To be concerned about friend and diazepam

[MaskellEtt]

She lost her husband in horrible circumstances 3 weeks ago. Really awful.

We took her to the GP 24hrs later because she was in such a state; hysterical, in shock, zoning out and not communicating with anyone.

Her GP put her on diazepam 15mg 3 times a day. I’ve taken them myself so I know how good they are for short term anxiety and upset.

But we are at the end of her prescription now and the GP has renewed it for another month. I work in healthcare and know from listening to the doctors how addictive benzos are. She is doped up and drowsy most of the day. I was hoping they would reduce it today but he gave her another 4 weeks on the same dose.

The last thing she needs on top of all of this is an addiction to diazepam. Would you be concerned about this or just think in the short term it doesn’t matter and can be dealt with later?

Don’t think you’ve got the dose right there op, no GP in their right mind would prescribe 15mg 3 times a day. She would be comatose.
I’m prescribed diazepam, I’m allowed 10 every 3 months, 5mg. If I need one I break one in half and have 2.5mg which takes the edge off but leaves me compos mentis.

I dunno. She's in total shock, and having something take the edge off seems sensible to me. But, 15mg is a big dose.

I don't think you should add to her worries by telling her that you're worried about the diazepam, but I do think it is good that someone is looking out for her in this way.

See how she's doing in a week?

If she's virtually sedated all the time, she may want to stop having that feeling when the time is right. Or she'll be addicted. Keep a close eye, but don't say anything just yet.

Omg 15mg? 5mg pretty much almost knocks me out. Taken occasionally to get through dental procedures.

Maybe in a week suggest she starts reducing? Do you mean 5mg three times a day which is 15 in total or 15mg three times a day?

15 mgs three times a day was a lot. I was addicted to benzos for nearly a year (did outpatient rehab) and the top end of what I was taking was 30mg a day!

Poor love, she's in for a world of pain if they don't take her down slowly. Doctor sounds like a maniac.

Are you sure it's not 5mgs three times a day?

No way can it be 15mg!

It’s only been three weeks. It still doesn’t feel real to her. It has literally just happened. She is still coming to terms with the fact that this has been even happened. Back off. More harm is done at this stage by well meaning people and their “shoulds” than you can even know.

My partner died unexpectedly and traumatically and I am still in early grief. Early grief. I was on multiple diazepam and sleeping tablets at that point because my body was in a full blown trauma response, as hers is.

If she’s still on multiple diazepam a day in three or six months you might have a point. But it’s perfectly normal at this stage.

Died unexpectedly 18 months ago, that should say.

Theyll.probably tapper them off slowly..it is a big dose

I'm betting it's 5mg TDS total of 15mg per day

No GP would give someone 15mg off the bat. Wouldn't happen.

She was already on 5mg 3 x a day for back spasms. It absolutely is 15mg x 3 a day. I’ve seen the prescription. She is completely out of it, not sure if it’s the diazepam or if it’s the shock to be honest. Droopy eyes, you have to repeat yourself a few times before she takes it in, falls asleep throughout the day (but to be fair she isn’t sleeping at night), she has people with her 24/7 as she’s suddenly hysterical if anyone tries to leave her alone for a bit so we’re staying in shifts. She is hugely traumatised and still in shock

@bobbiester

15mg 3 times a day is a very large dose for someone to start on. It is very unusual to be prescribed a dose that high initially and for such long period. Could she possibly have already been taking diazepam and the GP just increased the dose?

2mg taken 3 times a day would be more common to start with.

After a month or two on a dose like that she will certainly experience withdrawal symptoms if she stops suddenly. It will be critical that she tapers the dose gradually rather than stopping suddenly.

I'm thinking this.

I am not anti benzo and even I think that's an incredibly high dose to start with.

Oh x post.

Different then.

The gp knows what they are doing

I am. Prescribed 15 diazepam tablets a month on top of my propranolol for anxiety and panic attacks.

15mg TDS is a really high dose and will now no doubt take a very long time to titrate down. If someone appears to need such a high dose they would probably be better off with an antidepressant or anti anxiety medication.

Are you sure it’s not 15mg a day. The dose suggested is only meant for muscle spasm treatment or conscious sedation.

I’d be thinking about contacting the practice and suggesting a review, if she really was given that dose. I hope she’s having appropriate bereavement support too.

GPs often do know best and most are absolutely experts at managing grief reactions, but Shippman carried on for quite a long time. Nobody is suggesting her GP is murderous, but everyone makes mistakes.

You’re absolutely right to be concerned OP.

I’m a GP with 30 years experience, and I would never prescribe diazepam in this way. It is hugely addictive. Most of the benzodiazepine/opiate addicts I have as patients were people who were given them in an acute situation (injury, upset etc), and then couldn’t get off them.

Some people with long-standing mental health conditions take a low dose daily, but they are the minority. The standard way of prescribing for cases of acute trauma is a small number, a week or two at most, with advice to only take if really needed.

Will she listen to you? If so, I would be strongly encouraging her to try and reduce her usage, and keep to in reserve for when she feels overwhelmed by anxiety.

15mg three times a day seems quite high. Are you sure it's not 5 mg three times a day? How many is she getting in the prescription?

Our GPs sometimes, reluctantly, prescribe diazepam but weeks down the line the patients are still getting them. If I see a prescription dosage "for short term use only" and scripts are still being authorised for example 3 months later, I do bring it to the GPs attention. The patient then sometimes goes on a reduction programme but as they are already addicted it's not positively received. They sometimes go back to the GP because they are not coping with the lower doses and they up it again and the withdrawal programme is abandoned.

You are right to be concerned for your friend.

That is a massive dose to give to someone!!

She is going to have serious problems stopping taking them and I think the dr is rather negligent prescribing that dose and also extending her prescription.
That is not something that would happen at the go surgery I work in.

Not everyone gets addicted to them. I was prescribed Diazapam during a particularly difficult period of anxiety. I came off them myself with no problems, and my GP was happy for me to take it as and when needed up to the max daily dose I had been prescribed. We need to stop treating people like children when it come to benzos and pain medication.

By all means keep an eye on your friend, but I am sure her own GP knows best in this situation.

I think you are right to be concerned. It’s a big dose and tolerance to diazepam increases very quickly. I have it in my arsenal of meds for back pain but ration my use stringently because if I take it too often (5mg) it ceases to help very quickly.

If you are with her a lot I don’t think there’s any harm in gently mentioning that she is very woozy and could maybe try a slightly lower dose.

It's a huge dose and doesn't help the grief. I'm also GP with 30 years under the belt.
If she's dopey on that dose it's too much.

Are you sure it's not 5mg tds? So 15mg over the day? 15mg tds is a massive amount

My mum has been on 10mg for years since a death in the family. I do think she must be a bit addicted because she gets defensive and angry whenever they suggest prescribing less. She relies on them to cope now.