of benzodiazepines and the ordeal patients undergo to get off them. Yet, the CQC has taken no effective action on this issue despite promises to do so. Perhaps it is just too big and the CQC, like successive governments, does not know how to tackle it.

This issue is not confined to statins or clot-busting treatment for strokes. The health and care system is rotten at the core and has been for decades. It is pharmaceutically led with scant regard for patient safety. When patients are damaged by prescribed drugs all the organisations responsible for health join ranks and obstruct those damaged who ask for fairness and help.
Any enquiry must include the Department of Health, for which Prof Dame Sally Davies is Chief Medical Officer, and all the other organisations responsible for health, because the problem is systemic.

I and all the other patients I am in contact with look forward to hearing from you.

Yours sincerely,

John Perrott

Cc

Professor Dame Sally Davies, Chief Medical Officer, Department of Health

Sir Richard Thompson, Former President, Royal College of Surgeons

Professor Steve Field, Chief Inspector, CQC

Posted in Uncategorized | Leave a comment

email to Professor Sir John Tooke, President of the Academy of Medical Sciences

Dear Professor Sir John Tooke,

I am writing regarding a BBC news article yesterday in which Prof Dame Sally Davies was reported as having concerns about the use of medicines damaging faith in the way research is carried out and presented, and ‘about a view that doctors and scientists are “untrustworthy”’. The article said that Prof Dame Sally Davies has written to you in your capacity as President of the Academy of Medical Sciences to request an independent review of the safety and efficacy of medicines. http://www.bbc.co.uk/news/health-33127672

I have provided research in an unpaid capacity for an All Party Parliamentary Group on Involuntary Tranquilliser Addiction (APPGITA) for the last 5 years. The APPG campaigned for patients’ rights, who through no fault of their own have become addicted to benzodiazepine and z drug tranquillisers prescribed beyond the 2 – 4 week CSM guidelines issued in 1988.

I wish to contribute to the review being conducted by the Academy of Medical Sciences with the following evidence:

After 30 years of inaction by the Department of Health to help over a million patients who have been abandoned by their GPs on these prescribed drugs (with most likely to be addicted), the All Party Parliamentary Group on Involuntary Tranquilliser Addiction was formed in 2008 and chaired by the late Jim Dobbin MP.

The work of APPGITA and the campaign is documented on this website which I manage  http://www.appgita.com/

APPGITA worked hard to get the Department of Health to take effective action. In July 2009, Gillian Merron, then Public Health minister, announced that the Department of Health would conduct a policy review on addiction to medicines, including tranquillisers.

Campaigners, some of whom had been bringing this issue to successive governments’ attention for nearly thirty years, welcomed Gillian Merron’s statement. However, it was not long before it was apparent that the process was developing into a sham for the following reasons:

1. The Department of Health and the Royal Colleges continually and consistently persisted to incorrectly treat the issue as substance abuse by the patients. This continued throughout the Department of Health’s Policy review processes. In reality, patients were not warned regarding the addictive nature of benzodiazepines. One benzodiazepine widely used, Ativan, had no warnings regarding dependence from Wyeth the manufacturer receiving a licence in 1972 until 1988, by which time a benzodiazepine addict population had been created. Wyeth knew that it was addictive in 1972 through the De Buck trials yet the regulatory authority at the time took no action. Evidence has been presented to Dr June Raine, Director, Vigilance and Risk Management of Medicines at the MHRA showing that Wyeth knew about Ativan by comparing drug data sheets from different countries yet, to this day, no action has ensued. I wish to point out that there are still patients being prescribed Ativan (lorazepam) today who became addicted in the 1970s. I personally suffered a 32 year addiction to Ativan and a protracted withdrawal with no NHS support because there are no NHS tranquilliser withdrawal services. The only support available is provided by a handful of specialist charities which have been supporting those iatrogenically addicted since the 1980s.

You may read more about this here –  http://www.benzo.org.uk/behan2.htm

The MHRA routinely destroys clinical trial data after 5 years making accountability of drug companies almost impossible. Not one drug company has been prosecuted for withholding data and the MHRA appears to be the first line of defence for the industry. Not one of the recommendations which would benefit patients made by the Health Select Committee’s 2004/5 report on the Influence of the Pharmaceutical Industry was implemented. The enquiry found that the MHRA is far too close to the industry and operates a revolving door system.

2. As part of its policy review, the Department of Health commissioned two reports, one from the National Addiction Centre at Kings College London, the other from the National Treatment Agency (now PHE). Professor John Strang who co-authored the National Addiction Centre (KCL) report informing the review had undeclared interests with manufacturers of the drugs which were the subject of the review, including Genus/Brittania which manufactures Ativan and Clonmel Healthcare whichmanufactures diazepam zopiclone and zolpidem.

Professor Strang also had a financial relationship with Napp Pharmaceuticals, Reckitt Benckiser all of whom manufacture codeine containing over the counter products which were also part of the subject matter of the DH policy review. These conflicts of interest were not declared by Professor Strang at tendering or publication.

