CEP welcomes trailblazing report by Public Health England on withdrawal and dependence on psychoactive drugs

CEP today welcomes the publication of a report by Public Health England which recognises for the first time the scale of prescribing of drugs that can cause dependence and withdrawal.  The report shows that one in four adults in England has been prescribed a benzodiazepine, z-drug, gabapentinoid, opioid or antidepressant in the past twelve months, with up to a third of these receiving a prescription for at least three years.  Prescribing rates are significantly higher in deprived areas of England, while women and older adults have the highest rates.
The report is the culmination of over five years of work by CEP, which has focused on this issue since being founded in 2014. CEP provides the secretariat for the APPG for Prescribed Drug Dependence, which played a pivotal role in the commissioning and development of the report.
CEP is pleased to note that the report contains recommendations which CEP and the APPG have long campaigned for, including:
  • A 24 hour national helpline and associated website to provide expert advice and support, also acting as a resource for patients and doctors to support shared decision-making
  • Updated clinical guidance as well as new guidance on management of dependence and withdrawal, and improved training to ensure clinicians adhere to this guidance
  • Provision of better information to patients about risks and benefits of these medicines, as well as alternatives such as social prescribing
  • Further research into the nature and severity of withdrawal, and the treatment of dependence and withdrawal, caused by prescribed drugs
  • Appropriate support from the NHS for patients experiencing dependence and withdrawal problems, including dedicated support services
  • Review of the training and educational resources for practitioners in relation to prescribed drug dependence and withdrawal

CEP and the APPG will now continue to work to ensure the implementation of these recommendations.

21 Responses to CEP welcomes trailblazing report by Public Health England on withdrawal and dependence on psychoactive drugs

  1. Thalia Martin 10/09/2019 at 9:12 am #

    Brilliant! I’m so glad your work is being recognised.

  2. Rosemary Knowles 10/09/2019 at 12:08 pm #

    I heard this news on Today Programme, Radio 4 and went out and bought 3 copies of the Daily Mail – great coverage – and also The Sun. What a lovely change from the B—– Parliamentary shenanigans we have had to endure. At last this prescribing epidemic is getting priority – so huge Thank You to cepuk and also to Matt Hancock. Is a little bit of sanity returning to our poor beleaguered country?

  3. Fiachra 10/09/2019 at 1:36 pm #

    Thank you very much for the information.

    It doesn’t surprise me at all. If we don’t watch out for ourselves our life expectancy is likely to start to going down; dependency on “tranquillisers” is bad for a person’s health.

    I would like go join the CEP and attend your meetings. Would this be possible?

  4. AD 10/09/2019 at 1:48 pm #

    Great news and it is a pity that this didn’t happen many years ago when I was going through withdrawal . I would never have ended up on a psych ward due to the withdrawal symptoms I was having .

    • Sylvia 21/11/2019 at 11:10 am #

      Absolutely… I have an on antidepressants for 33 years!!!!
      Ended up in a psychiatric ward for 2 months after my first of many many attempts at withdrawing. Being told was psychologically addicted… when in fact I was addicted…. I am now very cautious of doctors and medicines.

  5. Paula Kovacs 10/09/2019 at 3:01 pm #

    This is a momentous event. I hope that those of us who have been involved for decades with the campaign to raise awareness of the effects of iatrogenic benzodiazepine addiction and the ensuing prolonged and distressing withdrawal process, can at last feel that the medical profession is taking a step back from its complicit liaison with Big Pharma and
    demonstrating that it is listening to, and beginning to take responsibility for, the effects of these drugs on a largely unaware general public. As a fully recovered, long term involuntary benzodiazepine addict myself, I celebrate this development and hope that future generations won’t have to endure the living hell that those like me have been through. I would like to know if the further withdrawal training of the medical profession, mentioned in the announcement, will include the ‘experts by experience’, the survivors of addiction? I feel we have much wisdom, insight to contribute to this process.

    • Ian Harris 11/09/2019 at 7:12 pm #

      Perhaps you may realise but sometimes such benzo’s as Valium are very much needed when certain spinal & neck conditions exist. Putting the patient’s posture completely out of natural form. Also used for muscle spasm’s & most likely other conditions. However, coerced detoxification is rarely a good idea, it can put a person in a mental institution & if coerced against the persons will, it won’t work anyway.

