Prozac

Suspension of standing and sessional orders agreed to.

Motion by the Hon. D. J. Gay agreed to:

That General Business Notice of Motion No. 34 relating to the Committee reference on Prozac be called on forthwith.

The Hon. D. J. GAY [2.44]: I move:

That as a matter of urgency and in view of public concern both in Australia and overseas, the Standing Committee on Social Issues investigate and report on:

1. The evidence available regarding the drug Prozac to ascertain whether a more detailed inquiry is required.

2. Whether this drug should be further restricted.

3. Possible inappropriate prescribing of this drug.

4. Mechanisms for monitoring the use of this drug and its effects and side-effects on individual patients.

Prozac was introduced to the United States in 1987 by Dista Products. This company is a division of Eli Lilly and Company, which also manufactures Prozac in Australia. As a State member of Parliament I am very much aware that the registration of new pharmaceuticals is a Commonwealth responsibility exercised by the Therapeutic Goods Administration, and registration is based on assessment of quality, safety and efficacy, and also involves the Australian Drug Evaluation Committee. However, that certainly does not mean that we should wash our hands of any perceived problems in New South Wales.

Prozac is available in New South Wales on prescription, and by prescription only. Prozac was approved for use in the treatment of major depressive disorders in Australia in 1990, and to date it has not been approved in Australia for any other disorders. However, Prozac is now widely prescribed in Australia for depression, both mild and clinical. It is also being prescribed for eating disorders, panic disorders, social disorders and other phobias, despite the fact that it has never - I emphasise this point - been approved for these uses. Currently, the community has concerns that Prozac increases suicidal and violent behaviour. I am alarmed at how widely Prozac is prescribed by general practitioners and mental health workers for any degree of depression, regardless of how slight it might be and regardless of any prior mental evaluation by a psychiatric specialist.

General practitioners justify their excessive prescription of Prozac by the fact that one cannot overdose on Prozac; therefore, there is no danger in widespread use of the drug. But that is not a good premise on which to act. Despite the claims made by pharmaceutical companies and the medical society that Prozac is safe - that is, that one certainly cannot overdose on it - more objective studies as well as many concerned past Prozac users and family members have found many mild and severe negative side effects associated with the drug. The mild side effects include an activation or an energising feeling similar to that found with stimulants such as amphetamines and cocaine: these are nervousness, anxiety, agitation, nightmares, sweating, tremors, drowsiness, a dry mouth, diarrhoea, anorexia, weight loss and, the most widely claimed symptom, insomnia.

As insomnia is almost always a symptom associated with Prozac use, doctors must prescribe Valium to allow for sleep. As a result of the highly addictive character of Valium, the mixture of both drugs can lead to overdose and even death. The withdrawal symptoms experienced while coming off Valium are so bad that they are considered worse than those associated with heroin. Death can result from withdrawal from heroin. The danger is not with the Prozac itself, but with the prescription of Valium. This is a very risky situation.

The extreme negative side effects include hyponatremia, which is a depletion of sodium in the blood; mania, which is a mental derangement marked by great excitement, frequently followed by violence; craze and/or passion; paranoia; violence; depression; and akathisia, which affects one's motor skills and causes the knee to move around constantly, or a sense of restlessness. Other extreme negative side effects include the development of intense suicidal preoccupations, loss of sex drive, and fatal drug overdose when taken with other drugs. The case studies conducted on Prozac - those which have been used to approve its use by regulatory institutions - indicate that it is important to keep in mind that certain groups are usually excluded, based on certain conditions.

This exclusion includes patients with hypersensitivity to antidepressants, the likelihood of a poor compliance or the risk of suicide. All patients
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used in these studies are heavily monitored by professionals in the fields of psychiatry and depression. Therefore, they are better able to assess progress and any evidence of adverse effects that may occur. Generally, because general practitioners are able to prescribe Prozac without submitting their patients to mental examination, the masses of people who are prescribed Prozac are not screened for hypersensitivity to antidepressants, let alone one as controversial as Prozac; nor are they monitored by the general practitioners who are allowed to prescribe Prozac. Patients who could be hypersensitive to antidepressants such as Prozac could be at great risk by using Prozac which could prove, and has proved, to be fatal.

