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- a call for papers and evidence including unpublished research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