      Big Pharma has been greedy for money and uncaring for patients, but don’t use patients to punish big pharma. Seems your saying – I gave this habit up, now I want everyone else to do same.

  6. Alastair Knox 10/09/2019 at 4:56 pm #

    I’m presently taking 600 mg/day of Tregabolin for pain following an accident where I broke my neck. I belong to a Facebook group devoted to the withdrawal from this drug and some of the case stories are extremely disturbing. Withdrawal can lead to all manner of pschyiatric and physical symptons lasting years.. I’m now terrified to come off this drug.

  7. Dianne Bunn 10/09/2019 at 7:08 pm #

    Wow! We need more physician education on dependance and withdrawal here in Canada. I am on Gabapentin and the side effects are horrid but the withdrawal I have suffered through 3 times now with multiple runs to the ER have put tapering on the shelf for me. I an so done with this poison!! If only I had known that this would happened.

    • J.Hill 11/09/2019 at 7:50 am #

      A safe taper from Gabapentin is functionally difficult because a liquid delivery form retains original potency only for a short time. This means that the amounts tapered at intervals are really unknown, This leaves dry-form tapering, and that is easily inaccurate.

      I’d like to add this: If Gabapentin is prescribed to ease benzo-withdrawal symptoms and the benzo already is eliminated, you may be suffering not from Gabapentin withdrawal but from an incomplete benzo taper. It’s worth considering.

  8. Pauline Thomas 10/09/2019 at 9:00 pm #

    ‘If only I had known that this would happen’ is a most poignant sentence. The awful truth is that nobody would be willing to take these drugs if they were given proper information on how addictive they are or even how hard it is to stop taking them.

    It is time for the big Pharma giants to start taking some responsibilty for keeping patients in the dark. My son had awful mind blowing withdrawal symptoms coming off of the antiepilepsy drug called Tegretol. Tegretol is a cousin to the tricyclic antidepressant and Peter Breggin says in his book that TCA’s have awful withdrawal symptoms. I did not know that. However trying to get information from the drug company was near impossible. They only talk to the medical people. Shocking abuse of power.

  9. Alison Tierney 10/09/2019 at 9:02 pm #

    Well done to everyone who worked so hard to bring the PHE report to fruition and who will go on working to ensure the implementation of the recommendations. This is a very important day and a wonderful example of the positive impact of an All Party Parliamentary Group. Keep up the good work and thank you for everything you do.

  10. J.Hill 11/09/2019 at 7:59 am #

    I did have success in telephoning Roche, the manufacturer of Diazepam. They were uninformed, but civilized. I spoke with one of their pharmacists and did learn that the brand-name, Valium is still available.

    Something else: Tegretol will alter the rate of clearance of most benzodiazepines. Still it is prescribed as insurance against seizure in benzo withdrawal. However, we have identified taper process that lowers that risk without medications. I wish that prescribers would access drugs’ interactions before prescribing them.

  11. M. Gasparova 11/09/2019 at 9:39 am #

    I didnt find there any prevalence on withdrawal effects for pregabalin and benzos (simply percentage – average number of population getting withdrawal from benzos and pregabalin. I hope I didnt miss it anywhere. This was what was for me interesting and what I looked for. In this respect the report was somewhat disappointing for me. The people have to fight further.

  12. Rosemary Knowles 13/09/2019 at 7:49 pm #

    Reading the comments above, they can be summed up by people wishing they had been informed beforehand about the outcomes of all these addictive drugs which need supervised slow tapering. Nobody told them about the risks of horrendous withdrawal but warned them of not going “cold turkey” – proving they actually knew they were addictive like all psycho-active drugs, legal or illegal. The dishonesty is glaring. The general public can be excused about their ignorance of what “withdrawal” is and what it actually is like. One neighbour recommended my poor struggling son go and help the refugees in our community to learn that other people were worse off than he is, having lost everything through bad drug prescribing by trusted GPs. This ignorance needs to be redressed. Mental abuse is worse than physical abuse to recover from. Make it known.

