To think that doctors in the UK/EU are stigny with benzos/opioids?

[janef001]

I understand how addictive these drugs can be but I think the pendulum is swung too far on the other side. I know a woman who had to have a painful root canal and wisdom tooth extraction. She wasn't given any strong post-operative painkillers but instead told to take panadol . OTC Codeine and tramadol never worked for her as she was deficient in the liver enzyme that metabolises them. She ended up having to get a friend from America bring her Vicodin.

I've heard the same things with benzos. Many GP's and psychiatrists just refuse to hand them out and instead put patients on SSRI after SSRI even when they say that they don't work.

There are massive social and medical problems in the US with people “addicted to painkillers” (the ones you’re describing amongst others), OP, caused by too lax prescribing. Doctors here are stingy for a reason and this has avoided the huge problems in the US with this.

You said that there is no reason not to give opioids other than this stoicism. That is not true, the risks of addiction are also a reason.

People seem veey worried about opiod addiction, are they so worried about paracetamol addiction which is freely available in shops and is very damaging in overdoses..

Paracetamol is not physiologically addictive, but opioids are. That’s the whole point.

Paracetamol may well be more dangerous and much easier to OD on but it’s not addictive

Have you ever met anyone addicted to paracetamol? It's not an addictive drug.

Alcohol is addictive, it doesn't mean every one drinking becomes an alcoholic. The problem is that GPs don't have the ability to really get to know their patients and monitor their medicines. There will be a review annually if lucky but indeed, by then, vulnerable people can become addicted and the management of that addiction than becomes even more demanding.

It's easier to put a band on it for all Those who can take it reasonably without addiction are easier to manage than those who become addicts.

It's not hard to buy diazapam off the street. Well it's online with online illegal 'pharmaceutical' businesses that sell weed, mushrooms, diazapam etc. If someone wants to become addicted to drugs they will be. Treating adults like they don't know better and not treating pain is a shitty stance that this country takes. Leaving me unable to work, drive, look after my dc and sink into depression because of chronic pain for months on end is shitty treatment.

Yes i have.

This is so true. I had a grown man holding, squeezing my hand and begging me through tears to please make the pain stop. Doctor said other patients cope just fine and refused more pain relief. I think his cries will haunt me forever.

There's a good reason to be stingy with them.

A balanced approach is best

Exactly. After years of working in drug intervention and offender management I am very aware of why prescription and NICE guidelines are as they are.

Well then they should be prescribed 3 days worth.

No you haven’t, it’s not addictive. Maybe you’ve met someone dependent on it for pain management, but that’s not the same.

My niece developed appendicitis while on a short trip to New York. She was discharged with a ONE MONTH supply of oxycodone.
In the UK a person having a knee replacement (very painful recovery) is typically give six doses total of oxycodone over three days.

If you read this article you will understand why my sister promptly threw the month supply of oxycodone in the bin and why I believe NHS stinginess is justified.

www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain

3 days of opioids is enough to start an addiction. Honestly, it is.

Rather that than what's happened in the US and the opioid crisis

Even short term use has been shown to fuel both addictions and overdoses; and it was the loosening of prescribing guidance combined with the influence of pharmaceutical companies that led to the current appalling situation in the USA. Avoiding short term pain is not, in my opinion, worth the risk - particularly when we see what the over-prescribing / dependence on anti-depressants has done, especially to women.

Pain management is tricky, especially chronic pain. There is lots of evidence that opiates are not the best thing for chronic pain, and certainly not benzodiazepines.

Analgesia should really be suggested via the pain ladder - starting with paracetamol and ibuprofen for example, then adding in codeine for example. Opiates are third level.

Acute pain is miserable but people seem to forget that paracetamol, taken properly and regularly, is a very effective painkiller. Patients often dismiss suggestions of paracetamol before you’ve even started talking saying they want something stronger. It’s not always about strength, it’s about giving the right analgesia at the right times and often adding in other meds too, as well as using adjuvant therapies such as heat, exercise, massage, meditation, etc. Horses for courses though, you often need a many pronged approach.

It's simple really. You feel anxious, diazepam helps so you take diazepam. After a while your body develops a tolerance (that's what addiction is), so the diazepam stops helping. So you have to take 2. Then your body develops a tolerance to that as well, so you have to take 3. And so on. Soon you're taking 10, 20, 30 a day, and it's not working any more, because you're body is tolerant to it.
Same with opiates. Have you never read any of the threads on here by women addicted to codeine? Invariably it started with a prescription for some kind of pain, and now they're left spending all day going from chemist to chemist buying codeine products, just to function.
Do you think we should go back to the 60s when women were give Valium like smarties?

I have to buy diazepam from " other" sources so that i can get on a plane! Drs point blank refuse to prescribe me any for flying, saying it's dangerous and could make me unable to exit the plane in an emergency. This is despite me explaining that 5-10mg does not make me sleepy or drowsy, in fact it has no effect other than to calm the sheer sense of hysteria I feel when flying. They are quite happy however to prescribe co codamol by the hundred for mild arthritis!!!! I don't take those any longer because I could feel myself becoming addicted.

Paracetomol can be psychologically addictive and cause withdrawal symptoms. For all those saying they wouldnt prescribe short term opiods or benzo for short term acute pain or anxiety what would they prescribe.

I think it's one of the amazing and wonderful things about our NHS that we haven't gone down the US route with Opiods. It's horrific how easy it is to ge addictive drugs over there.

People are being massively naive about the situation in America. I’m glad we have such strict controls.

Saying that we need to improve our pain management approach and provide access to proper chronic long term pain management clinics.

We need to improve the availability of therapies to help with the anxiety. It’s a shit situation here for people with chronic anxiety. Or short term specific anxiety.