Response from Jane Ellison MP, Public Health Minister, 10 July 2014 to a letter from Jim Dobbin MP, 4 April 2014

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Benzodiazepine litigation Official Transcripts 1990 – 1997

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Wayne Douglas benzo campaign in Japan

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Article in The Bulletin, Oregon US

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Parliamentary Questions by Jim Dobbin MP

Drinking Water: Contamination

Jim Dobbin: To ask the Secretary of State for Environment, Food and Rural Affairs with reference to the answer 196584 of 6 May 2014, Official Report, column 41W, on drinking water, what plans his Department has to test for the levels of tranquillisers and antidepressants in drinking water; and if his Department will conduct a study into levels of psychotropic drugs in UK river and seawater. [201036]

Dan Rogerson: In 2012, the Drinking Water Inspectorate (DWI) published research looking at pharmaceuticals likely to present the worst case scenario in drinking water. Fluoxetine was included in the study, the outcome of which was that these pharmaceuticals presented no concern for public health. The research is part of an ongoing risk assessment which is revisited in the event of new information. The DWI has also responded to the earlier PQ (0019) on this matter.

23 Jun 2014 : Column 64W

Monitoring river water and seawater is driven by requirements under the EU water framework directive (WFD). As psychotropic drugs have not been identified as harmful chemicals under the WFD they are not routinely monitored, although they may be detected in less specific investigations.

The water industry has undertaken collaborative research into chemicals in sewage effluent through the UK Water Industry Research (UKWIR) Chemicals Investigation Programme. Some medicines were included in the first programme of 2010-13, including fluoxetine. A second Chemical Investigations Programme, beginning in 2015, will look at the psychoactive medicines fluoxetine and sertraline in sewage effluent.

23 Jun 2014 : Column 13W

Antidepressants

Jim Dobbin: To ask the Secretary of State for Health with reference to the answer of 19 January 2012, Official Report,columns 932-3W, how many companies hold licences for the manufacture or distribution of (a) Nitrazepam, (b) Flurazepam, (c)Loprazolam, (d) Lormetazepam, (e) Temazepam, (f) Clonazepam, (g) Medazepam, (h) Midazolam, (i) Zopiclone, (j) Zaleplon,(k) Zolpiden, (l) Eszopiclone, (m) SSRI antidepressants and (n) trycyclic antidepressants; and how many of those licences were issued in the last three years. [201050]

Norman Lamb: There are currently 15 products authorised in the United Kingdom containing nitrazepam and 15 different companies authorised to manufacture and distribute them.

There are currently two products authorised in the UK containing flurazepam and one company authorised to manufacture and distribute them.

There are currently two products authorised in the UK containing loprazolam and two different companies authorised to manufacture and distribute them.

There are currently eight products authorised in the UK containing lormetazepam and four different companies authorised to manufacture and distribute them.

There are currently 10 products authorised in the UK containing temazepam and six different companies authorised to manufacture and distribute them.

There are currently six products authorised in the UK containing clonazepam and three different companies authorised to manufacture and distribute them.

There are currently no authorised products in the UK containing medazepam.

There are currently 22 products authorised in the UK containing midazolam and 10 different companies authorised to manufacture and distribute them.

There are currently 17 products authorised in the UK containing zopiclone and nine different companies authorised to manufacture and distribute them.

There are currently two products authorised in the UK containing zaleplon and one company authorised to manufacture and distribute them.

There are currently 21 products authorised in the UK containing zolpidem and 12 different companies authorised to manufacture and distribute them.

There are currently no authorised products in the UK containing eszopiclone.

There are currently 238 products authorised in the UK containing SSRI antidepressants and 57 different companies authorised to manufacture and distribute them.

There are currently 16 products authorised in the UK containing tricyclic antidepressants and 11 different companies authorised to manufacture and distribute them.

One loprazolam, four lormetazepam, two clonazepam, two midazolam, three zopiclone, four zolpidem and 75 SSRI products have been authorised in the last three years.