Various case studies have been conducted. I will refer to one which makes a comparison between Prozac and its cousin, an alternative antidepressant, Zoloft. Both have similar side effects; however, they are much more severe in Prozac. The first published comparative study on the efficacy and safety of Prozac in major depression, with its cousin Zoloft, found that: first, accompanying medication had to be used in 60 per cent of Prozac patients, compared with 40 per cent of Zoloft patients; second, in the Zoloft group adverse events were mostly described by the patients as mild, but in the Prozac group the severity was described mainly as moderately severe; third, agitation, anxiety and insomnia were more frequent in the Prozac group than in the Zoloft group; and, fourth, adverse events led to the discontinued use in 15 per cent of the Prozac patients, compared with 7 per cent in the Zoloft group. In the Zoloft group 13.5 per cent discontinued prematurely because of clinical improvement, yet only 9.6 per cent discontinued because of therapy failure. In the Prozac-treated group 10.7 per cent discontinued because of clinical improvement and 19.6 per cent because of therapy failure.

Finally, adverse events such as agitation, anxiety and insomnia were found to be much higher in patients using Prozac, and accompanying drug treatment was initiated during this study on 30 per cent of the Prozac patients in comparison to 12.5 per cent of the Zoloft patients. This reflects the increased agitation, anxiety and insomnia reported by patients. The conclusion of this first published study was that further investigation was warranted because of the demonstrated poorer toleration for Prozac. The major point here is that at least one antidepressant is available which has almost 50 per cent less adverse effects and has not been implicated in any suicidal tendencies or deaths. That is an important point; there is at least one antidepressant that is clearly much better than the one that is illegally in widespread use within our community.

My concern, as well as that of others, is that Prozac has become overwhelmingly popular because of its cocaine and/or amphetamine-like lift and not because people are solving their problems or because they are feeling better about life while using it. It is illogical to endorse a drug such as Prozac that has serious adverse side effects and serious controversial tendencies, when a drug such as Zoloft has been proved to be much safer to use. Virginia Patterson and Heidi Kone of my staff have undertaken a great deal of research on this topic and played a large part in the preparation of my submission. With them I recently interviewed a very experienced and well-qualified mental health worker who is in charge of a crisis centre in Sydney. She is familiar with Prozac and deals daily with patients who are taking it. She is concerned about the way Prozac is prescribed and used. First and foremost, she felt that people with a wide variety of mental illnesses, ranging from trauma to mild or major depression, were prescribed Prozac by their general practitioners who had made no mental evaluation of the patient and had no knowledge of what the problem was or how it manifested.

Instead of referring patients to a mental health specialist for diagnosis of the problem, and more appropriate types of treatment such as counselling and/or therapy, general practitioners would prescribe Prozac as a cheap alterative. No evaluation was done as to whether a patient may have any adverse side effects to Prozac based on mental history and current mental condition. There was little, if any, monitoring of patients by their general practitioners. Honourable members should note that as a rule general practitioners are neither qualified nor skilled in the field of mental illness to make any type of conclusion or detect any type of adverse side effect, even if they took the time to monitor their patients' success.

A large number of the patients on Prozac were also prescribed Valium to counter the side effect of insomnia commonly experienced by Prozac users. Because these patients were so heavily drugged by the Valium, mental health workers could not properly assess their problem. Valium is an addictive drug and its mixture with Prozac heightens the possibility of drug overdose. As I said earlier, the greatest problem with prescribing Prozac with Valium is that death can occur in a patient that chooses to come off Valium. Patients on Prozac were found to act irrationally, to be incoherent, hyperactive, angry, anxious, agitated and frightened. They seemed to feel good for the first few hours after taking Prozac and then to feel badly after the initial effect began to wear off. This is typical of any type of amphetamine such as speed or cocaine.

Studies done by the regulatory institutions responsible for the approval of drugs, such as the Food and Drug Administration in America and the Therapeutic Goods Administration in Australia, found the following results in regard to the approval of Prozac. The studies used for drug approval were financed, constructed and supervised by drug companies using doctors that they hired. Controlled studies by these drug companies last for only four to six weeks. Prozac patients were monitored for only two years prior to the drug being approved for the open market. Seriously suicidal patients and hospitalised patients were excluded from these studies, yet general practitioners, without any experience, are now prescribing these drugs for the very group of people excluded from the studies used to approve the drug.

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I hope the Government will not tell me that this is a Federal problem and that I should not be worrying about it. I sincerely hope that the Government would give me that courtesy. Many patients involved in the studies were allowed to take sedatives and minor tranquillisers to overcome Prozac's stimulant-like side effects, vastly compromising data interpretation. Researchers weeded out the case studies that showed negative results and used only a few that provided positive feedback to effect approval.

