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Committee calls for prescription drug guidance

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TACKLING prescription drug dependence should be given a higher priority in Wales according to the National Assembly’s Petitions Committee.

The Committee concluded there is growing recognition of the issues surrounding prescription drug dependence (PDD) among clinicians and organisations, but there is no Welsh Government strategy aimed at addressing them and few targeted services. As a result, patients are often referred to substance misuse services which may not be well-suited to providing the support they need.

The Committee report stems from a petition started by Stevie Lewis from Monmouth, which collected more than 200 signatures. Ms Lewis told the Committee: “My name is Stevie Lewis and in 1996, at the age of 41, I was prescribed an SSRI (Selective Serotonin Re-uptake Inhibitor) antidepressant for intermittent insomnia and PMT.

“In 2002, after several attempts at stopping and failing, I discovered that I had become physically dependent on the drug. For years I kept trying to come off the drug and each time the withdrawal symptoms got worse and worse.

“In 2009 I developed a movement disorder which has its roots in long term use of an SSRI antidepressant. Eventually, I stopped in 2013 and have been through a long and crippling withdrawal.”

Ms Lewis highlighted both antidepressants and benzodiazepines (sedatives) as among the medications which can cause PDD, with patients potentially experiencing difficulties coming off them due to side effects.

The Committee also received concerns that:
• There is a high volume of prescribing of these medications across Wales;
• There is a lack of alternative services available for people with depression, leading to an overreliance on medication;
• Current advice on how to withdraw from antidepressants is insufficient and underestimates the challenges related to coming off these medications; and,
• Not enough use is made of professionals such as pharmacists who could give advice to patients.

“The Committee received a range of concerning evidence about the impact that attempting to stop a range of prescription medication can have on individual patients,” said Janet Finch-Saunders AM, Chair of the Petitions Committee.

“Antidepressants and other prescription medications can be a lifeline to many people. However, there is a growing body of opinion that it can be difficult to stop using some medications and that not enough advice is available to patients at the outset.

“What is clear is that we need to do more to improve the support and information that is available to people who are prescribed these medications.

“The Committee received evidence demonstrating that good services exist in parts of Wales, and we feel that these should be replicated much more widely.

“The personal experiences we have heard during this inquiry have been, at times, deeply upsetting and we thank the petitioner for having the courage and strength to bring this to our attention.”

Petitioner, Stevie Lewis, said: “The Welsh public petitions process has turned out to be truly democratic and empowering. All those who provided evidence to my petition were listened to with attention and respect.

“The committee has taken seriously my contention that we need to be able to hold as true two apparently conflicting beliefs about antidepressants at the same time, namely that they can help people and also that they can harm people. And once a patient has been harmed by any drug that causes dependence and withdrawal, there are no nationwide NHS services in place to guide and support their recovery. I look forward to hearing the Welsh Government debate this issue in the Senedd.”

The Committee makes 10 recommendations, including:
• Greater recognition should be given to prescription drug dependence in national policy and strategy, and this should be distinguished from substance misuse services.
• The Welsh Government should restate and emphasise antidepressants should not be routinely prescribed for mild depression in guidance to healthcare professionals, and should provide assurances that sufficient alternative treatment options, such as psychological therapies, are available across Wales.
• Additional guidance is produced and promoted in relation to the safe tapering of prescription medications, both for patients and healthprofessionals.

The report will now be considered by the Welsh Government.

 

Health

Welsh adults using harmful habits to manage mental health

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NEW POLLING shows more than two-thirds of adults in Wales are using potentially harmful coping mechanisms when feeling stressed, anxious or low.

The Mental Health Foundation said the findings, released for Mental Health Awareness Week, show a need for the new Welsh Government to prioritise prevention and action on poor mental health.

The survey found that 69% of adults in Wales had taken harmful actions to cope with their mental health in the past month.

More than a third, 36%, said they had spent time isolating themselves from others, while 34% reported spending more time scrolling social media or going online as a way to deal with anxiety, stress or low mood.

Other commonly reported behaviours included comfort eating or overeating, at 27%, and oversleeping or not getting out of bed, at 31%.

The Mental Health Foundation said these behaviours were concerning because evidence suggests they can make mental health worse over time.

However, the polling also found that many people in Wales are taking positive steps to support their wellbeing.

More than four in five adults, 84%, had taken at least one helpful action to support their mental health. The most common were accessing nature, at 41%, doing something enjoyable such as a hobby, at 37%, and taking part in physical activity or prioritising sleep and rest, at 35%.

The poll of 1,015 people in Wales was carried out by Opinium on behalf of the Mental Health Foundation. It was released to mark Mental Health Awareness Week, which runs from May 11 to 17.

Catherine Razzell, Policy and Public Affairs Manager at the Mental Health Foundation, said: “This polling tells us that, here in Wales, there is a concerning degree of harmful actions taken by people as a way of dealing with their feelings of poor mental health, such as doomscrolling or overeating.

“We are hopeful to see positive actions being taken by individuals to help maintain and improve good mental health. Tried and trusted activities such as connecting with nature, which many of us are fortunate to have access to in Wales, and taking part in physical exercise and rest, in equal measure, are all known to support our mental health.”

Calls for action

The polling found that nearly two-thirds of people in Wales, 64%, are using at least one harmful coping mechanism alongside positive actions.

Only one in five, 20%, reported taking only helpful actions to support their mental health.

The Mental Health Foundation said the results come at a significant moment following the Senedd election, with a new Welsh Government now in place.

