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.

Interesting responses but I'm still wondering about the difference in attitudes between doctors in the States and here in Europe. Why does it seem so much easier to get drugs of any kind there than it is here?

Take ADHD meds for example. Many doctors here don't believe it even exists in kids and getting a diagnosis and meds as an adult is nearly impossible. There are plenty of stories of Americans going to a physician without any childhood diagnosis and getting prescribed.

Is it simply money making or perhaps taking pills is less stigmatized?

Sorry to derail the thread, and admittedly I haven’t RTFT, but would you be able to tell me more about this enzyme please? Tramadol and liquid morphine have absolutely no effect on me, so I don’t take any painkillers. ( it’s not because I am “hard as nails” and I do NOT have a high pain tolerance, it’s just that nothing works). I’d be really interested to know more about why they have no effect on me.

You don't need vicodin for a wisdom tooth extraction, I think sometimes dental pain is more psychosomatic (I don't mean toothaches I'm talking about tooth extraction, root canal etc). I had a root canal and tooth extraction during pregnancy and only had paracetamol and was absolutely fine, I think some people let their fear of the dentist get ahead of them.

But I do actually agree about certainly benzos anyway. It would be nigh on impossible to get them in my surgery. It's so easy to get them on the street now aswell.

Is it simply money making or perhaps taking pills is less stigmatized?

money. Have you seen ads in the us for medicines? Direct to consumer advertising “ask you doctor about x”.

plus dr’s are private. Don’t prescribe what customer wants, customer goes elsewhere.

it’s one big downside about private medicine, the more they do, whether thats investigations, prescribing, treating, the more they get paid.

Well, it is and it isn’t.

In recent years, a numbers of states have introduced new laws restricting the prescription of opiates by doctors.

As a result, you may be referred to a pain specialist to deal with long term pain. The doctor who previously prescribed them for is no longer legally able to do so. If a doctor (non-pain specialist) is able to prescribe them, you may be limited to a three day supply unless you have, for example, terminal cancer.

As I said, these are recent changes brought in as a result of the opioid crisis. It was practically wall to wall coverage on the news about 4 years ago in the US.

However, marketing continues. On TV and in magazines, there are advertisements for drugs. Not generics. Actual name brand drugs. And advertising is a little different in that they can name their competitors and do direct comparisons. For example, ‘buy Advil instead of Nurofen because our trials show it relieves pain 5 minutes faster with fewer side effects!’

Marketing is effective. That is why people go to their doctor and say ‘I want a prescription for SuperDrugOfTheDay’. The doctor has a choice. Prescribe it or risk losing the patient (and their money) to a doctor who will. Not all doctors have the skill to gently explain that a) don’t believe all the marketing hype, b) a different and more reliable set of trials not sponsored by the pharmaceutical company show it is less effective or has more side effects, c) they get benefits from the pharmaceutical companies ranging from stress balls and pens to fancy dinners out or even trips to ‘conferences’ in luxury resorts to fulfil their CPD hours and learn about the latest Drug Du Jour.

Americans get diagnosed more because their insurance only pays when they're diagnosed with something. In england we still try not to put diagnoses on children and YP - BPD is a perfect example of this. If you get diagnosed with BPD you're more likely to act like you've got it, if you don't get diagnosed you are more likely to grow out of it (most people do in their 30s, it's normally a trauma response and we keep medicalising trauma responses and giving them names like BPD partly because of the way the US is).

ADHD medication isn't great. It takes a toll on your heart. It's basically speed! Also, I don't mean this horribly at all, in my job (SW) we see lots of YP diagnosed with ADHD and autism and they don't have it, they have trauma responses. Sometimes trauma can manifest into ADHD symptoms and C-PTSD overlaps a lot with autism traits. From what I can gather in up to date training and in my work we're moving away from diagnosing as it leads to the self fulling prophecy.

I had dry socket following a wisdom tooth extraction, worst pain of my life but no way would I touch opioids. My dd has Valium, it is prescribed in the U.K. where clinically appropriate, this doesn't include taking aeroplanes which are optional leisure activities for 99% of people and there's always an alternative

@motogirl I had dry socket too! Absolute killer! The numbing package they filled it with helped immensely as did that numbing liquid you can buy in a chemist. Painkillers didn't touch it and I was on a shit load of pain killers from my sciatica at the time.

You don't need vicodin for a wisdom tooth extraction, I think sometimes dental pain is more psychosomatic (I don't mean toothaches I'm talking about tooth extraction, root canal etc). I had a root canal and tooth extraction during pregnancy and only had paracetamol and was absolutely fine, I think some people let their fear of the dentist get ahead of them.

You can only talk about your own experience of pain. You may have a high tolerance of pain, when others have a different brain structure and a low tolerance of pain. I have red hair; it’s widely recognised they need 20% more anaesthetic to sedate them and more local anaesthetic. Our experience of pain is different from other people’s, due to our genes!

I have vomited at the dentist’s when the pain from the drill hit me, and that was after the injection. After that I assumed the point of injections was just to take the edge off the pain, so patients didn’t vomit during a filling. I was absolutely astonished to hear a colleague talk about how he hadn’t felt a thing after the injection for a filling! I have not had that pain free experience.

Likewise, I had to tell a consultant anaesthetist that I could feel everything during the general anaesthetic for a procedure done regularly, and it was excruciating! I wanted more next time!

PS - I was eleven, when I vomited at the dentists. It hadn’t occurred to me to be frightened of them, until that experience!