Despite the fact that the NAC report was supposed to be a literature review it “missed” 129 papers documenting the harms caused by long-term use including correlation with early death; long-term use causing dementia; that 40 – 80% of users become dependent; the withdrawal syndrome being much longer than for other drugs of dependence; no mention of the post-withdrawal syndrome (PWS); that symptoms may persist for up to 5 years or more; withdrawal taking up to a year or more; social deterioration including failure in achievement and professional decline , divorce, bankruptcy; suicidal ideation, suicide attempts, suicides caused by addiction/withdrawal symptoms; depression; long-term illness being caused which is much worse than the original condition benzos prescribed for; long-term use causing agoraphobia, depersonalisation and perceptual distortions; benzo babies (floppy infant syndrome); and toxic poisoning.

None of these known harms were mentioned in the NAC report yet the scientific papers were all easily accessible from websites

http://www.benzo.org.uk/amisc/rpeart.pdf

http://www.benzo.org.uk/vot4.htm

Most notably Professor Ashton’s voluminous work on tranquillisers and tranquilliser withdrawal was virtually ignored. Professor Ashton is a world recognised expert on benzodiazepines and has written over 70 papers on the subject. Professor Ashton wrote a manual on benzodiazepines http://www.benzo.org.uk/manual/ which underpins the successful slow taper method of withdrawal and also ran a tranquilliser withdrawal clinic in the 1980s.

The evidence of benzodiazepine related brain damage by another benzodiazepine expert, Professor Lader, was dismissed in one sentence  http://www.benzo.org.uk/lader2.htm

The late Jim Dobbin MP wrote to the Department of Health and Andrew Lansley regarding Professor Strang’s undeclared pharmaceutical interest but no action was taken.

I have written to the authors of the NAC report asking for an explanation but they do not reply.

The report provided by the National Treatment Agency (NTA) informing the review was incorrectly on substance misuse. It contained incorrect information quoted by Earl Howe, Health spokesman in the House of Lords, more than once in Parliamentary debates, including the claim that most local areas had tranquilliser withdrawal services when a survey I conducted proved that 83% of local areas did not. Survey of PCTs in England recording provision of services for involuntary tranquilliser addiction by John Perrott

In 2014 the Department of Health figures for drug hospital admissions showed that prescription drugs dwarf those for illegal drugs with a total for heroin and cocaine combined at 4684 yet admissions for prescription drugs (benzodiazepines, z drugs and antidepressants) combined total 54,474. You would think the Department of Health would act on this yet inaction yet again prevails.

3. Further undeclared conflicts of interest in the benzo campaign included Professor Nutt. A submission was made to the ACMD in 2003 on the harms associated with benzodiazepine tranquillisers. On the advice of the ACMD Technical Committee chaired by Professor Nutt the ACMD concluded that the reclassifying and/or rescheduling of benzodiazepines would be likely to be ineffective. Professor Nutt had serious undeclared conflicts of interest at the time with benzodiazepine tranquilliser manufacturers, including Wyeth which manufactures Ativan. You may read more about this here Omand Review of the ACMD

Professor Nutt has been a strong advocate of the use of drugs including benzodiazepines and antidepressants. He has financial links with many drug companies which he often does not declare.  The credibility of the 2003 government inquiry into anti-depressant drugs on which he sat was questionable with most of the inquiry members, including Professor Nutt, having shareholdings or other links to the manufacturers. GSK’s Seroxat was known to cause suicidal behaviour amongst other ADRs. Professor Nutt and Professor David Baldwin, who also has many pharmaceutical interests, jointly fronted the promotional press launch of Seroxat.

I also point out that the half-dozen tranquilliser withdrawal charities, including BDTP http://www.btpinfo.org.uk/ and CITA http://www.citawithdrawal.org.uk/ report that antidepressants now outnumber benzodiazepines in calls from patients needing help withdrawing from psychiatric medication.

I have reported both Professor Strang and Professor Nutt to the GMC but the GMC does not understand what a conflict of interest is or that it includes a bias or a perception of bias and does not necessarily mean a direct financial reward to either the professor concerned or the drug companies involved. I also reported Professor Strang to Kings College London which conducted a whitewash inquiry and found him not guilty. It is impossible as a damaged patient to challenge powerful institutions or for that matter government bodies and exact any fairness as they are all self-serving and protect themselves.

4. Doctors continue to ignore the 1988 CSM 2 – 4 week prescribing guidelines which remain unenforced after 27 years of non-compliance which caused the problem in the first place.Patients we are in contact with verify this and prescriptions for tranquillisers have remained at around 16 million for a decade.

What is the point of guidelines if doctors ignore them?

Many doctors do not understand ADRs because they do not receive training in pharmacology.

Patients are left on medication, especially psychiatric medication, for years with no review. Adverse drug reactions are mis-diagnosed as new symptoms leading to polypharmacy, patients are withdrawn too rapidly and withdrawal symptoms are often mis-diagnosed.

All of these issues have been reported through voluminous correspondence with the Department of Health, PHE, the Care Quality Commission, the Royal Colleges and numerous other agencies and organisations over nearly three decades and still no effective action has been taken.

My MP, Eric Ollerenshaw, a member of APPGITA, requested a meeting with Prof Dame Sally Davies on the issue of involuntary tranquilliser addiction in July last year but her office informed him that she was too busy to meet him.

