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.

Erm, I very much doubt that @BlanketsBanned paracetamol isn't physically addictive. To anyone.

Opioids are strictly controlled for a very good reason. As well as being horribly addictive, they are also unsuitable for longer-term use as your body gets tolerant to them and will require an ever-increasing dose to get the same effect. They shouldn't be used daily. There was a problem in the past where pain patients were taking them every day, growing tolerant to them, and requiring them more often in greater doses - doctors have quite rightly been told that it isn't kind or helpful to the patient to keep prescribing them ad infinitum.

Some people get addicted very quickly, in a few days - it's a huge risk. I personally avoid opioids, even after major surgery, because I have an addictive personality so am extra cautious.

I think for most wisdom teeth pain is dealt with by OTC painkillers. If you went to the chemist, speak to a pharmacist and say you have toothache or you've had your wisdom teeth out you'll get a nice big box of co-codamol, paracodol, solphadeine etc. I was given a box of soluble paracodol from the hospital when I had made wisdom teeth out and pretty much only needed them for one day.

Dentists are not licensed to prescribe opiods on the NHS

Have you tried promethazine which is available over the counter (at a pharmacy)?

When I had a hip replacement, I was given oromorph. I told the staff that it doesn't work for me and that dihydrocodeine and/or IV paracetamol would be much more effective. I had to BEG for something other than oromorph!! I had to get the ward sister involved as they just kept offering oromorph.

I said they can be psychologically addictive

@BlanketsBanned but so can literally anything. You can get psychologically addicted to winegums.

I have spent my whole working life working with people addicted to opiates.
I would say about 30% of these were not your stereotypical street heroin users but people who became addicted, very quickly and unexpectedly, to prescribed opiate based medication.
It ruins lives ... it breaks up families and destroys childhoods.
This is why UK GPs are reluctant to prescribe them for pain that can be managed in other, less dangerous ways.

Whats the answer then, how should we manage acute short term pain.

I'd suggest a combo of OTC pain meds and good old-fashioned getting on with it, for short term pain.

From the point of view of somebody who had a mother generally either off her tits or in screaming, raging withdrawals from painkillers, tranquillisers, antidepressants, muscle relaxants and everything else she demanded for pain that rarely affected her ability to punch me in the head or stamp on my bare feet - it's far better this way.

They're not that strict in my part of the EU (or its just because I can't take NSAIDs so they resort to opioids for me?), they are always happy to prescribe tramadol for some reason (except one doctor, who refused over the phone after I had to call because the electronic prescription system was down the night before when I was in A&E, and said young people just need to cope with pain...), and benzos when my insomnia was bad, last time I went to the doctor about insomnia he just asked me what I wanted him to prescribe.
On the flip side they're really stingy with anaesthetics, no sedation for cystoscopies, colonoscopies, gastroscopies (even when they say they'll sedate me they don't give enough meds to even take the edge off). My daughter got a filling without even local anaesthetic/gum numbing at all!

@BlanketsBanned I've been in substance misuse for over 10 years. I've seen hurrendous things from opiate addiction but nothing from paracetamol addiction. Is that even a thing?

The way the NHS currently deals with it seems pretty good. Opiates are available, but are used very sparingly.

I recently had opioids for the first time ever - liquid morphine after a c section.

My god that stuff is good and I 100% can see how that stuff is addictive. But some ladies in another hospital were given nothing and told to take OTC paracetamol and ibuprofen - that IMO is barbaric.

There’s a balance and I think we can be too stingy in this country.

I was given paracetamol for my second ceasarean. No morphine drip that time. It was a joke. Eventually i was given 2 codine to make me sleep.

Fuck me 😂😭

Precisely. There are a lot of clients in community drug services who've become addicted to prescribed medication.

Empire of pain is a good read…

Years ago, it starts with Valium and then is mostly about OxyContin. There are good reasons strong opioids like Vicodin aren’t prescribed all over the shop now.

For whom are benzos and opiates prescribed then? Is it end of life care only.

I didn’t have a morphine drip after my section either. I wasn’t prescribed any painkillers.

I get horrific migraines every month with my period and I have always taken the lowest grade/dose of pain meds. I usually start with paracetamol and aspirin (don't get on well with ibroufan) if that doesn't work I swap the paracetamol with over the counter cocodamol(along with migraine meds) this will deal with 9 out of 10 migraines but for that 1 in 10 I have to use prescription cocodamol and have never had issues with getting my Dr to prescribe 1 strip of them (rarely use the strip in 1 migraine) because they know that it's always a last resort for me. I would guess that when dts know their patients they tend to know who is going to want the highest level of pain relief without trying anything else 1st and those who treat it as a last resort but as many drs don't really know their patients they assume that everyone is basically drug seeking rather than try over the counter meds (which is fairly reasonable as they are dangerously addictive)

I was given everything in 2017
Diazepam, oramorph, dihydrocodeine, naproxen and paracetamol for months

Still on dihydrocodiene daily

This is how the pain ladder works. You can’t just go straight in with something that may actually not be needed. Two people with the same pain trigger will likely require completely different pain relief to the other.

When I went home that is.

i got paracetamol in the hospital.