A health initiative that has already helped scores of people to end or cut their use of sleeping pills and tablets for anxiety is to be extended to help many more people.
When the Clarity Project started in North Kirklees in January 2014 patients were taking more tablets for insomnia and anxiety than in most other areas of the country.
That position has improved but effort is still needed to help more patients addicted to prescribed benzodiazepines (drugs in the diazepam ‘family’) and ’z-drugs’ (including zopiclone, zolpidem and zaleplon) to stop or reduce their use of the drugs.
Before the project started GPs struggled to reduce use of the drugs. Feedback from patients helped by the project has been very positive and GP practices are keen to support it.
The project originally worked with six practices with high numbers of patients on tablets for insomnia or anxiety and is now being extended to all practices in North Kirklees. Around 100 patients a year are expected to benefit. Support sessions will be held at health centres in Dewsbury, Ravensthorpe, Cleckheaton and Heckmondwike.
Savings on the drugs bill and other costs to the NHS locally cover the cost of the project, which is partly funded by NHS North Kirklees Clinical Commissioning Group, the organisation that chooses and pays for many local health services, and run by Lifeline Kirklees.
The project works by giving addicted patients time with a specialist substance misuse adviser, who supports them with information about the effects of the tablets and how best to reduce or stop their use.
Patients are also offered help with non-drug ways of managing anxiety and insomnia, including natural relaxation techniques, massage, mindfulness and cognitive behavioural therapy.
Dr Khaled Naeem, NHS North Kirklees Clinical Commissioning Group’s lead on medicines management and a GP practising in Batley, said: “Sleeping tablets like diazepam are meant for short-term use and are highly addictive. People get used to them very quickly and need higher doses to get the same effect and it becomes very difficult to come off them.”
“Many patients, particularly young people and those over 50, have been using sleeping tablets for months or years, which is a threat to their long-term health.
“There is a link between higher doses of benzodiapines and a greater risk of accidents and falls and a general inability to deal with everyday life.
“The Clarity Project provides a structured withdrawal programme that takes more time than most GP practices are able to give. Specialised substance misuse workers help patients understand the likely effects of withdrawal and establish better long-term sleeping patterns without using sleeping pills.”
In a one-year trial at a GP practice in Cleckheaton support for patients resulted in half those helped stopping taking tablets and half managing on a lower dose.
The Clarity Project operates throughout Kirklees and is funded jointly by Kirklees Council Public Health and NHS North Kirklees and NHS Greater Huddersfield Clinical Commissioning Groups (CCGs). From October the project will be integrated into local Drug and Alcohol services.
Tony Cooke, Head of Health Improvement for Kirklees Council, said, “People in Kirklees have for many years faced problems with addiction to drugs, alcohol and tobacco but we have made huge progress in reducing all three by investing in strong community-based services.
“Funding this project with the CCGs is a good example of local government, communities and the NHS working together with local people. The project complements our other services for reducing addiction and is clearly paying dividends in improving the quality of life for many local people.”
What the patients think
These are some of the comments made by patients helped by the Clarity Project:
“After about twenty years taking Zopiclone to aid my sleep problem and trying for many years to come off the drug even with hypnosis and trying reduction on my own unsuccessfully, I was delighted with the idea of coming off Zopiclone on a planned reduction with support.
“After my meeting with you and careful explanation how it would work, I then set about putting the scheme into practice. The weekly/fortnightly follow ups have been supportive and the opportunity to attend the Lifeline Centre for Mindfulness (meditation) and the complementary therapies (acupuncture and massages) have been a great help.”
“Sleeping really well and feeling much more alive in the daytimes.”
“Very good support during and after my medication reduction.”
“Would not have been successful if I had to do it on my own, I feel more alive and myself than I have for years.”
These are some of the comments made by GP practices involved in the Clarity Project:
“We have been delighted with the results of the Clarity Project and have had excellent feedback from the patients who have participated. Having tried over the years to get patients to stop z-drugs and failed we are amazed at what has been achieved.
“Most of the patients are also surprised and pleased with their achievement. Many of them report an improvement in their general wellbeing as a result of stopping these medications.”
“I have noticed a significant number of individuals who been through your service have modified their benzodiazepines and z-drug taking and the ones who have been successful have actually stopped taking this medication completely.
“Of those who have engaged with the service, I have noticed harm reduction and minimisation and more rational prescribing with the medications that they are currently taking. It would be really welcomed if this service was to be extended… there is still a lot of work to do.”
Every year, Lifeline Kirklees works with hundreds of people who have problems with drugs or alcohol in supporting them to change their behaviour and achieve their recovery goals. For more information visit lifelinekirklees.org.uk or call 01924 438383.