Overworked GPs are partly behind a recent surge in psychiatric drug prescribing, the director of a leading drugs charity has said.
Harry Shapiro, director of the charity DrugWise, said the rise in benzodiazepine-type drug prescriptions was, in part, due to a “hidden collusion” between stressed GPs and patients, looking for a prescription.
He said: “Part of the rise in levels of prescribing are some kind of hidden collusion, to some extent, between GPs, who are under enormous amounts of stress and feel they don’t have the time for the talking aspect, and there is a patient expectation that they will leave the surgery with a prescription.”
Speaking at the Nursing in Practice event in London today, Shapiro said England has seen a 92% increase in the level of psychiatric drug prescribing between 2003 and 2014.
Yet there has been no indication that the prevalence of depression has increased to the same extent in that time, he said.
Shapiro estimated that there are more than one million people on long-term psychiatric drug prescriptions, leaving them susceptible to addiction.
“Drugs might get you through a little bit of a crisis, but… people are on them for years,” he said.
In one online survey of GPs and pain specialists, Shapiro noted, that even having identified that a patient was addicted to their pain medication, 67% of GPs and 75% of pain specialists were uncertain what to do next.
Shapiro said that part of the reason behind this is that GPs are poorly trained in dealing with addiction.
“Professional training around addictions generally is woeful. They hardly get any training on this at all,” he said. “It is such a ubiquitous problem that we’ve got, across all sorts of drugs and alcohol, that the level of professional training is disgraceful.”
As a result, Shapiro said GPs have a tendency to “just scribble and go”.
“Mental health, as far as I’m aware, is the Cinderella service of the NHS,” he said. “The reason why we don’t get the response is that, I suspect, the money needed to put the services we’re talking about in place is huge… and we’ve got the CQC [Care Quality Commission] running around telling GPs how to save money. It’s a horrific situation.”
However, Shapiro told Nursing in Practice that GP training was not what needed to be addressed first.
“This is about more specialist services,” he said, adding that the all-party parliamentary group for prescription drug dependence is working with the British Medical Association (BMA) to push the Department of Health for a helpline serving those addicted to pain medication.
Most local addiction services are not funded to help people with this type of addiction, causing patients to be “bounced” between these services and primary care.
The helpline, Shapiro said, would give some support “for people who are in a huge amount of distress”.
“There has to be a way of trying to assess that there might be a problem before one happens,” he said.