The drop-out rate in most studies was very high and the actual number finishing the trials used for approval was very small. Many statistical manoeuvres were required to make the studies look positive. America's FDA analysis, omitted from its published conclusions, originally determined that Prozac is a stimulant like a drug. Prozac's effects are the same as and indistinguishable from those of stimulants such as amphetamines and cocaine. Prozac causes activation or energising, nervousness, anxiety, insomnia, nightmares, sweating, anorexia, weight loss and, in extreme cases, hypomania and mania. There was also evidence that Prozac could produce behavioural abnormalities consistent with stimulants, including paranoia, violence, depression and suicide. Patients on Prozac lost touch with themselves and others and perceived this as relief from depression. It disconnected the patient from the rest of the world and from his or her real life issues. A report on the television program 4 Corners some time last year found:

In the United States Prozac is being used not only for depression but for obesity, eating disorders, panic disorders, social disorders and many more.

I suspect the same is happening in Australia. Prozac is being prescribed for a range of conditions despite the fact that it can only be obtained on prescription and has only ever been approved for the treatment of major depressive disorders in Australia. It has not been approved for anything else, yet it seems that it is being handed out like confetti. Coming back to the 4 Corners program that dealt with the American findings, the program stated:

In an interview with a male user of Prozac who was very overweight and had begun taking Prozac (6) years ago to lose weight it was found that he was still at the same weight and was still using Prozac, but was not sure why. In addition, doctors now had his wife and his 14 year old daughter on Prozac but was not sure why.

Thousands of people were being prescribed Prozac by general practitioners under the false pretence that it is risk free.

I referred earlier to the risks. Prozac will not kill people as a dose of cyanide will. In other words, a patient cannot overdose on Prozac. The risks are related to the side effects from stopping Valium treatment and to suicide.

The Hon. Ann Symonds: Is it addictive?

The Hon. D. J. GAY: I do not believe Prozac is terribly addictive. It is the Valium that the patient has to take at the same time that is addictive.

The Hon. J. R. Johnson: Is it available under the national health scheme?

The Hon. D. J. GAY: I do not know. It does have value in certain circumstances. My concern is related to the overprescribing of Prozac. I do not want the drug banned. As I said earlier, I want it re-evaluated because I believe it has a use. What concerns me is its widespread use, which was never approved. It has grown like Topsy, and that is quite alarming. The 4 Corners program stated:

The Surgeon General in America has been called upon by the public to further investigate the effects of Prozac, but big business was using its power to prevent further investigation.

Prozac is considered a mind drug capable of changing your personality, but it is not possible to determine whether that would be good or bad.

Pharmaceutical companies are using the public as an Experiment.

Warning bells are going off, as they did with silicone implants, Dalkon shields and Copper Seven, and Prozac is another tragedy being allowed to happen by result of lack of regulation by federal institutions.

The Hon. J. R. Johnson: It is another trial on women.

The Hon. D. J. GAY: I understand the Hon. J. R. Johnson's concern, but it is certainly not a trial on women; the drug has been used throughout the community, unfortunately. Despite the many potential dangers, private drug companies have been allowed to dictate to our regulatory institutions what drugs can and will be approved for the public. It seems that drug approvals are not necessarily based on safety, effectiveness or long-term accurate studies of effects, but are adversely swayed by the profitability of big business, and its ability to influence. General practitioners are using the drug Prozac as an instrument to ensure their economic stability and a quick turnover of patients.

Prozac is no different from illegal drugs such as amphetamines or cocaine, because it is now being used by the general public as a form of speed. Prozac is not always effective in solving the problems of depression; it is used to mask the problem temporarily. Prozac can cause violence and promote the act of suicide; Prozac, sadly, has become a cheap alternative to solving the problem of mental illness. Prozac may be effective for those few mental illnesses that are caused by chemical imbalance. The evidence that has been given to me indicates that there is a proper role for the drug in the treatment of mental illness caused by a chemical imbalance.

However, many who suffer depression and mental illness caused by personal trauma and stress-related problems cannot be cured by drugs. The prescribing of drugs is the wrong treatment for those conditions. Only counselling and personal development will help them to overcome their problems. It is this group of people who are being wrongly prescribed Prozac, and it is that group that is suffering the most. The group includes people who have been sexually abused as children. The public is now at great risk as their health has become secondary
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because the therapeutic goods administration and the pharmaceutical services branch of the Department of Health, together with the Commonwealth, have allowed the laziness of doctors to go unchecked and unregulated.