  13. Sarah Ruddock 24/09/2019 at 5:19 pm #

    Indeed. Rejection by one’s husband, friends, employers and even family following the receipt of a label ending in “disorder” is more painful than the label itself. The fact that the science behind the application of these labels is now recognized as nonsense makes matters even worse.

    People who are on prescription drugs are abused and taken advantage of in all sorts of ways, even by their supposedly nearest and dearest. The hypocrisy of the charity Mind which seems to advocate the taking of addictive drugs with associated isolating effects, yet has the strap line “no one should have to face a mental health problem alone” is hard to bare.

    I too have lost everything as a result of being prescribed a number of these drugs for twelve consecutive years for no good reason. I would like to see the psychiatrists who prescribe them, the GPs who comment that the prescriptions are odd, but do nothing because they must bow to the supposedly superior knowledge of private consultants and the NHS consultants who note that there is “something really wrong” but do nothing, together with the companies who manufacture and sell the drugs prosecuted and imprisoned for theft of my life and countless others. Has the government considered the cumulative effect in the economy of incapacitating so many people with mind altering drugs which have such terrible side effects and from which withdrawal is so painful?

    I would also like to see mental abuse classified as a hate crime.

  14. Rosemary Knowles 03/10/2019 at 5:35 pm #

    Hello Sarah- I totally empathise and agree – only I told the President of RcPsych that prescribing these antidepressives was a “crime against humanity” – which is like a hate crime. I had to send a copy to the Health Secretary before anything was done to bring about their change in attitude. Letters do work eventually. About the MIND charity – if you access it online now you will find a huge difference in its attitude – hardly any mention of psychoactive drugs. I wrote to Stephen Fry the President twice; he listened. Things are changing but I commiserate with you about family and friends whose attitudes are so hard to re-educate. Many families must be broken over the damage to a single member. I have never felt so isolated as during my campaigning for my son. These comments have been so encouraging in reassuring me that I am not alone.

    • Sarah Ruddock 18/09/2020 at 5:58 pm #

      Hello Rosemary, I am sorry for the protracted delay in responding to this one: I have thought about it a lot and something that I read in The Times newspaper this week has finally prompted me to do so. “the global chairman of EY has said the accountant ‘regrets’ that fraud at Wirecard was not uncovered sooner …the collective acts of fraud at Wirecard were implemented through a highly complex criminal network designed to deceive everyone…auditors at EY’s German office signed off on its accounts for a decade before raising the alarm over E1.9billion of missing cash balances this year…”
      You see, one of the problems I have with Mind is that my ex-husband Ian Ruddock is its treasurer! He and i both qualified as chartered accountants many years ago, but he has had rather more of a career than I have, as we have discussed. Accountants are encouraged to serve on boards of charities and this “opportunity” revealed itself to Ian in about 2012. As luck would have it, he knew a little bit about mental health having been one of a group of people who drove me to exhaustion in April 1996. As you also know, this exhausted collapse was treated by a private psychiatrist/drug seller as a source of funding for his pension for many years. Whilst i know that Ian did not intend or wish for this to happen, he was the one who made the telephone call which started the process which allowed the Harley Street shrink to ply me with drug after drug for year after year because we were too naive in our early thirties to realise that not all doctors are on the side of the angels. I know that Ian genuinely wanted the best treatment for me, but he did not want a zombie for a wife and after 11 years, he left me. In a way i do not blame him – a zombie is not much use. However, as the saying goes, i was lucky, I went to a brilliant osteopath who weaned me off the drugs. This took a further 2 years.
      This is why I find the hypocrisy if Mind hard to bear: I was left incapable of earning a living having been on various prescription drugs for so long, I had been deprived of the ability to think for myself for over a decade (I have virtually no memories of that period), my family were strangers because they were the sort of people who did not like to think that they were related to a mentally ill person (perhaps they realised that they were prime causes of the illness and did not wish to risk being implicated by association!) and I had to deal with the withdrawal process, which we know is horrendous, alone. Mind says that no-one should have to face a mental health problem (and i assume that addiction to prescription drugs and having to deal with the aftermath of lengthy incorrect psychiatric treatment could be described as such problems) and yet my now ex-husband who left me totally alone to deal with these issues is its treasurer. Does this make any kind of sense to you ?!!!! I believe that a charity whose directors do not live its values is corrupt and best avoided.
      People do good things for bad reasons and I wonder whether Ian chooses to work for Mind because he feels guilty about what he inadvertently did to me and because doing so serves as a cover.
      I once approached a local Mind branch for some information, but the information I was given was factually incorrect so I was not impressed about that either. Regarding Stephen Fry, I am afraid that I think that although he is well intentioned, he is a rather ill-informed celeb who embraces the plethora of labels which are applied to people these days.
      My apologies once again for the delay in posting this Rosemary. I hope that you find the explanation useful. I will continue to do whatever I can and am also so glad not to feel alone in my struggle to ensure that what happened to me cannot happen again. I did the Futurelearn/University of Liverpool/Professor Peter Kinderman Psychology course recently. It is brilliant: i now understand why my “medical” treatment was such flawed, out of date unscientific nonsense. Wish we could meet.

