Doctor won't give me diazepam ..aibu?

[lucyhar]

I've been getting diazepam off my doctor for around 4 years now for when I have to travel by plane.
I normally get 7 tablets a year.
My doctor has retired now and I'm travelling to Australia in may to see my aunt and uncle.
I've just got out of the doctors (new doc) and he refused any.
Now I understand people get addictive but I get 7 tablets a year!
I have a massive fear of flying,I've tried CBT,hypnotherapy,kalms,I did a fear of flying course and nothing.
Before I was prescribed diazepam I didn't go on holiday for 7 years.
They gave me my life back (without being dramatic)
Aibu to speak to the practice manager?

Saying that it’s a ‘lifestyle choice’ is a very slippery slope. I would hope that people would be more sympathetic if she was flying to see a terminally ill relative? What if it was to attend a child’s wedding?
I am currently in rehab for alcoholism, I’m sure plenty of people don’t think taxpayers’ money should be spent on that despite every medical organisation from the WHO downwards agreeing that alcoholism is an illness.
What about treating sporting injuries? Playing sport is a lifestyle choice.
Having children can be seen as a lifestyle choice. Why should people who choose not to have children pay towards maternity care? Or schools?
A PP who said that she has to fly twice a year for work and is prescribed Diazepam for this should ‘get another job’. So she should pack in her job and stop paying tax and claim benefits while she looks for another job?
This thread is beyond ridiculous

lost so you think people like me should just struggle then when there's a perfectly effective drug that works.

As I said earlier I came across a new GP that didn't want to prescribe me diazepam and insisted I take zopiclone instead because it's better. I ended up hallucinating and in a far worse state. I had to go to out of hours and my husband came with me and basically told them I needed it and I got it no problem. Funny how when my husbsnd asks for it they gave it...

28 tablets of 2mg diazepam costs the NHS 45 pence. A few tablets a year. Sometimes a little bit of common sense would go a long way

PCPlums exactly. Apparently you should only medicate for life or death.

@Lostmychristmasspirit so my GP has committed fraud by giving me a private prescription? She's prescribed diazepam for flying, once or twice a year for the past 9 or 10 years - on an NHS prescription. Why would she suddenly now say she's unable to do so but can provide a private script, if this is known to be fraudulent?

Or are you saying you don't believe me?

seline no I didn’t say that, please don’t put words in my mouth. Not prescribing doesn’t mean I feel people with anxiety should be left to suffer.

tequilamockingbird again, I didn’t say anything about not believing you. A lot of GPs don’t realise this is fraudulent hence why I said ‘little known legislation’. I know for a fact a lot of GPs do not realise this is the case and they are unknowingly issuing a prescription that will defraud the NHS of money due to the very complicated way that prescriptions are funded. It’s not just ‘oh diazepam costs only 10p or whatever’, there are dispensing fees, prescription budgets set by NHSE not by the practices and they can be penalised for going over etc etc. It’s a bloody confusing nightmare.

So what do we do lost? Nothing else works.

ust an FYI for those suggesting OP should ask her own GP for an private prescription. There is (unfortunately) little known legislation that mandates that if a drug is available on the NHS your GP cannot prescribe it for you privately. It’s fraudulent to do so.

It’s amazing the shit that gets spouted here. The vast majority of doctors operating privately also do work for the NHS: that they can do this was a fundamental part of the deal that was done with the BMA in the 1940s to get the NHS off the ground. NHS doctors can prescribe anything in the BNF (there are things NICE say they won’t pay for, but ability to prescribe and ability to prescribe and get it paid for are different problems). Is the contention, seriously, that your local BUPA hospital can only prescribe the stuff that isn’t in the BNF? Seriously?

My daughter has had operations and MH treatment privately. It’s involved prescription painkillers and prescription ADs. BUPA paid. The doctors were NHS employees. And this is illegal? FFS.

seline also as someone who actually has an anxiety disorder I would never want anyone with anxiety to suffer. Surprise surprise GPs are humans and also can get unwell both physically and more commonly- mentally. There is no easy solution here but I’m not sure why people think GPs are lying/making it up when we say that the guidelines have changed re: diazepam and flying. Again, a lot of GPs don’t know this. I’m part of a working group to educate GPs about the minefield that is prescribing certain medications that are off licence or contraindicated where in the past they were given out like smarties. If it was cut and dry and easy peasy, this thread wouldn’t need to exist.

reflectentMonatomism by all means dismiss what I have said - rudely - this is true that GPs cannot prescribe something that is available for the same indication on the NHS. These things are very fast changing and rules can change all the time depending on licensing, patents etc. Viagra is a good example.

Also the BNF is not the be all and end all. We have CCGs who control our locality formulary so for example Azeliac acid used to be prescribed for hyperpigmentation and now it is blacklisted for GPs to prescribe, also Vaniqa. As I said above it is complicated!

lost sorry if it sounded like i was blaming you personally, I understand that doctors are people too. I just don't see what other solution there is. I think it's really unfair that we're left to suffer because someone in an office that's never met or clinically reviewed us as individuals issues a blanket policy.

So lost, how do BUPA and Nuffield hospitals, which employ mostly NHS doctors, issue prescription painkillers? Are BUPA acting illegally? Under which law?

