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

Background

In 2017 a Petition was submitted “calling on the Scottish Parliament to urge the Scottish Government to take action to appropriately recognise and effectively support individuals affected and harmed by prescribed drug dependence and withdrawal, this petition was well supported by evidence from members of the public.

In January 2018, the UK Public Health Minister, commissioned Public Health England (PHE) “to undertake a review of the scale and distribution of dependence, and the short term discontinuation or longer term withdrawal symptoms associated with prescribed medicines, and the optimal means of reducing it.”

The Scottish Government had regular engagement with PHE during the scoping phase, asking them to extend the specifics of the review to Scotland. However, in May 2018 the PHE gave notice that whilst Scotland would be afforded observer status in the expert reference group, and have access to findings and learning, the scope of the review would not be extended to report separately on Scotland.

In September 2019, Public Health England (PHE) presented its evidence review of “Dependence and withdrawal associated with some prescribed medicines”. The review made five key recommendations. Scottish Government were an observer on this group. During this period, analysis of the Scottish data was undertaken to provide comparisons and to inform the recommendations.

At the end of 2019, Scottish Government set up a Short Life Working Group (SLWG) to consider the PHE recommendations in a Scottish context. A Patient Group was set up to sit alongside the SLWG with Patient Representatives sitting on the SLWG itself.

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

• benzodiazepines (for anxiety and/or insomnia)
• z-drugs (for insomnia)
• gabapentinoids (for epilepsy, neuropathic pain and, in the case of pregabalin, anxiety)
• opioids (for pain)
• antidepressants (for depression, anxiety disorders and neuropathic pain)

During 2020, the SLWG and Patient Group met six times, due to the COVID pandemic, most of these meetings took place virtually either by telephone or video conference.

Draft recommendations were provided to the Cabinet Secretary for Health and Sport who has approved their publication by way of public consultation.

Over the following pages, this paper discusses each of the PHE recommendations in turn, describes the current landscape in Scotland, work that has been undertaken during the life of the SLWG and recommendations for further work agreed by the group and patient representatives.