We have failed to provide the citizens of New South Wales with protection and we are condoning the use of drugs as an alternative to dealing with life's problems. We are sending a message to our young people that popping a pill will solve their problems. That is my reason for moving as a matter of urgency, and in view of the concern in Australia and overseas, that the Standing Committee on Social Issues investigate and report on the evidence available regarding the drug Prozac to ascertain whether a more detailed inquiry is required. I am not asking for the drug to be banned because it has its place. I know this is a Federal issue but I ask that the committee investigate the matter. I know the committee has a very busy program and already has three matters on its books.

It is important that the social issues committee look at the possible inappropriate prescribing of the drug that I have detailed to the House today. I could give further evidence of the results of interviews and recount my personal knowledge of the matter. Many honourable members have spoken to me since I detailed this matter to the House. I gave notice of the motion in June and the Government has not suggested that anything in the motion was other than appropriate.

The Hon. R. D. DYER (Minister for Community Services, Minister for Aged Services, and Minister for Disability Services) [3.08]: Prozac is an antidepressant drug that was approved for use in the treatment of major depressive disorders in Australia in 1990. It has not been approved for any other purpose in Australia and is available in New South Wales on prescription only. Prozac is available in more than 30 countries worldwide. I am advised that early media attention given to Prozac focused on claims that the drug increases suicidal and violent behaviour. Similar unsubstantiated claims have been made in the past concerning other antidepressant drugs, mainly by groups opposed to the use of any psychotropic drugs in the treatment of mental illness. There were also claims that Prozac made people more confident and assertive, even if they were not depressed.

I am advised that the claims of adverse reaction, however, are not borne out by scientific evidence. Further, the drug is considered by the psychiatry profession, and supported by clinical trials, to be a useful and relatively safe drug that offers some advantages over other antidepressants, including safety in overdose, that is, it is less toxic. It is not effective in all cases of depressive illness and does have some side effects, such as nausea. The registering of new pharmaceuticals such as Prozac is a Commonwealth responsibility exercised by the Therapeutic Goods Administration. Registration is based on assessment of quality, safety and efficacy and often involves the Australian Drug Evaluation Committee. The Senate Standing Committee on Community Affairs last May released its report "Psychotherapeutic Medication in Australia". The inquiry was commissioned in June 1992 with terms of reference requiring it to review the use of psychotherapeutic medication in Australia. The inquiry was required to pay particular regard to:

(a) prescribing patterns of general practitioners, psychiatric specialists, and non-psychiatric specialists;

(b) the effects of mixture of medications and other substances;

(c) evaluation and monitoring of the use of psychotherapeutic drugs;

(d) existing guidelines on the use of psychotherapeutic medication and availability of alternatives for the treatment of people with psychiatric conditions; and

(e) levels of community support for people on psychotherapeutic medications.

The committee's conclusions contained a recommendation that Australian Statistics on Medicines, published by the Commonwealth, include in its annual reports the following information:

•measures to ensure that prescribed drugs are the most appropriate;

•details of procedures for monitoring patients on long-term medication;

•surveys on prescribers and consumers to establish their awareness of the range and effects of the prescribed drugs;

•research undertaken to minimise adverse effects of medication;

•surveys conducted to establish whether consumers and practitioners are aware of the range of drugs available for some illnesses; and

•monitoring of quantity of drugs prescribed by individual prescribers.

More recent media reports on the use of Prozac based on local experiences have been favourable. The Sydney Morning Herald on 28 August 1995 in a front-page story reported that "five years after Prozac was released in Australia many fears and promises surrounding the anti-depressant drug have not been realised. But . . . it has revolutionised the treatment of depression". In view of the Commonwealth's responsibility for approving drugs for use, and funding the monitoring of drugs and the adverse reactions of people to them, and the Senate Standing Committee on Community Affairs report "Psychotherapeutic Medication in Australia", investigation -

The Hon. D. J. Gay: It really is a bit tough when some bloke down in the office makes up his mind that they are going to oppose it, prepares this speech and you have to deliver it. It is not fair on you.

The Hon. R. D. DYER: The Hon. D. J. Gay will appreciate that the House has given him leave to raise this matter this afternoon during private members' business. My duty in the Chamber is to represent the health Minister, which is precisely what I am doing. The view of the health Minister, and one would presume the Department of Health, is that this reference to the social issues committee ought not to be made.

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The Hon. D. J. Gay: That is why we have got this problem in New South Wales. But I will not interrupt any more.

