Diolch, Llywydd. I'm very happy to take the opportunity to respond to the Petitions Committee's report and the debate today. Tackling dependence on prescription-only and over-the-counter medicines remains a priority for this Government. The budget for substance misuse has increased to almost £53 million a year to provide a range of services and actions to respond to all forms of drug use, including prescription and over-the-counter medicines. We've also ensured prescribers across Wales have comprehensive guidance and advice in this area, so we are happy to note the motion today and we accept or accept in principle all but one of the recommendations, as Janet Finch-Saunders has set out.

The committee's recommendations are very much in line with the work already under way, which is led by both the Welsh Government and our partners across the national health service and area planning boards, bringing in a wider range of partners, including members of the third sector and the police.

Recommendation 1, which seeks recognition around prescription drug dependence in both national policy and strategy, I'm pleased to give that recognition and outline the support that is already in place and work under way. I agree with the need to distinguish between substance misuse and dependence. So, our 2019-22 substance misuse delivery plan, which we'll be consulting upon in the coming months, will make that distinction clear. In recognition of this, our work in responding to the issues of prescription drug dependence going forward will be overseen jointly by our pharmacy and prescribing as well as our substance misuse teams within the Government. Research is being undertaken at the University of South Wales, and the Welsh Government aims to gain a better understanding of the causes, characteristics and consequences of prescription and over-the-counter medications. That work will inform policy and identify best practice for us in the delivery of treatment and, hopefully, we expect this should lead to the development of a treatment framework on this issue.

Turning to recommendation 2, the Government recognises SSRI and SNRI antidepressants are in some cases of discontinuation associated with withdrawal symptoms, and they can be consistent with symptoms of inadvertent dependence. We also know that some antidepressants are more likely to cause symptoms than others, but this is a complex issue where caution should be exercised so we don't conflate the problems of dependence with those of discontinuation. Our position reflects the evidence that indicates discontinuation effects can be minimised through the structured tapering of those medicines, overseen with the support of the prescribing clinician. 

In recommendations 3 and 4, I know clarity is sought on the guidance on not routinely prescribed medication and on the tapering of prescription medicines. As Janet Finch-Saunders set out, current guidance from NICE advises prescriptions and antidepressants are generally not recommended for mild depression, but they're more likely to be effective for moderate to severe cases of depression. And those guidelines are, of course, being reviewed, and we will ensure those guidelines, which are expected in February next year, 2020, are circulated widely to clinicians in Wales for their adoption. I understand that the Royal College of Psychiatrists are planning to issue a new position statement on antidepressants and depression, including specific reference to how best to manage discontinuation. We will, of course, work with the Royal College of Psychiatrists in Wales, which will be making recommendations specific to Wales.