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Last Updated: Wednesday, 11 February, 2004, 10:45 GMT
GPs warned over tranquillisers
Pill
Tranquillisers can cause dependence
The Chief Medical Officer has warned GPs to restrict prescription of benzodiazepine tranquillisers.

Professor Sir Liam Donaldson is concerned that they are being handed out to patients too freely.

He has stressed to doctors that they should only be prescribed for short-term treatment.

Long-term use exposes patients to risks such as road traffic accidents, dependence and, in the older population, debilitating falls.

Some people have been on the drugs for many years, and it is very difficult to get them off because they are very addictive.
Dr Peter Fellows
Guidance published by the Committee on Safety in Medicines (CSM) recommended that benzodiazepines such as Valium and Librium should only be prescribed for two to four weeks for the relief of severe anxiety or insomnia.

The CSM guidance also stressed that the drugs should not be prescribed for the treatment of mild anxiety.

This was echoed by advice published in the Mental Health National Service Framework in 1999, which also called on health authorities to implement systems to monitor and review prescribing of the drugs.

However, Department of Health data show that in 2002, 30% of prescriptions for benzodiazepines were for 56 or more tablets - suggesting a high number of patients are receiving long-term treatment.

Overall, the total number of prescriptions has come down over the last decade - but only by a relatively small amount.

In 2002, GPs wrote 12.7 million prescriptions, compared to 15.8 million prescriptions in 1992.

Drug abusers problem

Sir Liam says GPs and hospital doctors need to work more closely together to try to minimise over-prescribing of benzodiazepines, possibly by developing shared treatment guidelines.

In his monthly bulletin, he also stresses that more attention should be paid to prescribing of benzodiazepines to older people.

And he warns that giving the drugs to people who have a history of substance abuse is still an area of concern.

It is estimated that 14% of substance mis-users attending drug treatment centres report benzodiazepine use subsidiary to their main drug use.

The Department of Health is planning to introduce instalment dispensing of benzodiazepines to minimise access to excessive doses for addicted patients.

Instalment prescribing allows a GP to write a single prescription that the pharmacist is able to dispense over several days.

The idea is to give more control to doctors and reduce the risk substantially of a patient misusing the drug.

In some parts of the country, specialist clinics are available to help people with benzodiazepine dependence.

GP reaction

Dr Peter Fellows, chairman of the British Medical Association's prescribing committee, accepted that benzodiazepines were still being over-used.

He said that a significant proportion of prescriptions were written for drug abusers.

And he added: "Some people have been on the drugs for many years, and it is very difficult to get them off because they are very addictive.

"We can nibble away at the problem, but it is a very time intensive thing to have to do.

"However, GPs do need to be constantly aware of the fact that these drugs are only designed for short term use."




SEE ALSO:
Your stories about tranquilliser dependency
14 May 01  |  Tranquillisers
Benzodiazepines A - Z
09 May 01  |  Tranquillisers


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