The Hon. R. D. DYER: I would ask the honourable member not to take the matter personally. I am representing the health Minister. I am delivering his response in an official capacity. I was about to conclude my remarks. In view of the Commonwealth's responsibility for approving drugs for use and funding the monitoring of drugs and the adverse reactions of people to them, and the Senate Standing Community Affairs report on "Psychotherapeutic Medication in Australia", investigation of the prescription of Prozac by the Standing Committee on Social Issues at this time would appear inappropriate and an unnecessary use of resources.

The Hon. ANN SYMONDS [3.14]: As the current chair of the Standing Committee on Social Issues to which it is proposed the reference be made I feel obliged to respond to the motion moved by the Hon. D. J. Gay. In one sense the committee should regard the proposed reference to it of this highly complex and important matter as an acknowledgment of the committee's reputation for a high standard of work and an indication of the extraordinary success the committee has had with its recommendations in influencing legislation and government policy and programs. It is more than a compliment; it shows the Hon. D. J. Gay has a high regard for the committee and its operation. Perhaps not all honourable members are aware of the committee's current workload. We are in the process of completing a long and detailed report on the incidence of sexual violence in Australia, which we hope to be able to table this year, but the current operations of the House make this seem more remote day by day.

The committee has already begun an inquiry which has enormous community interest and which is of particular consequence for the Minister for Community Services, Minister for Aged Services, and Minister for Disability Services and his guardianship role within the community. The children's advocacy inquiry is long overdue, and we must address it with alacrity and put all our resources and energies into completing it as soon as possible. Those two inquiries are in operation. I have also announced a third inquiry that is of major consequence for social justice and the rights of children - the inquiry regarding the children of imprisoned parents, which of necessity will be very detailed and difficult. The committee will have to give full attention to that inquiry over a period. Notwithstanding that workload, the committee also has received by motion of this House a further reference relating to the injustices in the status of Aboriginal people in our society, with particular emphasis on the need to examine the desirability of allocating dedicated seats for Aboriginal representation within our Parliament.

I have outlined all the inquiries before the committee to demonstrate its extensive workload. Every member of the committee is convinced of the need to proceed with those inquiries. They are regarded as matters of the utmost importance in social policy and justice terms. There is no question of our wishing to resile from any of the references or to proceed with them in any way that would undervalue the importance of the inquiry. While I am keen for the House to be conscious of the work program of the committee, I have some additional remarks to make about the nature of the inquiry proposed by the Hon. D. J. Gay. Honourable members know that the question of registration of new pharmaceuticals is a Commonwealth responsibility, which is exercised by the Therapeutic Goods Administration Act. That registration is based on assessment of quality, safety and efficacy, and often involves the Australian Drug Evaluation Committee. The Hon. D. J. Gay knows that last May the Commonwealth Senate Standing Committee on Community Affairs released its report "Psychotherapeutic Medication in Australia". The inquiry was commissioned in June 1992 and the terms of reference required it to review the use of psychotherapeutic medication in Australia. The inquiry was required to pay particular attention to:

(a) prescribing patterns of general practitioners, psychiatric specialists, and non-psychiatric specialists;

(b) the effects of mixture of medications and other substances;

(c) evaluation and monitoring of the use of psychotherapeutic drugs;

(d) existing guidelines on the use of psychotherapeutic medication and available alternatives for the treatment of people with psychiatric conditions; and

(e) levels of community support for people on psychotherapeutic medication.

The committee's conclusions included a recommendation that Australian Statistics on Medicines provide information in its annual reports on the following:

•measures to ensure that prescribed drugs are the most appropriate;

•details of procedures for monitoring patients on long-term medication;

•surveys on prescribers and consumers to establish their awareness of the range and effect of drugs;

•research undertaken to minimise adverse effects of medication;

•surveys conducted to establish whether consumers and practitioners are aware of the range of drugs available for some illnesses; and

•monitoring of quantity of drugs prescribed by individual prescribers.

That is a substantial inquiry and it has made useful, pertinent recommendations, which I think would provide some satisfaction to the Hon. D. J. Gay and others who are questioning the manner in which psychotherapeutic medication is distributed. I have outlined the heavy program of the Standing Committee on Social Issues. Nevertheless, the committee should be at such a stage in its development as an agent of the Parliament to be flexible enough not necessarily to undertake a four-
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year inquiry, such as the sexual violence inquiry, but to undertake an examination or take evidence from a group of experts that would give honourable members authority to determine whether in the committee's assessment the citizens of New South Wales, for whom they have responsibility, deserve a further inquiry or examination into the way in which the operation of a Commonwealth Act and the medical processes in this State are affecting their constituents. Therefore, it is not beyond the committee at some stage - and I certainly would not determine at what stage, given its workload - to focus sharply on whether a need exists for an additional range of investigations. That is all I wish to say on the matter. I offer my contribution in the hope that my remarks will be taken into account when responses to the proposal are determined.

