The risks associated with some prescribed medicines: Public Health England’s 2019 report

At Big Health, we exist to makepsychological treatment just as accessible as pharmaceuticals. One of thereasons we do this is the risks associated with some prescribed medicines,including z-drugs (also known as sleeping pills) commonly prescribed to peopleliving with insomnia.

In 2019,Public Health England published a review designed to tackle the rising issue ofprescription drug dependence, focusing on medications like benzodiazepines,z-drugs, opioids, antidepressants, and gabapentinoids. Prescription drug usewas growing, particularly among adults over 18, and it became evident thatwhile these drugs are essential for treating certain conditions, they alsocarry significant risks, including dependency, misuse, and challengingwithdrawal effects. The review aimed to assess the scope of these issues andidentify solutions to mitigate harm while ensuring effective patient care.

The reviewhighlighted z-drugs, a class of medications often prescribed for insomnia, asparticularly concerning. The report stated that Z-drugs present risks ofdependence and withdrawal, and that prolonged use can have severe consequences.Though prescriptions for z-drugs peaked in 2014 and have reduced slightlysince, they are still at high levels, with NHS data showing 5 millionprescription items for z-drugs were written last year.¹Long-term use of z-drugs remains problematic, especially in vulnerablepopulations like the elderly or those with multiple health conditions.

The reviewemphasises the need for alternatives to z-drugs in order to reduce overrelianceon them. Evidence-based digital treatments such as Sleepio, which deliverscognitive behavioral therapy for insomnia (CBTi), rigorously tested in clinicaltrials and delivered through apps or online platforms, offer a solution. Thesetreatments can provide patients with a safe, effective, non-pharmaceuticaloption for managing insomnia without many of the risks associated with z-drugs.

Byintegrating digital treatments into care pathways, the NHS can offer patientssafer, evidence-based alternatives to z-drugs, reducing the risk of dependenceand improving patient outcomes.