GP messing with medication

[SimplySteveRedux]

Moved in October last year and had to transfer GPs. I take around 15 different medications each month and have seen numerous professionals over the years, and has taken close to a decade to find a medication regime that works for me.

However, my medication was summarily reviewed in November, and no changes made. Since them I have had a strong opiate removed from my repeat and I have to request it individually; same with diazepam,; same zopiclone; same anti-sickness drug. I've now been asked to attend another medicaments review.

AIBU to question what they are doing? How do I prepare to deal with - I will be in a terrible state if the above three medications are deemed unsuitable, and worried they may individually target others. I have several medical conditions, some of which are rather broad in regard to symptoms. Not sure what to do here!

Thanks for reading :)

But have you tried acupuncture?

How about aromatherapy?

I'm sure a vegan diet would work.

Antidepressants also cause dependence though, some people struggle horribly coming off them. That's a physical addiction, like it or not.
But as they're not taken recreationally that's not somehow seen as a moral issue.

Yep, try telling anyone who’s been on Paroxetine for any length of time that it doesn’t cause dependency. My DH was pooh-poohed by the GP years ago when he asked about terrible withdrawal symptoms, and was assured it couldn’t possibly be that. Funny how it always happened when he missed a dose. Funny how there was subsequently a class action lawsuit taken out against the manufacturer..... Funny how it’s hardly every prescribed these days, and certainly not as a first resort.....Funny how he can’t get off it, having taken it for over 20 years with diminishing effects necessitating dose increases... It now does sweet FA, apart from causing iatrogenic insomnia which - wait for this.... yep, you guessed it! He’s not allowed to get any medication for!!

But as Max and Euro point out, nobody’s panicking over that, because there’s no pleasure to be had from them. Heaven forfend the depressed should feel any pleasure, of course.

I saw some interesting stats on Twitter today about the Opiod panic. It seems that the dependency/addiction issues relate primarily to street drugs, and prescription meds account for only a very small proportion of cases. Yet the sick and disabled are having their pitifully low level of relief taken away from them, so that addicts can be prevented from getting hold of them (as if there would be many people in pain prepared to sell any of their precious, hard fought-for supply). I will see if I can get some links.

Half

Oh, and there have already been noises made about too many anti-depressant prescriptions, it has been in the press at least twice over the last few months. I also wouldn’t be surprised if it’s the next thing to come into the crosshairs.

The last two GPs I saw before the marvellous pot plant encounter tried to talk me into coming off or lowering my antidepressant dose. Neither were interested in the fact that I take them because I suffer from GAD and PTSD and every time I have tried to reduce my dose or even change brand I've had terrible side effects and ended up back in the surgery unable to function.

Ah, but you must be mistaken, Toria. They’re not habit-forming, you see. It must just be you.

Antidepressants definitely cause withdrawal symptoms, I do wonder why we all keep being told they don't 🤔

For many people coming off them can be horrendous. I also think they're way overprescribed but that seems to be an unpopular opinion on here.

Of course they do - which is why a tapered supervised withdrawal is essential!!

I have permanent spinal nerve damage following a number of surgeries. It won’t get better; it’s been more than 5 years.
Luckily I have a great GP who sees me every month - as much to check in with me - to re-prescribe my controlled drugs. I’ve been through the pain team debacle, where I was to lie on the floor, walk to the shops, and take paracetamol. When I asked how I should fit this around a busy FT job, and masters study, they looked at me blankly. Apparently people with chronic pain don’t work!
If I didn’t take my drugs, do my Pilates, go swimming, I couldn’t work. Then I wouldn’t be able to pay my bills or mortgage; I’d be homeless and a burden to the benefits system. I’d also probably throw myself off a bridge within a year.
Heavy duty medication (up to 17 plus a day...) aren’t a miracle cure, but they do help me function and have some semblance of life. Pain clinic was so detrimental to my
Mental health that I seriously worried about myself. It’s not the panacea for everything. It should be a more holistic view with GP and relevant AHPs/other health staff, in a person-centred approach - not a one size fits all fix.

It seems that the dependency/addiction issues relate primarily to street drugs, and prescription meds account for only a very small proportion of cases.

This. It's laughable that establishment that is supposedly educated and intelligent, one of usually great privilege, cannot entertain or conceive that street drugs are manufactured for this market, including street 'blues'/diazepam. I mean, really, a whole epidemic, a crisis of addicts and they are all sourcing drugs from legitimate outlets? And their suppliers as well? C'mon, no one is surely that obtuse. 'Bad' street blues are not sourced from people who flog their 30 tabs, LOL; they've been manufactured on a large scale for the illicit user market by illegal labs and not prescribing certain drugs will not stop this. In fact, it will possibly only fuel the market because people in desperate pain will ultimately do desperate things.

