§ Mr. Gerald Bermingham (St. Helens, South)
I am grateful to the Minister for giving me the opportunity of raising this matter at such short notice. I wish to bring to the attention of the House a fairly well known and widely canvassed problem that is developing steadily with regard to the use of benzodiazepine drugs, which are more commonly known as tranquillisers. There are 10 or 12 drugs in that generic group, and I noticed from the statement of the Secretary of State the other day that many of the branded drugs that were taken off the prescription list will in future be obtained only privately and will be replaced in the National Health Service by substitute drugs. I welcome the use of generic substitutes, but I draw to the Government's attention the fact that the problem of addiction will be just as great.
In reply to questions from me on 9 November, the Minister for Health said that in 1980 23.9 million prescriptions were issued for drugs within the group. To make clear what I am talking about, the group includes drugs such as Valium, Librium, Anxon, Ativan, Frisium, Halciom, Mogadon, Normison, Serenia-D and Transene. In 1981, the figure rose to 24.2 million; in 1982 it was 24.4 million; and for the first nine months of 1983—one accepts that it takes time to collate the figures—there were 17.7 million prescriptions. We cannot say how many drugs are issued with each prescription, but at a conservative estimate we are talking about more than 100,000 capsules in only nine months.
I accept that there are clinical needs for what might be called anti-depressants, but I do not accept that the present method of prescribing them is always in the best interests of the patients. I do not challenge the clinical judgment of doctors, but I shall draw to the attention of the House some of the effects of prescription policy. It has been estimated by Professor Malcolm Lader, who is the professor at the Institute of Psychiatry and who has carried out research into this matter at Maudsley hospital in London for about five years, that there are about 100,000 tranquilliser addicts or dependants. He considers that to be a conservative estimate, and that the real figure is nearer 250,000.
Why has that happened? Dependency upon those drugs causes many side effects such as agoraphobia, nausea, a loss of the sleep pattern, an effect on one's ability to enjoy life and a general state of depression. Indeed, some of the researchers explained that the side effects are often such that they constitute a need for further drugs of the same generic structure.
§ Mr. D. N. Campbell-Savours (Workington)
My hon. Friend welcomed the change to generic drugs. Is there not a danger that the problem may be aggravated where a medical practitioner is subjected to pressure by his patient to prescribe the branded drug, because the patient has become convinced that the generic substitute, although technically the same, does not alleviate the problem that the patient believes exists? The problems could increase in the coming years as more people reject the generic substitutes because they have convinced themselves that those drugs will not deal effectively with their problems.
§ Mr. Bermingham
My hon. Friend makes a valid point. I hope that we convince the Government that there 931 is need for action, for further research and for more self-help groups to wean people off the drugs. We also need a revision in medical practice to avoid the problems to which my hon. Friend refers. I welcome the introduction of generic substitutes, but even they will give rise to addiction and dependency.
We have all heard of the "smartie" syndrome. One visits the local practitioner and says to him, "I am feeling a bit off." The doctor is often rushed—I accept that that happens—and gives the patient a prescription for a pick-me-up, which may be Valium, Librium or any of the other benzodiazepine drugs.
§ The Parliamentary Under-Secretary of State for Health and Social Security (Mr. John Patten)
I appreciate what the hon. Gentleman is saying, but Valium does not pick one up; it puts one down.
§ Mr. Bermingham
I accept the Minister's comment, but the point is that the drugs are designed to get rid of depression. A few weeks later the patient returns to the doctor and his symptoms have not changed. Sometimes he will not even see the doctor, but will pick up a repeat 932 prescription from the receptionist. That is not good medical practice. Women's Own magazine, which conducted a large-scale survey on the matter, showed that there were cases of people being prescribed such drugs for as long as 18 years. Who needs medication for 18 years, or even for four years? There are clear signs that an addiction problem has grown.
I hope that the Government will begin to fund research into the problem and self-help groups. The Minister for Health said recently, in reply to my question, that about £10,000 is spent on self-help groups. That is nowhere near enough. We must do four things: first, stop repeat prescriptions; secondly, enable doctors to have time clinically to treat their patients; thirdly, be on our guard to prevent people being given drugs for long periods; and, fourthly, fund massive research to alleviate the problem.
§ Mr. John Patten
I welcome the contribution made by the hon. Member for St. Helens, South (Mr. Bermingham) to this debate, raised at short notice. I shall write to him on all the points that he has raised.
§ Question put and agreed to.
§ Adjourned accordingly at 12 noon.