I suggest you look at the APPGITA website post 25 years of “taking it seriously” by the Department of Health – a trail of false promises

It is no wonder that patients are mistrustful. The various comments by Department of Health officials and ministers are typical of the formulaic responses, pretending to care, and obfuscation received in correspondence over the years.

Prof Dame Sally Davies says that “I have, therefore, reluctantly come to the conclusion that we do need an authoritative independent report looking at how society should judge the safety and efficacy of drugs as an intervention”.

The CQC is supposed to protect patients and I appreciate they are under pressure. Professor Steve Field who is Chief Inspector knows all about this issue through correspondence with me and a meeting with the late Jim Dobbin MP. He was also past Chair of the RCGP and is aware of the addictive nature of benzodiazepines and the ordeal patients undergo to get off them. Yet, the CQC has taken no effective action on this issue despite promises to do so. Perhaps it is just too big and the CQC, like successive governments, does not know how to tackle it.

This issue is not confined to statins or clot-busting treatment for strokes. The health and care system is rotten at the core and has been for decades. It is pharmaceutically led with scant regard for patient safety. When patients are damaged by prescribed drugs all the organisations responsible for health join ranks and obstruct those damaged who ask for fairness and help.

Any enquiry must include the Department of Health, for which Prof Dame Sally Davies is Chief Medical Officer, and all the other organisations responsible for health, because the problem is systemic.

I and all the other patients I am in contact with look forward to hearing from you.

Yours sincerely,

John Perrott

Cc

Professor Dame Sally Davies, Chief Medical Officer, Department of Health

Sir Richard Thompson, Former President, Royal College of Surgeons

Professor Steve Field, Chief Inspector, CQC

Posted in Uncategorized | Leave a comment

Correspondence with Brian Brown and Steve Field, Care Quality Commission

Dear Mr Perrott                                                                                             22 June 2015

Thank you for your recent response to the email from Brian Brown in which he set out the position of CQC. The issues that you raise around the independence of NICE and the training provided to doctors are outside of our remit .

We are the independent regulator for quality and safety in health and social care services.  We do not enforce prescribing guidelines.  We do not regulate healthcare practitioners or the clinical/prescribing decisions they make, that is the role of their professional and regulatory bodies such as the General Medical Council, the General Pharmaceutical Council and the Nursing and Midwifery Council.

We believe that by looking at the level of prescribing of hypnotics, and highlighting where there is variation, we encourage individual practitioners to consider their use of these medicines.  We do however recognise that this is not going to bring about an overnight change in prescribing levels as this is part of a process to stimulate improvement and not the final result.

I hope you will take heart from Dame Sally Davis, the Chief Medical Officer’s announcement last week of the independent review into the efficacy and safety of medicines to address some of the issues you are concerned about.

Kind regards

Steve

Dear Brian Brown,                                                                          14 June 2015

Thank you for your email.

You say that, regarding NICE, “Their guidance and other recommendations are made by independent committees”, yet six out of the twelve-strong panel of experts who drew up the guidelines have received substantial funding from statin manufacturers. The NICE panel chairman, Dr Wierzbicki, has been given funds from five companies making statins.

Professor Rory Collins, a strong advocate of their use and advisor to NICE and the British Heart Foundation lists among his financial interests statin manufacturers Pfizer, Merck, Bristol-Myers Squibb, Sanofi and AstraZeneca.

So the research and supporting evidence underpinning the NICE guidelines are not independent.

To compound the problem, doctors still receive no pharmacology training apart from information coming from drug companies, who it is well recognised withhold negative clinical trial data for commercial purposes.

You also say that the CQC has no jurisdiction over NICE and cannot explain its actions. It is precisely this fragmented responsibility, made worse by the Health and Social Care Act, which has caused the “pass the parcel effect” practiced by the Department of Health and regulators and has led to iatrogenic drug scandals, including involuntary tranquilliser addiction.

I must add that following correspondence and meetings you and Professor Field had with the late Jim Dobbin MP, Chair of APPGITA, and correspondence with me on this issue, I am very disappointed that the CQC has done nothing effective to address the issue of involuntary tranquilliser addiction. Collecting data only on numbers of hypnotics prescribed by GPs with no account taken of dosage, reason for prescribing, length of time on the drugs etc, will not provide any useful data or help those iatrogenically addicted to tranquillisers. Furthermore, comparing hypnotic prescribing to the national average will not help because doctors are mis-prescribing nationally and this will just result in the normalisation of bad practice.

Would you please explain how you think this has helped?

I have asked you this before but you did not answer – why can’t the CQC enforce existing 2 – 4 week tranquilliser prescribing guidelines for new patients to avoid future addicts? Also, the CQC has done nothing to help the million plus patients abandoned on these drugs, some for decades, and who, as Professor Lader said in 1991, “will go to their graves with their tranquilliser bottles beside them”.

I have emailed you since on this issue and received no reply. I take it that the CQC like the Department of Health, the MHRA and the Royal Colleges, considers the issue kicked back into the long grass once and for all.

You are correct that I have strong views on over-prescribing and mis-prescribing because through my correspondence with those responsible for involuntary tranquilliser addiction it is clear that our health and care system is pharmaceutically led with little or no regard for patients damaged in the process.