  15. Theseus 04/10/2019 at 8:07 pm #

    The Public Health England report is a good sign and a step in the right direction (congratulations to the CEP and APPG for their involvement), but I hope it is ensured that GPs actually assimilate and implement the training. In particular I hope that:

    1. GPs will be made fully aware of all the potential withdrawal symptoms and that they will get some understanding of how unpleasant the withdrawal experience can be for (most) people.

    2. GPs will not react to the report by simply trying to get patients off benzodiazepines with a rapid withdrawal (or cold turkey) and / or simply downplay or ignore the suffering patients may have to endure during withdrawal (and perhaps a long time after stopping, since neurophysiological recover takes at least a year).

    3. GPs will take on board the advice from Professor Ashton when she states:
    “a). The rate of tapering should never be rigid but should be flexible and controlled by the patient, not the doctor, according to the patient’s individual needs which are different in every case.
    b). The decision to withdraw is also the patient’s decision and should not be forced by the doctor.”

    I write this because a local surgery has decided to stop prescribing benzodiazepines and to make every patient currently taking benzodiazepines withdraw and stop. They are trying to enforce a one size fits all approach, making patients taper on a rigid protocol with a fixed reduction rate (the GP’s default rate being significantly faster than the NICE/Ashton suggestion of 10% every 1-2 weeks).

    The GP also suggested they could prescribe an antidepressant (SSRI) to assist with benzo withdrawal; seemingly oblivious to all the possible side effects, the danger of dependency and withdrawal symptoms with SSRIs. When pressed about the potential side effects, they said they are mild and only lasted for a few weeks.

  16. Charlie 10/10/2019 at 5:15 pm #

    All I can say is coming off benzos is the most appalling experience anyone can endure. When people like me use the words hellish experience, brutal or traumatic those words nead to be re read and taken in. It is the most brutal,scariest and disturbing thing for one to go through. U cannot escape it. U cannot sleep. It is a rollercoaster through to the furthest reaches of hell. U become mentally and physically and emotionally incapasated and u are fully aware of every thing that is happening to you and can do nothing to prevent or get away from it. The withdrawal will end but only after weeks, months or years. Yes opioids or hard but benzos ads antiosychotics? Absolutely abhorrent and deplorable drugs.

    I welcome further empathy particularly from drs,NHS who seem to be on the most part thouraghly ignorant and judgemental to the whole SFX of these drugs. These drugs where designed by Dr Frankenstein. For that is what they do to you. This is no Joke. Just type in BENZO WITHDRAWAL into YouTube and see for yourself.

    One thing to remember if anyone is going through this. Do not take your own life for it will end and you will be the happiest person on earth once again.

  17. Chuckster 07/11/2019 at 4:34 pm #

    Thank you for all comments above. Thank you Rosemary for your perseverance and letters. I’ve continually put off seeing the Dr as I second guess what they will say. I was given some couselling leaflets last time and told to up the med a bit just to get me through -PASTthe period. I don’t think it clicked it was WD syndrome. Dr David Healy (on James Moore: Let Talk Withdrawal PAST Senedd Drug Awareness Part 1) is really interesting. NICE guidelines are ghost written – how can GPs know?

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