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Meeting with Duncan Selbie, CEO, PHE promised by Jane Ellison, Public Health Minister has not happened

5 July 2014

Dear Jane Ellison,

I am informed by an email today from Alex Sienkiewicz, Chief of Staff, PHE, that no meeting has taken place between you and Duncan Selbie, CEO, PHE on the issue of involuntary tranquilliser addiction. Alex Sienkiewicz says ” there is not a note of conversations between PHE’s Chief Executive and the Minister for Public Health, who has not yet raised this matter with Mr Selbie”.

Would you please explain the delay on such an important issue which you made special mention of in handwriting at the end of your letter of 17 January 2014 attached.

Would you confirm when a meeting is planned on this issue and also when you intend to answer Jim Dobbin MP’s letter to you of 4 April 2014?

Yours sincerely,

John Perrott

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email to Addiction To Medicine round table members

To round table members

On 15 September 2011 specific actions were agreed at the Addictions To Medicines (ATM) round table meeting to address the issue of involuntary tranquilliser addiction.

Action point number 2 with responsibility given to the RCGP was:

“To develop updated guidance and training for GPs and other healthcare professionals on addiction to medicines”

The SMMGP draft Benzo guidance was sent out in 2011 to a limited number of people including benzodiazepine expert Professor Heather Ashton.

Professor Ashton sent Chris Ford, who is responsible for the development of the guidance, criticisms of the draft, the main ones being:

1.  The draft guidance is overly long and complicated with doctors unlikely to read it.

2. The draft guidance repeats the same error made in Professor Strang’s NAC review by conflating the two populations of involuntary tranquilliser addicts and substance misusers. Classifying patients as misusers rather than involuntary tranquilliser addicts leads to dangerous and unsuccessful rapid withdrawal regimes circa 12 weeks. The guidance also conflates different drugs such as opiates and benzodiazepines/z drugs.

3. Doctors will not be prompted by the guidance to comply with the existing 1988 prescribing guidelines or provide appropriate tranquilliser withdrawal treatment.

On the SMMGP forums an enquiry was posted 20 June 2014 asking when the new benzo guidance would be published. This was the reply from Elsa Browne, PHE, who along with Chris Ford, met Jim Dobbin MP to discuss the issue of ITA in February 2012.

“Hi Pete, Ah, the benzo guidance. We have a final draft but have not been able to progress it to publishing for reasons too numerous and too complex to go into here.

For more information, please email me on elsa.browne@phe.gov.uk

This is a link to the thread: http://smmgp.groupee.net/eve/forums/a/tpc/f/1064030241/m/8337082176

The reasons are not numerous or complex as Elsa Browne claims, simply that the guidance is unfit for its intended purpose as laid out in the Addiction to Medicines round table action points and remains unpublished.

http://www.appgita.com/index.php/2014/06/smmgp-draft-updated-benzo-guidance/

Furthermore, the training referred to in action point number 2 has resulted in a RCGP/CPPE training module which was equally criticised by Professor Ashton who’s comments were:

“This misrepresents involuntary tranquilliser addiction as substance misuse. This is the very issue that APPGITA has been campaigning against and was discussed at the round table. Jim Dobbin MP warned about the consequences and advised attendees not to sign the consensus. This is the sad consequence caused by those who signed it – involuntary tranquilliser dependent people still labelled as drug misusers”

Click here to read e-learning module

Click here for further details about e-learning module

Click here to read about launch of the e-learning module on the RCGP website

Click here for details of consensus statement and list of signatories on RCGP website

Another round table action point, number 4, was:

“4. To ensure that the eligibility criteria for Increasing Access to Psychological Therapies (IAPT) programmes do not exclude those who develop problems with prescribed or over-the-counter medicines, who are suitable.”

This is not happening either as shown in this article in Pulse, GPs forced to prescribe as psychological therapy services are “bursting at seams”

The only action point which has been successfully completed is the signing of the consensus which was the Department of Health’s goal.

It must be obvious to all those round table members who are listed below that signing the consensus was a huge mistake which gave credibility to the Department of Health’s process resulting in no action. None of you have answered emails requesting that you retract your signatures.

Furthermore, none of you who proclaimed yourselves as experts have followed up any of these issues or done any campaign work since the round table was disbanded.