Yours sincerely,

John Perrott

 

Dear Mr Perrott

Thank you for your email, Professor Field has asked me to reply on behalf of both of us.

As you know NICE is a Non Departmental Public Body (NDPB)  set out in the Health and Social Care Act 2012. As an NDPB, it is accountable to the Department of Health, but operationally independent of government. Their  guidance and other recommendations are made by independent committees. NICE guidance is intended to help health, public health and social care professionals deliver the best possible care based on the best available evidence. Different types of NICE guidance have a different status within the NHS, public health and social care. Their recommendations are not intended to replace the professional expertise and clinical judgement of health professionals, as they discuss treatment options with their patients.

The specific question you ask is “Why is NICE being allowed to reward GPs putting healthy patients on drugs rather than lifestyle advice?”.

Currently NICE guidance recommends treatment with statin therapy for anyone who has a CVD risk assessment score of 10% or greater where lifestyle modification is ineffective or inappropriate.  Their proposal to include a  QOF indicator for statin therapy for  2016/17  was the subject of significant discussion and consultation and one of the questions asked during the consultation was if lifestyle choices and statin therapy should have been jointly incentivised. The 2015/2016 QOF indicators include lifestyle- health promotion/smoking/obesity.

You clearly have very strong views on this matter, which I respect, however CQC cannot answer for or explain the actions of NICE , an independent public body, and  whilst  I understand your concern regarding the proposal , I do not agree with the conclusions you draw.
I am sorry that I am not able to assist you further.

Regards

Brian

Posted in Uncategorized | Leave a comment

Correspondence regarding independent prescribing of controlled drugs

Dear Jasmine Ganesh,

Thank you for your reply (below) of 6 May 2015.

You say that “Therefore, at the time of the review, there would have been no patients in receipt of controlled drugs prescribed by allied health professionals” but this is not the point.

The point is that when the Department announced a policy review on addiction to medicines in July 2009 it was at the same time leading contradictory work to deregulate the prescribing of the addictive drugs which were the subject of the review, including the benzodiazepines temazepam, lorazepam and diazepam. To claim that the drugs in question were not actually prescribed by allied professionals at the time of the review is just playing with words.

In 2009 the Department produced a scoping document and in September 2011, Ministers agreed to a public consultation on proposals for independent prescribing by podiatrists and physiotherapists. The subsequent risk assessment in 2012 was led by the Department of Health.

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213480/DH-1019-Proposals-to-introduce-independent-prescribing-by-podiatrists.pdf

On page 5 the Policy objective is described in the following terms “The objective of introducing independent prescribing for podiatrists is to enhance patient care by improving access to medicines through an increased and more flexible approach.”

Would you explain why on the one hand the Department was conducting a policy review on addiction to medicine including benzodiazepines and on the other hand leading contradictory work to deregulate the prescribing of these drugs?

Secondly, would you please explain how the introduction of independent prescribing for podiatrists and physiotherapists will enhance patient care by improving access to medicines (including lorazepam, diazepam and temazepam) through an increased and more flexible approach as stated in the Department’s impact assessment, when many hundreds of thousands of patients have already become addicted caused by doctors not complying with existing prescribing guidelines?

Thirdly, in answer to a PQ by my MP Eric Ollerenshaw (below), George Freeman said “The Department is looking into the feasibility of commissioning further research on patterns of long-term prescription of dependency-forming medicines, including analyses of relevant prescribing data.”

Why is the Department allowing further deregulation of the prescribing of these drugs when by its own admission it has no idea how many patients are addicted to them? There is plenty of evidence on the harms caused by benzodiazepines so surely their prescribing should be more controlled, not less?  Research by benzodiazepine expert Professor Ashton and also by BBC Panarama in 2001 pointed to over a million patients on these drugs long-term, with most likely to be addicted.

Would you also provide more information regarding this feasibility study?

Lastly, regarding your comment that “the Department of Health and Public Health England have undertaken to address this important issue”, no effective action has been taken to date and my survey of PCTs in 2012 proved that 83% of local areas had no prescribed tranquilliser withdrawal services and my survey of 152 local authorities conducted in 2013 proved that involuntary tranquilliser addiction is not being treated and that it is still incorrectly treated by DH and PHE as a substance misuse issue.

http://www.appgita.com/wp-content/uploads/2013/08/Survey-of-PCTs-in-England-recording-provision-of-services-for-involuntary.pdf

http://www.appgita.com/index.php/2014/09/survey-of-152-local-authorities-in-england-recording-numbers-treated-since-april-2013-for-involuntary-tranquilliser-addiction/

Yours sincerely,

John Perrott

 

Your email of 6 May 2015

Our ref: DE00000933295

Dear Mr Perrott,

Thank you for your further correspondence of 23, 24 and 25 April to Una O’Brien about prescription medicines.  I have been asked to reply.

In 2011, two reports on addiction to prescription and over-the-counter medicines were published, and are available to view at:

https://www.gov.uk/drug-safety-update/addiction-to-benzodiazepines-and-codeine

A consensus statement was then published in January 2013, which predated the decision to amend regulations to allow independent prescribing of controlled drugs by allied health professionals.  Therefore, at the time of the review, there would have been no patients in receipt of controlled drugs prescribed by allied health professionals.  From previous correspondence, you will be aware of the work that the Department of Health and Public Health England have undertaken to address this important issue.

