February 10, 2008
Denis Campbell, health correspondent
· Inquiry slams mis-prescribing of drugs
· Doctors 'ignoring official guidelines'
Doctors are unwittingly fuelling the growing number of Britons hooked on prescription drugs by giving patients dangerously high doses of medicines that can prove highly addictive, a parliamentary inquiry has concluded.
MPs say that 'mis-prescribing' of drugs such as painkillers, sleeping tablets and anti-anxiety pills by some doctors is 'leading to addiction and dependence'.
GPs ignore official advice that patients should take powerful benzodiazepine tranquillisers for no more than four weeks by handing out repeat prescriptions without even seeing them in their surgery, says an all-party parliamentary group on drug misuse. The Home Office blames the mis-use benzodiazepines for causing 17,000 deaths since their introduction in the Sixties.
'It was extremely concerning for the inquiry to receive so many testimonials of people still being negligently prescribed these drugs by their GP,' say the MPs. 'The guidelines now in place recommend that benzodiazepines are not taken continuously for longer than four weeks, but there were many cases of GPs continuing to prescribe the drug for a lot longer - sometimes even allowing repeat prescriptions without having the patient in for a consultation.'
News of the inquiry's report follows last week's revelation that 28-year-old Hollywood actor Heath Ledger died as the result of 'acute intoxication' caused by an accidental overdose of anti-anxiety medication and prescription painkillers. Health experts are warning that prescription drug abuse is now widespread on both sides of the Atlantic.
Dr Brian Iddon, the Labour MP and former chemist who chairs the group, told The Observer: 'Some GPs are addicting people by giving them repeat prescriptions without checking to see how long they've been on the drugs in the first place. They are not stopping patients from getting any more of them after the set amount of time.'
The MPs' investigation into prescription and over-the-counter drugs also claims that family doctors are contributing to growing problems associated with these substances by not taking seriously enough requests for help from addicts, and by mismanaging patients with chronic pain.
Dr Steve Field, chairman of the Royal College of General Practitioners, said it would take on board the MPs' findings, which raised some important concerns about how family doctors treat patients who may be abusing either prescription or shop-bought drugs, or both.
Some GPs needed to improve their repeat prescription systems so that the amount of drugs that patients were taking could be monitored and that fresh supplies would only be approved if they were medically necessary, he admitted.
Patients who are addicted to prescription drugs could be 'extremely manipulative' in their efforts to get GPs to prescribe them more drugs. Identifying how much pain someone was actually suffering could be very difficult, Field said.
Medical experts told the inquiry that an unknown, but growing, number of people had become addicted to painkillers, often after taking them initially for a genuine medical complaint such as a sore back, period pains or bad headaches. Some developed a dependence on over-the-counter drugs as a result.
Solpadeine and Nurofen Plus are the two most widely misused such substances, the MPs say, with 4,000 subscribers to one specialist advice website alone hooked on Solpadeine.
A coroner in Lancashire recently called for Nurofen Plus to be reclassified after investigating the case of Linda Docherty, who died after taking up to 64 Nurofen Plus tablets a day, which she had obtained by visiting different supermarkets and chemists to evade the limit on customers buying only one packet of 24 at a time.
'Although the reclassification of some substances from prescription-only to over-the-counter has resulted in often significant cost savings for consumers, the abuse or misuse of these substances can result in serious side-effects, such as dependency, addiction, hospitalisation and potentially even death,' the MPs conclude.
The Medicines and Healthcare Products Regulatory Agency, which oversees drug safety, said the deaths of 1,135 people were suspected of having been caused by an adverse reaction to legal drugs in the last 13 months, including 25 who overdosed.
Health experts say the rise in prescription dependence has been worsened by the ease with which drugs can be bought on the internet.
Thousands of online pharmacies now provide potentially lethal drugs to anyone logging in and giving a credit-card number. An 'online consultation' merely asks the customer how old he or she is and how bad their pain is on a scale of one to 10.