Do they think only nicey lab geeks with PhDs in chemistry synthesize fentanyl and other opiates so that if all legitimate sources of this are cut off the nasty junkies and associated social ills will disappear?

Get fucking real! All this does is further drive already suffering and desperate people to further desperation and put off those suffering from seeking any sort of legit help because they realise they'll be treated like criminals looking for a fix so why bother?

NO z-drugs, at all, ever. They may as well be banned entirely. No one will prescribe them even for a few days, as someone experienced up the thread. There was a rape survivor on here who begged for something to help her sleep for a few days and was turned away with nothing. Can you imagine if she'd not had the support she already thankfully had and there was a friendly dealer was just a text away? What would you do, some pranayama breathing and lavender spray on a pillow whilst you waited months for your oh-so-helpful 6-8 sessions of CBT?

The problem with the medical paradigm here is as usual: lack of joined up thinking and a short-sighed all-or-nothing approach. But hey, makes the books look better, and I reckon a lot of dealer's books, if they kept them, will soon be looking better than ever, too. Because you can't magic chronic pain or insomnia away by pretending it doesn't exist, and when you get to the point where a dealer is a more sympathetic figure than a doctor, you've failed those people in every way possible. That's fucking shameful.

2mg is NOT a tenner 😱😱😱it's cheaper to get it illegally than it is on prescription bu far.

The US are a bit further down the line with this, Euro, and the effects you predict are, indeed, playing out. I was reading an article in the Washington Post yesterday on just this. The main problem on the street was illicit fentanyl, not prescription pain killers, yet so many chronic pain patients have been cut off from their meds. One state has even passed a law stating maximum doses to be prescribed, rather than leave it up to Drs’ professional judgement, so some patients have been left with much reduced doses, in constant severe pain. The results you foresee of respectable people turning to drug dealers in depaeration are indeed playing out in the US. There have indeed been suicides of people who can’t face life in constant severe pain

But hey, at least a tiny proportion of prescribed meds are no longer making it onto the street!! What are the lives of disabled people, by comparison.

As you say, this was entirely predictable by anybody with half a brain, so why are governments pushing it so blindly?

As for not prescribing the z drugs even for 3 days, that is just absurd and compassionless. Nobody will get addicted in 3 days. You can’t OD on three days worth either. It isn’t humanly possible.

I wonder what Drs think will happen to them if they write out a script for three days worth of Zopiclons or Zolpidem?

Why have we got to a position where the establishment no longer trust Drs to make clinical judgement as to what is best for their patients? Or, indeed, to be capable of knowing how disabled their patients are, though that is a different thread?

To refuse it to a rape survivor in crisis beggars belief. The cruelty.

£30 for a box of 28 is the going rate I believe. In my area anyway. And that's for the 10mg ones.

No ones gonna pay £10 for a 2mg!

GPs are in a incredibly difficult situation now. Constant barrage of abuse in the press for over prescribing, huge litigation culture if dependancy/addiction arises or if someone overdoses on prescribed drugs, not to mention professional sanctions/GMC intervention. Massive pressure / forced limits to prescribing from above. And yet there are no satisfactory safe alternatives. Long term NSAIDs carry big cardiac and gastro risks, gabapentin/pregabalin - addictive and side effects, The BMJ lead with an article in how paracetamol should not be prescribed for chronic pain... where does that leave frontline practitioners ? Talking therapies take months are not enough and dont suit many people. Sympathy doesn't help someone in agony at 3 am and fairy dust and magic are in short supply. There are NO completely safe drugs. Everything carries a risk. But litigation and fear have taken balancing that risk away from the dr/patient choice leaving patients suffering , drs deeply frustrated and trying to practice with both hands tied behind their backs and with no decent alternatives. I dont know where we go from here....

I had this happen to me, and the regular reviews and constant changes really damaged my physical and mental health for a long time. I ended up just not taking medication because I couldn't cope with justifying my need for them and fighting and the whole bloody battle over it. They kept changing the doses or not prescribing me any. It was upsetting and frustrating and exhausting. Which would be fine if I didn't need those drugs to function. So what's happened? My quality of life has drastically reduced and a lot of symptoms that had been under control for many years have come back with a vengeance. And now when I go to the doctors they say they won't prescribe them because I don't need them. I need them more than I did when first prescribed, they've just changed the goal posts. Apparently panic attacks, barely sleeping and hardly being able to move from pain are acceptable symptoms now.