Now that Parliament has been dissolved before the General Election, any future decisions about this matter will be for the incoming Government.

I am sorry I cannot be more helpful.

Yours sincerely,

Jasmine Ganesh
Ministerial Correspondence and Public Enquiries
Department of Health

 

 

The Department of Health has provided the following answer to your written parliamentary question (227804):

Question:
To ask the Secretary of State for Health, whether the General Practice Research Database includes data on the prescribing of tranquillisers; and if he will use this database to calculate the number of patients with a long-term dependency on tranquillisers. (227804)

Tabled on: 17 March 2015

Answer:
George Freeman:

The CPRD GOLD primary care database (former GPRD) includes information about all prescriptions issued in primary care for a subset of approximately 8% of the United Kingdom population. This database has previously been used to study prescribing of anxiolytic, hypnotic and psychotropic medication, commonly referred to as tranquilisers.

It would be possible to use the database to estimate the number of patients in the UK with a long-term dependency on prescription tranquilisers. However, as dependence will not be systematically identified by general practitioners, expert clinician advice would also be required to develop a definition. This could be based on frequency of prescribing and medication strength but could also include clinical codes for medical conditions including indications for these products, drug dependency and substance abuse, if recorded.

This work would represent a research project and as such, a scientific protocol would need to be submitted to the Medicines and Healthcare products Regulatory Agency’s Independent Scientific Advisory Committee for assessment and possible approval.

Even with such an approach, the rate of drug dependency in the population could only be estimated, and in order to assess whether this estimate was a true representation of the actual rate of drug dependency in this population, a validation study would be encouraged.

The Department is looking into the feasibility of commissioning further research on patterns of long-term prescription of dependency-forming medicines, including analyses of relevant prescribing data.

The answer was submitted on 24 Mar 2015 at 16:16.

DH response 18 May 2015

Our ref: DE00000934760

Dear Mr Perrott,
Thank you for your further correspondence of 12 May to Una O’Brien and the Department of Health about prescription medicines.  Please accept this as a response to each of your emails.

I was sorry to read that you were not satisfied with the Department’s earlier response of 6 May (our ref: DE00000933295), and note your continuing concerns about independent prescribing by podiatrists and physiotherapists.

The Addiction to Medicine review was set up to consider the extent of drug dependence and harm, and the service responses to it.  The legislative changes made to allow appropriately qualified and registered physiotherapist and podiatrist independent prescribers to prescribe some benzodiazepines were undertaken to enable patients who might benefit from these medicines to have readier access to them.  These are not contradictory positions, as the work of the review and current guidance applies to any prescriber, including any allied health professionals (AHPs) who are independent prescribers.

The changes only apply to independent physiotherapist and podiatrist prescribers, not all AHPs.  Prescribers are expected to follow current guidance on the prescribing of benzodiazepines and to only use them when there is a clear, clinical need.  They will also discuss the effects of the medication with the patient before a decision to prescribe is made.  The possibility that increased availability on these restricted terms could lead to increased dependence and demand for services is slim.

You will be aware from previous correspondence of the actions that the Department, Public Health England, the relevant Royal Colleges and others have taken to increase awareness of the addiction potential of some medicines, such as benzodiazepines, and to ensure that local health services are aware of their obligation to meet the needs of anyone in their populations who has become addicted to a prescribed or over-the-counter medicine.

There are entry requirements to ensure only advanced practitioner physiotherapists and podiatrists can enrol on prescribing education and training programmes.  The programmes are based on demonstrating competencies as detailed in the single competency framework for all prescribers.

Applicants for the programmes must:

–       be registered with the Health and Care Professions Council;

–       be professionally practising in an environment where there is an identified need for the individual to regularly prescribe independently;

–       be able to demonstrate support from their employer/sponsor, including confirmation that the entrant will have appropriate supervised practice in the clinical area in which they are expected to prescribe;

–       be able to demonstrate medicines and clinical governance arrangements are in place to support safe and effective independent prescribing;

–       have an approved medical practitioner to supervise and assess their clinical training as a prescriber;

–       normally have at least three years relevant post-qualification experience in the clinical area in which they will be prescribing; and

–       be working at an advanced practitioner or equivalent level.

Further information about the training programme is available online at:

http://anp.org.uk/2012/06/npc-publishes-single-competency-framework-for-prescribers/

Once successful applicants have been trained and their registration with the Health and Care Professions Council is annotated to record their training as an independent prescriber, physiotherapists and podiatrists will be covered by local governance arrangements.  These include the responsibility of controlled drugs accountable officers for registering prescribers of controlled drugs, issuing prescriptions pads and monitoring prescribing patterns.  The arrangements may also include use of local, organisation and personal prescribing formularies.