Ms Razzell added: “Whilst it is good news people are finding ways to prioritise and protect their mental health and support those around them, more action is needed from our governments to create the conditions to support good mental health.

“We are seeing a once in a generation change politically in Wales. We are one year into the new ten-year mental health strategy for Wales and are keen to see how the new government will implement and resource this.

“In addition to a resourced focus on prevention, which we know has long-term economic benefits, we know that inequalities exist here that are huge barriers to good mental health, keeping people locked in poverty for generations.

“We want to see these issues tackled head-on by the new government for Wales. Now is the time for action and not talk.”

Mental Health Awareness Week is run by the Mental Health Foundation. This year’s theme is “Action”.

 

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Health

Hywel Dda health board celebrates International Nurses Day

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HEALTH chiefs are marking International Nurses Day by celebrating the vital contribution made by nurses across mid and west Wales.

Hywel Dda University Health Board said the day, held each year on May 12, is an opportunity to recognise the work nurses do for patients, families and communities.

This year’s theme is Empowered Nurses Save Lives, reflecting the role nurses play in delivering high-quality, compassionate care, often in challenging circumstances and at some of the most critical moments in people’s lives.

Nurses work across a wide range of settings, including hospitals, community services, primary care, education, research and leadership.

The health board said supporting and empowering the nursing workforce is key to enabling nurses to use their skills fully, continue to develop professionally, and lead improvements in care.

Sharon Daniel, Executive Director of Nursing, Quality and Patient Experience at Hywel Dda University Health Board, said: “International Nurses Day is an important opportunity to recognise the incredible difference our nurses make every single day.

“Empowered nurses save lives, and we see this through the skill, compassion and professionalism shown across our services.

“As we review our Nursing and Midwifery Strategic Framework, Empowered to Care, this is a timely moment to reinforce our commitment to supporting the nursing profession to grow, lead and shape services throughout their careers.

“When our staff feel valued, trusted and supported, teams are stronger and patient care is safer and more effective.”

The health board said nursing is founded on teamwork, with nurses working at the heart of multi-disciplinary teams alongside medical colleagues, allied health professionals and others to deliver joined-up, person-centred care.

It said the approach supports its wider ambition of improving health and wellbeing and providing care closer to home.

International Nurses Day is also being used as an opportunity to thank the nursing and midwifery workforce for their dedication, expertise and commitment to caring for others.

 

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Health

NHS Wales users share mental health support stories

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Two Welsh patients say free online programmes helped them manage anxiety and stress

TWO people who transformed their mental wellbeing with the help of NHS Wales’ online support services are encouraging others to seek help during Mental Health Awareness Week.

Kate, 39, from Cardiff, and George Ryley, 27, from Aberystwyth, both say free online self-help programmes helped them regain control during difficult periods in their lives.

The pair were supported through SilverCloud Wales, a suite of digital mental health programmes based on Cognitive Behavioural Therapy, managed by Powys Teaching Health Board.

The stories are being highlighted as part of Mental Health Awareness Week, which this year focuses on the theme of “Action”.

Parental anxiety

Kate sought help after her young son began suffering febrile seizures, triggering severe anxiety that quickly escalated.

“My chest would tighten and I’d get this feeling like a wave of nausea,” she said. “I couldn’t eat, couldn’t focus.”

She described becoming consumed by fear, constantly checking on her son and worrying about possible seizure triggers.

“I was so distracted at work that I had to stay behind after hours, and at home I didn’t feel I was always present with my son in the right way,” she said.

After speaking with her GP, Kate was diagnosed with parental anxiety and referred to SilverCloud’s “Space from Anxiety” programme.

She said the flexibility of the online course made it easier to fit around family life.

“I could do it in the evening when my son had gone to sleep, or during breaks in the day. It worked around me,” she said.

Kate says she still regularly uses mindfulness, breathing exercises and writing techniques she learned through the programme.

“I haven’t had a single anxiety attack since I started it,” she added. “I’ve not looked back.”

Stress and illness

Meanwhile, Aberystwyth resident George Ryley turned to the service after work pressures and illness left him physically and mentally exhausted.

“I was used to being busy and active,” he said. “Then suddenly, even having a shower would sap all my energy for the day.”

George said a period of poor health linked to mould toxicity left him bed-bound for several weeks and badly affected his mental wellbeing.

After contacting his GP, he was referred for counselling and encouraged to try SilverCloud’s “Space from Stress” programme.

“I didn’t have the most positive mindset at first,” he said. “But as I worked through it, I was amazed at how effective it was.”

Each SilverCloud user is assigned a dedicated supporter who provides encouragement and advice throughout the course.

“Having such lovely feedback on my progress was really motivating,” George said.

“I’ve recommended SilverCloud to so many people who I know have been struggling with stress.”

Taking the first step

Fionnuala Clayton, project manager for NHS Wales’ Online CBT Service, said the stories showed how small actions could make a major difference.

“This Mental Health Awareness Week reminds us that action doesn’t have to be dramatic or overwhelming – sometimes it’s simply about taking that first step to seek support,” she said.

“SilverCloud Wales gives people the tools to understand their thoughts, manage anxiety and stress, and build resilience in a way that fits around busy working and family lives.”

SilverCloud Wales is free to access through NHS Wales and can be used on phones, tablets or laptops.

The service is not intended as a crisis support platform or for those requiring high levels of intervention.

People can sign up at nhswales.silvercloudhealth.com/signup.

 

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