ACP-UK response to government report reviewing evidence on dependence and withdrawal from prescribed medicines

  • Sarah Swan, Director for England

  • September 2019

ACP-UK welcomes this article highlighting the addictive nature of many commonly prescribed medications and the problems in coming off them.  Psychological therapies, for example cognitive-behaviour therapy (CBT), have been shown in many studies to be as effective as medication in the treatment of conditions such as depression, and these results are maintained at longer term follow up.  As the article describes, the medications prescribed to treat conditions such as depression, anxiety, pain and insomnia can lead to addiction. Despite the growth of Improving Access to Psychological Therapies (IAPT), Clinical Psychologists remain very concerned that medication is often the first line treatment offered to people with these common mental health problems.  We recognise that medication is helpful for many people but are concerned that current resources for mental health services mean that GPs often feel they have no other alternative than to prescribe.  Given the “millions” of people taking these prescribed medications on a long-term basis, investing in more Clinical Psychologists who can treat the underlying causes as well as the maintaining factors in common mental health problems, would be more cost-effective than the current situation.

The article highlights how those in more deprived areas are more likely to be prescribed medication for these issues.  ACP-UK would support the increase in more social prescribing services in order to help alleviate the impact of poor social and environmental circumstances.  Unfortunately, many of these services have been impacted by austerity measures that have led to a reduction in investment in social care, NHS and third sector budgets.

The article identifies the lack of support for those addicted to such medications to successfully withdraw from them.  We are appropriately skilled for this type of work, but again, there has been a disinvestment in Clinical Psychologists in addiction services over recent years.  Addiction services tend to be commissioned from joint NHS and third sector or just third sector providers.  Either way, the tight financial envelope has meant that Clinical Psychologists have largely been left out of the service delivery model, due to their relative cost.  However, this leaves a gap in terms of helping those with really complex problems to understand and work on the issues underlying their addiction, which often involves working with co-morbid mental health problems.

Thus, ACP-UK is pleased that this article has brought to light the narrow medicalisation of common mental health problems, sleep difficulties and pain management.  Clinical Psychologists are well placed to provide highly effective, evidence-based interventions that greatly reduce iatrogenic harm, improves outcomes for individuals and provides potential cost benefits for the NHS.  We would be happy to be involved in consultation regarding how we could support this work going forwards.