Short Life Working Group On Prescription Medicine Dependence And Withdrawal: consultation

Introduction

In response to a public petition in Scotland and work undertaken by Public Health England to review dependence and withdrawal associated with some prescribed medicines, Scottish Government established a short life working group (SLWG) to look at the scale of the issues in Scotland and the recommendations from the PHE report in the Scottish context, and with, consideration of Scottish data. Membership of the SLWG included medical, pharmacy and nursing representation from the professions as well as professional bodies, patients with lived experience, patient organisations, SIGN, Public Health Scotland and academia. In addition to representation from patients with lived experience on the SLWG, a separate subgroup of patients with lived experience was established to ensure that patients’ voices were heard and considered throughout the programme of work. The group sought to identify the scale, distribution and underlying contributors to prescription drug dependence and what might be done to address this in Scotland.

The review covered adults (aged 18 and over) and 5 classes of medicines:

• benzodiazepines (mostly prescribed for anxiety)
• z-drugs (sleeping tablets with effects similar to benzodiazepines)
• gabapentin and pregabalin (together called gabapentinoids and used to treat epilepsy, neuropathic pain and, in the case of pregabalin, anxiety)
• opioids for chronic non-cancer pain
• antidepressants.

Across Scotland, in 2019/20 almost 34% (1 in 3) of the Scottish adult population received a prescription for a drug from at least one of the 5 medicine classes. This ranges from about 1 in 5 of the adult population for antidepressants to 1 in 30 for z-drugs. Deprivation has a consistent association across all five classes of medicine, with higher proportions of those from more socio-economically deprived groups receiving at least one prescription during the year.

Despite the challenges of COVID, both the SLWG and patient subgroup have continued to meet to consider the Scottish prescribing data and finalise their recommendations. We are very grateful to all the members of the SLWG and patient subgroup for the time they have contributed to address this important issue.

The recommendations from the SLWG to address prescription drug dependence and withdrawal in Scotland are set out in the consultation document and the aim of the consultation is to now gather views from a much wider group of people. A summary of the data analysis is also provided to aid those responding to the consultation.

During the consultation period, we will additionally hold two virtual events to provide another forum for people to share their views. We look forward to receiving your contributions and thank you for engaging with this vital work.

Irene Oldfather
Director Strategic Partnerships and Engagement
Health and Social Care Alliance Scotland (the ALLIANCE)
Co-Chair of the Short Life Working Group

Alpana Mair
Head of Effective Prescribing and Therapeutics Division
Scottish Government
Co-Chair of the Short Life Working Group

Dr Nicola Steedman
Interim Deputy Chief Medical Officer
Scottish Government