The changes in prescribing described above are largely aimed at addressing ‘one-off’ episodes of care, with immediate supply/administration of a single dose, or as part of end-of-life care.  In addition, the changes do not represent a large-scale expansion of prescribing, with independent prescribing being introduced to address specific patient or service needs and not across the whole physiotherapist and podiatrist workforce.  These changes add a flexible approach to prescribing and will enhance patient care by allowing AHPs who are independent prescribers to:

–       maximise the treatment intervention through better pain management;

–       improve quality of care in palliative services – fine tuning the needs of the patient as they change;

–       manage pain in pre and/or post-operative treatment;

–       improve quality of care through the potential to reduce controlled drugs as the benefits of the physical treatment and health outcomes are recognised;

–       prevent delays in early intervention for first time and acute setting patients; and

–       treat specific episodes or long term conditions.

The changes in prescribing are not deregulation.  Regulations have been amended with the aim of enhancing patient care by making better use of the skills of these highly experienced healthcare professionals.  The following case studies describe real life circumstances in which flexibility in who can prescribe temazepam, lorazepam and diazepam would enhance patient experience:

Case Study – temazepam

Temazepam may be prescribed for the management of acute anxiety prior to undergoing scanning diagnostics for the investigation and management of spinal pain and/or other long term musculoskeletal conditions.  Patients are often managed in physiotherapy-led spinal services whereby the physiotherapist requests an out-patient diagnostic scan as part of the patient pathway. When the patient suffers from acute anxiety and/or claustrophobia, performing the scan may not be possible without some sedation.  The patient may be prescribed 10mg to take the night before the scan, followed by another 10mg one hour prior to the procedure.

Case Study – lorazepam/diazepam

These may be used in palliative or end of life care for the management of acute anxiety or respiratory distress at the end of life.  The physiotherapist is often the healthcare professional with expertise in managing respiratory function, and managing anxiety may be part of managing the decline in respiratory function.  Dosage will be according to British National Formulary guidelines and individual patient circumstances where either long or short acting sedation is required.

With regard to your concerns about commissioning further research on patterns of long-term prescription of dependency-forming medicines, as the commissioning process is not yet complete, the Department is unable to provide this information.

I hope this reply is helpful.

Yours sincerely,

Jasmine Ganesh
Ministerial Correspondence and Public Enquiries
Department of Health

Posted in Uncategorized | Comments Off on Correspondence regarding independent prescribing of controlled drugs

email to Una O’Brien, Permanent Secretary, Department of Health

Dear Una O’Brien,                                                                                             24 April 2015

Further to my email of yesterday I have since received a response from the Chartered Society of Physiotherapists (below).

The links show that the Department of Health supported deregulation of benzodiazepine prescribing allowing physiotherapists, chiropodists and podiatrists to prescribe temazepam, lorazepam and diazepam. These proposals were underway in 2009 and developed during 2011 – 2012 but were not disclosed during the Department’s policy review on addiction to medicines including prescribed benzodiazepines.

Would you please explain why the proposals, the “public consultation” and amendments were not disclosed during the policy review or in the Department’s dealings with the All Party Parliamentary Group on Involuntary Tranquilliser Addiction?

Yours sincerely,

John Perrott
Our ref: DE00000933295                                               6 May 2015

Dear Mr Perrott,
Thank you for your further correspondence of 23, 24 and 25 April to Una O’Brien about prescription medicines.  I have been asked to reply.

In 2011, two reports on addiction to prescription and over-the-counter medicines were published, and are available to view at:

https://www.gov.uk/drug-safety-update/addiction-to-benzodiazepines-and-codeine

A consensus statement was then published in January 2013, which predated the decision to amend regulations to allow independent prescribing of controlled drugs by allied health professionals.  Therefore, at the time of the review, there would have been no patients in receipt of controlled drugs prescribed by allied health professionals.  From previous correspondence, you will be aware of the work that the Department of Health and Public Health England have undertaken to address this important issue.

Now that Parliament has been dissolved before the General Election, any future decisions about this matter will be for the incoming Government.

I am sorry I cannot be more helpful.

Yours sincerely,

Jasmine Ganesh
Ministerial Correspondence and Public Enquiries
Department of Health
Dear Mr Perrott,                                                                                                          24 April 2015

Thank-you for taking the time to write to the CSP.

The decision to allow physiotherapists to independently prescribe was taken by Government, after a period of Public Consultation, in 2013. This  included the decision in principle, made by The Advisory Committee for the Misuse of Drugs which advises the Home Office, to  allow physiotherapists to prescribe from a limited list of 7 controlled drugs. The Home Office recently announced plans for the Misuse of Drugs Regulations 2001 to be amended to incorporate this recommendation.

The issues you raise about training and regulation are all covered in the Public Consultation documents and the Government Reponses to the Public Consultation these changes which occurred in 2011 and 2012:

https://www.gov.uk/government/news/proposals-to-introduce-independent-prescribing-for-physiotherapists-and-podiatrists

https://www.gov.uk/government/news/summary-of-public-consultation-on-proposals-to-introduce-independent-prescribing-by-physiotherapists

Physiotherapist have been able to use controlled drugs in their practice via other medicines mechanisms for many years and the introduction of very limited independent prescribing is the next step in delivering effective health care. There is to date, no evidence of physiotherapists misusing these prescribing privileges . Only approximately 500 of our 53,000 members are registered as prescribers, and not all physiotherapists will  choose to undertake this activity.