If you have a private GP appointment - and there are a lot of private GPs - how do they prescribe anything?

NHS doctors can prescribe anything in the BNF (there are things NICE say they won’t pay for, but ability to prescribe and ability to prescribe and get it paid for are different problems). Is the contention, seriously, that your local BUPA hospital can only prescribe the stuff that isn’t in the BNF? Seriously?

I don't know the legal side of this but I dont think that's what the poster was saying. I think they were saying that your nhs gp shouldn't be giving you a private prescription. That if you want or need a private prescription the correct way to obtain it it by booking in a private appointment with a doctor who then can write a prescription for any drug providing they think it is medical ok for you to have.

At least that was my understanding of the post.

seline unfortunately as is the case with mental health at the moment, the options are incredibly limited. CBT is often hyped up but I’m not convinced for this case it would work trying again. An alternative branch of therapy may do though, EMDR or ACT-CBT or CAT. It’s not about ‘curing’ the phobia, more so managing the phobia in other ways. Meds wise... we are limited to SSRIs/SNRIs that are used for both depression and anxiety and propranolol. Trust me, being on both ends of the argument it is frustrating on both sides regarding the limitations though I know being on the patient side is much worse.

reflectentmonatonism put simply private and NHS are two very different things with regards to prescription funding in terms of cost value and also in regulation. So private GPs etc are not acting illegally here because they are not prescribing under NHS prescription regulations.

That’s right -itswinetime thanks x

Oh come on lost diazepam is a very physically safe drug.
Yes there are huge issues around regular long term use that will cause a world of problems but it's an excellent medication for occasional situational use. It's ridiculous to expect someone to take daily medication like an SSRI, with all its associated side effects and discontinuation difficulties, for a situation that they may only face a handful of timed a year. Diazepam is ideal for that.

I think unfortunately the baby has been thrown out with the bathwater here.

Lost i find that.CBT is incredibly fashionable at the moment but i find that most talking therapies are crap for me personally. SSRIs don't work either because it's sporadic anxiety rather than crushing daily anxiety, the daily anxiety I can cope with.

It's frustrating because the only thing that works is diazepam. What is the reasoning for stopping legitimate uses of it? Abuse potential?

I think they were saying that your nhs gp shouldn't be giving you a private prescription

At an nhs consultation, probably that’s true (although it won’t be illegal, just a breach of their nhs contract). But your GP can see you privately and prescribe privately at that consultation. The pharmacy that takes the private prescription will fill it either way. Prescription-only drugs can be bought from a pharmacy at cost with a private prescription from a gmc registered doctor. The end. Whether the doctor’s full time employer is happy about the doctor writing the prescription is a different issue.

The NHS guidance our area sent out says very clearly that GPs should not prescribe medication on the NHS that is requested for holidays. Regular meds such as BP, diabetes, asthma, etc stuff can be issued as long as out of the country less than 3 months but requests that are specifically for travel, such as malaria tablets, diazepam and tablets to delay periods must not be done on the NHS. From the time this came out the practice have issued those things on private prescriptions at a charge of £15 rather than just stop instantly but have warned patients that a policy will be in place for next summer that will, most likely stop this and recommend see private GP

For whoever was saying the BNF supports prescribing it, I can tell you the NHS prescribing system comes up with a very clear alert along the lines of "This is not suitable for phobias" so it would be difficult to defend that prescribing decision to an insurer

maxthemartian nope sorry. Diazepam is a class C controlled drug that is now subject to drug driving conditions.

It’s not a physically safe drug. There is no such thing as a physically safe drug. ALL drugs have side effects, even paracetamol! Look at the medication insert in most meds, the list of side effects and contraindications for many medications are terrifying!

Not in OPs case but in long term use it’s not just addiction but effect on respiratory function, paradoxical effect on anxiety and I’ve recently seen literature mention increased risk of dementia.

Locally we can only prescribe for a maximum of 2 weeks for benzos and z drugs. I work in an area where historically all the older patients are on long term benzos. We work really hard to try to reduce them off and the ones that do always say after they come off them they feel so much better physically and mentally!

The majority of Docs just want to be able to practice safely for their patients and also appropriately due to the real fear of litigation which is another thread in itself! The process of litigation and fitness to practice referral/GMC can take years to complete and these things are the same even for ‘minor’ complaints. We are seeing increasing amounts of suicides in Doctors who are undergoing complaints procedures. It’s terrifying to work in medicine at the moment.

Back to the OP... I wish I could give better solutions. I really wish I do.

I’m signing off now. Goodnight all. I hope you can appreciate I’ve not come on here for a row but to give as much factual information that I can. What you guys think of it is out of my control. to all who suffer with anxiety because it’s a total bastard.

It's ridiculous to expect someone to take daily medication like an SSRI, with all its associated side effects and discontinuation difficulties, for a situation that they may only face a handful of timed a year.

This is the exact problem I have.

Reflectent your GP cannot issue you a private prescription for a medication that is available and indicated for on the NHS. Why on earth would anyone make this shit up?

At an nhs consultation, probably that’s true (although it won’t be illegal, just a breach of their nhs contract).

I think that's what some people were suggesting though booking another appointment but asking for a private script. No idea on the legalities of it as I said but it seems a better use of the op's time to book a private appointment and try with a fresh doctor who may have different opinions.