I was prescribed Seroxat at 17 and took it until I was in my mid 30's (complex PTSD, GAD and severe depression). Lost count of the number of times I tried to cut down on mg or stop cold turkey but had to continue taking them due to the horrendous withdrawal symptoms. I had to revert to taking it in liquid form and reducing my dose by 1mg until I was off them - took 18 months to achieve this and then another 12 months for the physical withdrawals to finally stop. They don't prescribe Seroxat nowadays funny that . I am 'clean' of that drug for over 10 years now.
I have also been addicted to Zopliclone and Valium, both prescribed for 3 years by a 'kindly' GP due to rampant insomnia and because of my mental health issues mainly anxiety.I moved to a new area and my GP changed. GP wouldn't prescribe the combination of Z drugs and Benzo ( quite rightly so! ) so I had to go cold turkey. Zopliclone withdrawal was awful, I spent a week in bed puking and sweating thinking I was going batshit ( I wasn't abusing Zopliclone ie taking more than prescibed or buying them illegally or from online 'pharmacies' ) I wouldn't wish my experience on anybody. The valium withdrawal wasn't as harsh physically as I was on a fairly small dose and again, I wasn't abusing but the rebound anxiety and panic was hellish for 6 months or more. Benzo addiction is hard to treat in rehab as its a drug thats used to help withdrawal most addictions.
I've been clean of those prescribed drugs for 4 years now and I wouldn't take them again if a gun was held to my head.

Rehab clinics have zopliclone withdrawal programmes in place now.

No-one needs Z drugs and benzos to function.

You win most ignorant, goady comment of the day, HowMovingBungalow.

Have a

I will stand by my 'goady' comment. Thanks for the biscuit though!

Me too OP, i'm hanging onto my job by my fingertips due to acute and chronic pain.
I need regular cortisone injections to control my pain but they take so long I've often waited a year over my due date.
As a result I have to take zapain during the day (8) and one tramadol at night in order to get a few hours pain free sleep.
My doctor cut all my analgesia in half without even reviewing me - I've just moved to a different county. No discussion, no medication review nothing, now I have tramadol for 20 days each month (they are capsules so can't be broken in half) and then I'm supposed to manage the last 10 04 11 days with nothing.
I'm incredibly pissed off. I'm not some random druggie, I take the minimum to control the pain when no other help is forthcoming.

Sorry, How, I had missed your prior comment, which puts your second comment into context a little.

I’m sorry for your suffering. However, it seems to me that the problems you mention with withdrawal arose because you were forced to withdraw cold turkey, rather than do a managed, gradual withdrawal.

It was actually pretty dangerous of your GP to force you to go cold turkey. This can cause seizures in some, so they exposed you to that risk. As it was, they caused you lots of unnecessary suffering.

Why didn’t they supervise you to cut down gradually? The end result would have been the same, but without all the unnecessary suffering, and without unnecessarily putting you at risk of seizures.

As you had been taking them so long, why the sudden hurry to cut you off? Where was the fire? Other than the GP shitting their pants about their own risk?

It sounds to me like your GP acted in a way that wasn’t in your best interests.

It is perfectly possible to withdraw from benzos and z drugs without major ill effects. But to do so, you need to take it slow. Really slow. For some reason I can’t fathom, Drs always seem in a tearing hurry to cut people down too quickly. That is when the problems start. Often with these drugs, dependency only causes the patient a major problem if they are cut off too suddenly by their Dr.

Make an appointment to see the new GP madcatlady/ and tell them the situation is unacceptable. They need to provide adequate pain relief of one sort or another. If they won’t prescribe more of what you usually take, what else can they do/give? Keep going back until you are sorted.

I do feel for GPs, who are caught in the middle. But this unacceptable situation won’t change while they, as a body, just go along with it. It would be good if there was some sort of working group on this made up of both medics and patients, to change policy.

To put your experience into context, How, I know a woman in her 80s who withdrew from Valium after more than 30 years of dependency. She did it very slowly- took her nearly two years - but she had no problems, and is now free of Valium.

She had to do this under the supervision of a private doctor, though, because her NHS GP wanted her to withdraw at a rapid pace, which she just couldn’t tolerate. Had she not had recourse to private help, she would now either still be on the Valium, or would have suffered horrendous effects of a too-rapid withdrawal, lasting months or years. And possibly a relapse of the MH conditions that led her to take Valium in the first place. Yet her withdrawal would have been seen as a ‘win’ by the system, regardless of the harm done to her by it.

I have no idea why that GP decided I needed to stop my prescription with no slow reduction of the Z and Benzo.
I wasn't given a reduction plan but then I wasn't with the Seroxat, I researched online forums for months and I was the one to suggest the liquid form and tapering to that GP.
I think there are lots of GP's that need more training on prescription addiction and taper plans.
I don't think zopliclone should be prescribed for more than 7 days at the most.

I agree with you, How about the zopiclone. A few days would be fine, though, hey people are not even given that now. Why?

We had the same issue with DH and the paroxetine/seroxat. The GP didn’t knOw about the liquid form, and was supremely un-bothered about arranging some for DH. It was all too off-piste, by the sounds of it, he just kept robbing DH off (he’s a lot more fob-offable than I am!). The pharmacist was more knowledgeable.