§ Mr. Wareingasked the Secretary of State for Social Services what efforts he is making to assist patients 252W suffering from the withdrawal effects of taking lorazepam; how this assistance is being given; at what cost; and if he will make a statement.
§ Mr. NewtonThe services of general practitioners, hospital psychiatric departments, and specialist drug treatment and advice agencies—many of which have been provided through special funding from this Department—are available to those people taking lorazepam who suffer withdrawal effects. The cost cannot be separately identified.
§ Mr. Wareingasked the Secretary of State for Social Services (1) if he has any plans to ban the prescribing of lorazepam to new patients; and if he will make a statement;
(2) whether he has set up or plans to set up a study of the problems associated with the prescribing and represcribing of lorazepam; and if he will make a statement;
(3) if he has now received a copy of the report of the Committee on safety of Medicines concerning the prescribing and represcribing of lorazepam; and when it is likely to be published.
§ Mr. NewtonOn the advice currently available to us, benziodiazepines have a place in medical practice if prescribed with appropriate care. The data sheet for Ativan (the trade name under which lorazepam is sold) was amended earlier this year, following discussion with DHSS medicines division to advise that it should be used only in the short term and to give doctors additional advice about avoiding dependence.
The Committee on Safety of Medicines is at present considering whether further steps should be taken in relation both to lorazepam and to other benziodiazepines. It would be premature for me to comment on the question of possible publication before the committee has completed this work.
§ Mr. Wareingasked the Secretary of State for Social Services on how many occasions and by what means his Department has drawn the attention of the medical profession to the dangers of represcribing lorazepam.
§ Mr. NewtonAdvice is given in the British National Formulary, which is distributed to all NI-IS doctors every six months, that treatment with benzodiazepines, of which lorazepam is one, should be limited to the lowest possible dose for the shortest possible time and that withdrawal of the drug after long-term administration should be gradual. "Guidelines of Good Clinical Practice in the Treatment of Drug Misuse", which have been issued to all doctors, contain advice on the addictive potential of benzodiazepines and on withdrawal procedures. The data sheet for lorazepam, sent by Wyeth Laboratories to all doctors, which provides guidance and warnings to doctors on the prescribing of lorazepam, has recently been amended in agreement with the Department to re-emphasise the potential problems of dependence on lorazepam. The data sheet now recommends lorazepam tablets for short-term use only and gives guidelines for treatment to minimise the risk of benzodiazepine-related dependence.
The Department funds the distribution to all general medical practitioners of a number of independently produced prescribing publications. Several articles about benzodiazepines have been published in the last 5 years. 253W These include "some problems with Benzodiazepines" and "Lessening the Use of Benzodiazepines" in the Drug and Therapeutics Bulletin. "Adverse Effects of Prolonged Benzodiazepine Use" in the "Adverse Drug Reactions Bulletin" and "Benzodiazepines and transient insomnia" in Prescribers' Journal. More general articles on, for example, repeat prescribing and the hazards of abrupt withdrawal of drugs have also contained references to benzodiazepines. In March 1980 the British Medical Journal published an article provided by the Committee on Review of Medicines entitled "A systematic review of benzodiazepines" which referred to the problems of dependence.