Patients are still waiting for action and APPGITA remains the only campaigning group fighting for patients’ rights which you all signed away.

John Perrott
Round table members:

Melanie Davis - Camden Mind, REST Tranquilliser Project

Una Corbett – Battle Against Tranquillisers (BAT)

Jon Royle – Service Manager Bridge BZN withdrawal project – statutory sector)

Dr. Cathy Stannard- Honorary secretary of the British Pain Society (BPS)

Dan Orgill - Moderator on ‘codeinefree.me.uk

Helen.Darracott - Proprietary Association of Great Britain (PAGB)

Leyla Hannbeck – National Pharmacists Association (head of information)

Graham Parsons – Specialist pharmacists (Local Areas) Substance misuse

Matt Wills – Local commissioner South Gloucestershire DAAT

Sanita Ellis - Primary care co-ordinator -Wandsworth DAAT

Linda Harris - Royal College for General Practitioners Dir. Substance Misuse

Steve Brinksman – Clinical Lead, Substance Misuse Management in General Practice

Mark Prunty – Chief Medical Officer, DH drugs policy team

Mark Edginton – Senior policy adviser, DH drugs policy team

Jeremy Mean - Access and Info. for Medicines and Standards Group Mngr. (MHRA)

Chris Heffer – Deputy Director, Alcohol and Drugs DH

Kevin Jarman – Operations manager, Improving Access to Psychological Therapies DH

Rosanna O’Connor – NTA

Hugh Griffiths – National Clinical Dir. Mental Health DH

Dr Henrietta Brook - GP in Wandsworth

Dr. Emma Whicher - Royal College of Psychiatrists

Steve Taylor – Drugs and Alcohol Programme Manager PHE

 

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SMMGP updated benzo guidance

On 15 September 2011 specific actions were agreed at the Addictions To Medicines (ATM) round table meeting to address the issue of involuntary tranquilliser addiction.

Action point number 2 with responsibility given to the RCGP was:

“To develop updated guidance and training for GPs and other healthcare professionals on addiction to medicines”

The SMMGP draft Benzo guidance was sent out in 2011 to a limited number of people including benzodiazepine expert Professor Heather Ashton.

Professor Ashton sent Chris Ford, who is responsible for the development of the guidance, criticisms of the draft, the main ones being:

1.  The draft guidance is overly long and complicated with doctors unlikely to read it.

2. The draft guidance repeats the same error made in Professor Strang’s NAC review by conflating the two populations of involuntary tranquilliser addicts and substance misusers and also conflating different drugs such as opiates and benzodiazepines/z drugs.

3. Doctors will not be prompted by the guidance to comply with the existing 1988 prescribing guidelines or provide appropriate tranquilliser withdrawal treatment.

On the SMMGP forums an enquiry was posted 20 June 2014 asking when the new benzo guidance would be published. This was the reply from Elsa Browne, PHE, who along with Chris Ford, met Jim Dobbin MP to discuss the issue of ITA in February 2012.

“Hi Pete, Ah, the benzo guidance. We have a final draft but have not been able to progress it to publishing for reasons too numerous and too complex to go into here.

For more information, please email me on elsa.browne@phe.gov.uk

This is a link to the thread: http://smmgp.groupee.net/eve/forums/a/tpc/f/1064030241/m/8337082176

The reasons are not numerous or complex as Elsa Browne claims, simply that the guidance is unfit for its intended purpose as laid out in the Addiction to Medicines round table action points and remains unpublished.

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GPs forced to prescribe as psychological therapies services are ‘bursting at seams’

Click here to read article in Pulse

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email to Duncan Selbie, Chief Exec, PHE, 20 June 2014

Dear Duncan Selbie,

The FOI response (attached) shows that there were no agenda or minutes relating to a meeting between you and Jane Ellison MP, Public Health Minister, on the issue of involuntary tranquilliser addiction and to which Jane Ellison makes a special point of referring in handwriting at the end of her letter (attached).

Would you please confirm whether any such meeting took place, what was discussed and what action is planned on this issue?

Yours sincerely,

John Perrott

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