Best wishes

Pip

Pip White BSc, MSc, MA(Law), MCSP| Professional Adviser | Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED               

Tel: 0207 306 6666| : E-mail: enquiries@csp.org.uk | web www.csp.org.uk

(Also sent to the Society of Chiropodists and Podiatrists)

Dear Sir/Madam,                                                                                   23 April 2015

I am writing about the recent decision to allow chiropodists, podiatrists and physiotherapists to prescribe controlled drugs including the benzodiazepines temazepam, lorazepam and diazepam under The Misuse of Drugs (Amendment) (No. 2) (England, Wales and Scotland) Regulations 2015.

http://www.legislation.gov.uk/uksi/2015/891/made/data.pdf

These drugs are highly addictive and were the subject of the recent Department of Health policy review on addiction to medicines. Doctors have ignored the 1988 CSM 2 – 4 prescribing guidelines which has caused mass addiction to prescribed tranquillisers in the UK dwarfing numbers addicted to illegal drugs. There are more deaths and hospital admissions caused by prescription drugs than illegal drugs. Withdrawal from benzodiazepines is often more prolonged with more psychological and physical withdrawal symptoms than heroin. There are no NHS tranquilliser withdrawal services with patients addicted to prescribed tranquillisers forced to cope on their own or seek help from under half a dozen charities including CITAp in Liverpool which is due to close soon due to lack of funding.

These are patients who have become addicted through following medical advice and are not to be confused with illicit drug users.

You may not be aware but there has been a campaign of nearly 30 years against the mis-prescribing of these drugs, more recently by the All Party Parliamentary Group on Involuntary Tranquilliser Addiction. Campaign work is documented on these websites – www.appgita.com andwww.benzo.org.uk

I would be grateful if you would clarify the following please:

  1. Why was it thought necessary that physiotherapists would need to prescribe these three benzodiazepine drugs?
  2. What conditions will they be prescribed for?
  3. What training are physiotherapists to be given regarding prescribing these drugs safely?
  4. Doctors have ignored the 1988 CSM 2 – 4 tranquilliser prescribing guidelines causing an estimated 1 million patients to be on these drugs long-term, some for decades, with most likely to be addicted.

The Department of Health’s recent policy review included a consensus statement on addiction to medicines http://www.rcgp.org.uk/news/2013/january/~/media/Files/News/RCGP-Addiction-to-Medicine-consensus-statement.ashx

Point 6 states, “Longer term prescribing can increase the risk of dependence, and with some medicines, such as tranquillisers like benzodiazepines, should only be considered under exceptional circumstances and with regular review by practitioners with suitable expertise and understanding of the risks.”

What safeguards have been put in place to avoid further iatrogenic addiction caused by physiotherapists?

  1. Will physiotherapists be directed to the Ashton manualhttp://www.benzo.org.uk/manual/before prescribing benzodiazepines so that they understand ADRs and withdrawal symptoms and the pharmacology of these drugs?

Campaigners and patients are very concerned about deregulation of the prescribing of these drugs and any further information you can give would be appreciated.

Yours sincerely,

John Perrott

Posted in Uncategorized | Comments Off on email to Una O’Brien, Permanent Secretary, Department of Health

email to Professor Les Iversen, Chair ACMD and Una O’Brien, Permanent Secretary, Department of Health

Dear Professor Iverson and Una O’Brien,

I am writing about the recent decision to allow chiropodists, podiatrists and physiotherapists to prescribe controlled drugs including the benzodiazepines temazepam, lorazepam and diazepam under The Misuse of Drugs (Amendment) (No. 2) (England, Wales and Scotland) Regulations 2015.

These drugs are highly addictive and were the subject of the recent Department of Health policy review on addiction to medicines. Doctors have ignored the 1988 CSM 2 – 4 prescribing guidelines which has caused mass addiction to prescribed tranquillisers in the UK dwarfing numbers addicted to illegal drugs. There are more deaths and hospital admissions caused by prescription drugs than illegal drugs. Withdrawal from benzodiazepines is often more prolonged with more psychological and physical withdrawal symptoms than heroin. There are no NHS tranquilliser withdrawal services with patients addicted to prescribed tranquillisers forced to cope on their own or seek help from under half a dozen charities including CITA which is due to close soon due to lack of funding.

  1. What is the reasoning behind the decision to allow chiropodists, podiatrists and physiotherapists to prescribe these three benzodiazepines?
  1. Why was it thought necessary that these therapists would need to prescribe these drugs?
  1. What conditions will they be prescribed for?
  1. What training are they to be given regarding prescribing these drugs safely?

5. Doctors have ignored the 1988 CSM 2 – 4 prescribing guidelines causing an estimated 1 million patients to be on these drugs long-term, some for decades, with most likely to be addicted.

The Department of Health’s policy review consensus statement on addiction to medicines point 6 states, “Longer term prescribing can increase the risk of dependence, and with some medicines, such as tranquillisers like benzodiazepines, should only be considered under exceptional circumstances and with regular review by practitioners with suitable expertise and understanding of the risks.”

What safeguards have been put in place to avoid further iatrogenic addiction caused by these therapists and why is there no mention of benzodiazepines or the 1988 CSM tranquilliser prescribing guidelines in correspondence from the Department of Health below?

