Prescribed medicines that may cause dependence or withdrawal

31 Jan 2018 04:15 PM

A review of the evidence on the scale and nature of problems with some prescription medicines and how they can be prevented and treated.

The Parliamentary Under Secretary of State for Public Health and Primary Care has commissioned Public Health England (PHE) to review the evidence for dependence on, and withdrawal from, prescribed medicines. Withdrawal is more accurately defined as discontinuation syndrome in relation to anti-depressants.

The review was launched on 24 January 2018 and is due to report in early 2019.

PHE will carry out a public-health focused review of commonly prescribed medicines, authorised for adults who have non-cancer pain, anxiety, insomnia or depression.

The review will bring together the best available evidence on:

• prevalence and prescribing patterns
• the nature and likely causes of dependence or discontinuation syndrome among some people who take these medicines
• effective prevention and treatment of dependence and discontinuation syndrome for each drug category

Included within the scope of the review are:

• adults (age 18 and over)
• dependence and discontinuation syndrome
• benzodiazepines, Z-drugs, GABA-ergic medicines, opioid pain medications, antidepressants
• medicines above that are prescribed to treat anxiety, insomnia, chronic non-cancer pain and depression
• community prescribing

The review will exclude or will not cover:

• cancer and terminal pain
• over-the-counter medicines
• prescribing in hospitals and prisons
• other medicines, such as anti-psychotics, stimulants, ‘smart drugs’, anti-obesity drugs

Methods for the review will include:

• mapping of medicine categories, conditions and guidance to inform scoping, data analysis and literature review
• analysing all prescription and some GP patient data to understand prevalence and detail of prescribing patterns, patients and conditions
• an expert group to inform our approach, interpret findings and propose recommendations
• broader stakeholder engagement to ensure relevance, appropriateness and support
• a call for papers and evidence including unpublished research and reports collating personal experiences
• a literature review to summarise the evidence on causes, harms and effective prevention and treatment responses
• a report of the evidence review and recommendations, which will be peer reviewed

If you have any concerns about medicines prescribed to you, you should talk to your doctor. Do not stop taking any prescribed medicine without medical advice.