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Letter from Professor C.H. Ashton DM, FRCP to
Anne Milton MP, Parliamentary Under
Secretary of State for Public Health

April 24, 2012

Rt Hon Anne Milton, MP
Richmond House
79 Whitehall

24th April 2012

Dear Anne Milton,

I have reluctantly come to the conclusion that the Round Table Meetings organised by the Department of Health are designed mainly to give the illusion of activity by the DoH. In practice, their only effect is to camouflage the lack of political will concerning the action that needs to be taken in respect of long-term prescribed benzodiazepine users who have iatrogenically become dependent on benzodiazepines and need services to help them with drug withdrawal and other problems. The result of these meetings has been that the DoH has done nothing effective to help this large population (estimated as 1.5 million in the UK).

I note that several attendees and others with similar concerns have voiced the same opinion. For this reason I am suggesting that members of the Round Table who agree with the above conclusion should refuse to attend the next Round Table meeting (which is scheduled for several months ahead despite the need for urgent action).

You were not able to meet me personally but you suggested instead that I should talk to your Senior Policy Advisor, Mark Edgington. I have had long and comprehensive telephone discussions with him, but it seems that my comments have not been accurately conveyed to you. In particular, I and many others have stressed the need for specialist services for prescribed benzodiazepine-dependent people who do not misuse other drugs. I understand that such issues are routinely referred by the DoH to the PCTs. It must be clear that, in the present economic climate, no immediate help can be expected from that quarter.

Need for specialist services

In your Ministerial Statement from the DoH when introducing the reports of the National Addiction Centre (NAC) and the National Treatment Agency (NTA) on addiction to prescribed and over-the-counter drugs, you stated: "Most areas of the country have services in place to support people who develop problems." This complacent statement is untrue of long-term prescribed benzodiazepine users who do not misuse other drugs. Treatment alongside drug misusers is inappropriate for these benzodiazepine users, and doctors in the misuse addiction services have no experience or expertise in the management of their problems.

At present, services for long-term prescribed benzodiazepine users is mainly provided by a handful of charities. These services are grossly inadequate compared to the magnitude of the problem. Melanie Davis (Director of Minor Tranquilliser Service, Mind in Camden - one of these charities) wrote in an e-mail to Mark Edgington, dated 11.4.12, referring to drafts of the Round Table consensus: "All of us from the benzodiazepine services were clear that specialist provision for benzodiazepine users remains extremely patchy and uncoordinated. Staffing levels are low across all the projects, with many using volunteers. Voluntary sector providers rely largely on small, insecure grants from a variety of private and statutory sources and would like assurance that financial provision would be more secure and that there will be more agencies funded across the UK." After what I have gleaned about the lack of action resulting from the Round Table Meetings, I fully endorse Melanie Davis' message.

What is needed is extended nationwide provision of specialised benzodiazepine support services for the large population under discussion. These services could take the form of counsellors, practice nurses, practice pharmacists and others operating together with GPs in primary care practices, as carried out successfully by the Bradford Bridge Project, which is also in need of more field workers.

This issue, and many related issues, have been raised regularly by benzodiazepine campaigners and through debates and questions in the House of Commons (Jim Dobbin, MP) and the House of Lords (Lord Sandwich) but have received only dusty answers.

I suggest that the least the DoH should do, if you persist in referring such matters to the PCTs, is to convey to all of them the urgency of the case and to provide ring-fenced funding so that they can provide specialised benzodiazepine support services. I see no point in the Round Table Meetings, nor in members attending them, until some concrete action is taken.

Yours sincerely,

C.H. Ashton

Emeritus Professor of Clinical Psychopharmacology, University of Newcastle upon Tyne

c.c. Jim Dobbin MP
Earl Sandwich
Round Table Members

Professor C.H. Ashton, DM, FRCP
Academic Psychiatry, Wolfson Research Centre,
Institute of Neuroscience, Newcastle University,
Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL

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