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/410923/2015-02-03-Dan_Poulter_-_LF.PDF

Will these therapists be directed to the Ashton manual before prescribing benzodiazepines so that they understand ADRs and withdrawal symptoms and the pharmacology of these drugs?

Yours sincerely,

John Perrott

Posted in Uncategorized | Comments Off on email to Professor Les Iversen, Chair ACMD and Una O’Brien, Permanent Secretary, Department of Health

THE MISUSE OF DRUGS (AMENDMENT) (No. 2) (ENGLAND, WALES AND SCOTLAND) REGULATIONS 2015

These amendments will enable further deregulation of benzodiazepine prescribing. From June 2015, physiotherapists will be allowed to prescribe some controlled drugs for treatment of organic disease or injury, including diazepam, dihydrocodeine, fentanyl, lorazepam, morphine, oxycodone and temazepam; chiropodists/podiatrists will be allowed to prescribe diazepam, dihydrocodeine, lorazepam and temazepam.

http://www.legislation.gov.uk/uksi/2015/891/made/data.pdf

http://www.legislation.gov.uk/uksi/2015/891/pdfs/uksiem_20150891_en.pdf

“7.27 This instrument provides for limited independent prescribing authorities to physiotherapists and chiropodists under these changes to improve safety and health outcomes for patients through improved access to medicines and more timely treatment. Physiotherapists are being given authority to prescribe temazepam (oral), lorazepam (oral), diazepam (oral), dihydrocodeine (oral), morphine (oral and injectable), fentanyl (oral) and oxycodone (oral). Chiropodists are authorised to prescribe temazepam (oral), lorazepam (oral), diazepam (oral), and dihydrocodeine (oral). Both professions are authorised to administer the specific drugs they are authorised to prescribe, but are not authorised to possess, stock or supply these drugs.”

Letter from Dan Poulter, Under Sec State Health to Minister for Crime Prevention about amendments 3 February 2013

Letter from Professor Les Iverson Chair, ACMD to Jeremy Browne, Minister for Crime Prevention on proposals 13 February 2013

Parliament approves changes to regulations governing controlled drugs – Pharmaceutical Journal

 

Posted in Uncategorized | Comments Off on THE MISUSE OF DRUGS (AMENDMENT) (No. 2) (ENGLAND, WALES AND SCOTLAND) REGULATIONS 2015

Recovering from benzodiazepines – a guide by Peter Hayes-Davies

Click here to read the guide

Posted in Uncategorized | Comments Off on Recovering from benzodiazepines – a guide by Peter Hayes-Davies

Andreas Lubitz was on prescribed antidepressants and the benzodiazepine Lorazepam (Ativan)

Click here to read article in the Telegraph

Also, transcript below is from the International Business Times, 2 April 2015

What Drugs Was Andreas Lubitz On? Lorazepam, Antidepressants Could Have Affected Germanwings Pilot by Elizabeth Whitman

Medical records indicate that Andreas Lubitz, the co-pilot who crashed the Germanwings plane last week in the French Alps, was on medications for depression, anxiety and panic attacks, including lorazepam, a tranquilizer that can have dangerous side effects, German newspaper Bild reported.Federal drug information advises that “patients receiving lorazepam should be warned not to operate dangerous machinery or motor vehicles” and that “in patients with depression, a possibility for suicide should be borne in mind.

Lubitz, 27, was also reportedly taking an antidepressant, Reuters reported. He lied to his doctors, saying that he was taking sick leave rather than working and flying planes. When he resumed pilot training in 2009, he provided medical papers showing a “previous episode of severe depression,” Lufthansa, the parent company of Germanwings,  confirmed Tuesday.

Lorazepam is a drug that is typically prescribed to treat anxiety that works by “slowing activity in the brain to allow for relaxation,” according to an information page by the National Institutes of Health. The NIH warned that the drug can be “habit-forming,” or addictive, and should not be stopped suddenly, as doing so can cause “anxiousness, sleeplessness, and irritability.” There are a host of side effects, including restlessness and blurred vision.

The Food and Drug Administration’s drug information page for Ativan, a brand name for lorazepam, noted that the drug’s effectiveness for long-term use — a period defined as more than four months — has yet to be clinically assessed. It remains unclear how long Lubitz had taken the drug. The FDA warned that “pre-existing depression may emerge or worsen during use of benzodiazepines [a class of tranquilizer drugs that includes Valium and Xanax], including lorazepam.” It highlighted as well that lorazepam can have an even more depressive effect depending on what other drugs are taken simultaneously. Brand names for lorazepam include Ativan and Lorazepam Intensol.

The plane Lubitz was flying was en route from Barcelona, Spain to Dusseldorf, Germany. All 150 people on board were killed when it crashed last week in a remote mountainous area of southern France.”

Click here to read article online

Posted in Uncategorized | Comments Off on Andreas Lubitz was on prescribed antidepressants and the benzodiazepine Lorazepam (Ativan)

Pregnant woman was killed by train after doctor “failed to warn her an anxiety drug could cause suicidal feelings” Daily Mail 26 February 2015

Click here to read article

Posted in Uncategorized | Comments Off on Pregnant woman was killed by train after doctor “failed to warn her an anxiety drug could cause suicidal feelings” Daily Mail 26 February 2015