The Hon. ELISABETH KIRKBY [3.24]: The Hon. D. J. Gay seeks an inquiry into the drug Prozac. As honourable members are aware the honourable member has moved that the issue be referred to the Standing Committee on Social Issues and the chair of that committee, the Hon. Ann Symonds, has just made her contribution to the debate. I was concerned when the Hon. D. J. Gay informed me that he wished to refer the issue to the Standing Committee on Social Issues. Frankly, I do not believe that the committee has the expertise to deal with this problem.

I fully support the observations, information and evidence put forward by the Hon. D. J. Gay. However, if the matter comes before the committee, I fear that two groups of psychiatrists will push their respective points of view and the committee will be unable to make a determination. The committee members are lay people without medical or psychiatric training. Honourable members will be aware that I have a close association with the medical profession. For many years I was married to a member of that profession and my youngest son is a psychiatrist. When I learned that the Hon. D. J. Gay had given notice of his motion, I asked my youngest son what I should do and how he felt about it. As a psychiatrist he is strongly of the belief that in certain cases Prozac has value and, therefore, it is proper that he be able to prescribe it. But that is not happening. If my information is correct, general practitioners who have no detailed knowledge of mental illness or mental disability are prescribing Prozac. The drug is promoted by the drug firms and it seems an easy option for general practitioners to give it to their patients.

I have read every word the Hon. D. J. Gay said in this House today. Unfortunately I was not present when he made his presentation but he paid me the courtesy of sending me his speech notes. Everything the honourable member said is 100 per cent true. Unfortunately, I do not believe that members of the Standing Committee on Social Issues can evaluate that information because they are not qualified to deal with a bombardment of conflicting medical evidence. This problem would best be dealt with through strong representations to the Federal Government and the New South Wales Minister of Health to make this drug - a valuable drug in some cases - available only on prescription from a psychiatrist. Prozac should not be prescribed by general practitioners, as they may lack the training to gain an insight into the problems of their patients. The prescribing of Prozac is just another easy option.

General practitioners have too often, in good faith, taken the easy option with drugs that down the track have been discovered to be damaging and against the best interests of the patient. It is ironic that the next motion on today's notice paper relates to the Sydney Olympic Games and the following motion, which will be moved by my colleague the Hon. R. S. L. Jones, to the misuse of cannabis. If ever a drug has been misused in the western world it is the drug Prozac. If honourable members are to talk about drug misuse, they should discuss Prozac as well as cannabis.

Therefore, I agree with my colleague the Hon. Ann Symonds, who is the chair of the Standing Committee on Social Issues, that this is not a matter for the committee to discuss. The Minister for Health should raise this issue with his Federal and State colleagues. He should raise the issue with the Federal Minister for Human Services and Health to ensure that Prozac is a drug of value in certain cases but should be prescribed only by registered psychiatrists, not by general practitioners. That is not unusual - many drugs used in the treatment of mental illness are not able to be prescribed by general practitioners. Prozac should be put into that category. That would not be very difficult for the Government to do. The Minister for Health should be able to do it quickly; it would not take him weeks or months.

I have already explained to the Hon. D. J. Gay that, although I did not dispute anything in his presentation, I do not believe that this is a suitable reference for the social issues committee. I am privileged to be a member of that committee, which was chaired by the Hon. Dr Marlene Goldsmith under the previous Government and is chaired by the Hon. Ann Symonds under this Labor Government. That does not mean that I believe that the matter the Hon. D. J. Gay has brought before the House is not very serious. This drug is being abused; it is being overprescribed. There could be serious repercussions as a result of that overprescription.

I would hope that the Hon. Ann Symonds could go to her colleague the Minister for Health and say, "The committee has reservations about this drug. Can you please restrict the right to prescribe the drug to psychiatrists only and not make it so readily available? In the interim, can the matter be referred to the National Health and Medical Research Council and to the Federal Minister for Human Services and Health? Can we take a close and serious look at the way this drug is currently being prescribed?" I believe that the Doctors Reform Society and the College of General Practitioners would support that view. The ethical members of those associations accept that the drug is being overprescribed, and possibly with dangerous effects. Regrettably, I cannot support the motion. We need to have further debate on this subject.

Debate adjourned on motion by the Hon. Elisabeth Kirkby.

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