Eight-year wait for drug misuse report

THE publication of a Health Research Board (HRB) report, warning of the continued misuse and possible fatal effects of prescription drugs for anxiety and depression, comes eight years after a governmental report recommended action on the issue.

Yesterday’s HRB report found that benzodiazepines — prescribed for anxiety and depression — are being widely abused and are a factor in 31% of drug-related deaths.

This is despite a Dáil committee report pledging to prevent misuse of the highly addictive legal drugs.

Micheál Martin, the then the Minister for Health, established the Benzodiazepine Committee in June 2000 asking it to examine the prescribing and use of benzodiazepines and to consider recommendations on good prescribing and dispensing practice, paying particular attention to the management of drug misusers.

Eight years on, the HRB has again called for greater awareness among prescribers — as the governmental report did.

The 2002 report describes a scenario of “many long-term prescribed users” of these drugs.

“It would appear that these patients receive little support or advice from their doctors, and generally it would also appear that some medical practitioners are not well informed about benzodiazepine withdrawal symptoms or methods of withdrawal,” it found.

The main anticipated outcome of the report was cited as “greatly reducing” inappropriate use of the benzodiazepines and seeing a significant reduction in the number of patients becoming dependent on them and to lessen consumption by known opiate misusers.

It set out guidelines for prescribing the drugs to include taking a full history including an alcohol and licit and illicit drug history, considering and treat, if possible, any underlying causes, consider referral to other services and not prescribe for longer than four weeks.

However, since this report data shows the number of people taking these drugs has continued to increase.

Figures from the PCRS shows the prescribing of Xanax has increased in recent years, with 283,000 prescriptions written in 2005 compared with 382,921 in 2008.

Other frequently prescribed drugs in 2008 were Valium at a prescribing frequency of 479,305, and Temazepam at 213,630 prescriptions.

What both reports also highlighted is that benzodiazepine misuse amongst opiate users is a problem.

The HRB report found that alcohol was the most common additional problem substance reported by both men and women using a benzodiazepine as their main problem substance.

The majority of cases reporting a benzodiazepine as their main problem substance did not report use of an opiate.

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