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Great find Angel  :thumbsup:

 

What2do I have a feeling I know which response was yours.  :D

 

Here was my email to this GP:

 

Dear Jobbing Doctor,

 

I will gladly come to your surgery and meet with the two patients you mentioned if you come visit the hundreds of online Benzodiazepine support groups filled with thousands of "Iatrogenic Benzodiazepine Addicts."  I assure you that these people who were told to stay on Benzodiazepines for an extended period of time would love to explain their stories.  By extended period of time, I am referring to a period longer then the 2 to 4 week that most experts on this class of medications have recommended. 

 

"Long term use of benzodiazepines carries an undisputed risk  of  inducing dependence.  Approximately  35% of patients taking benzodiazepines for more than four weeks develop dependence as evidenced by the appearance o f withdrawal symptoms if dosage is reduced or the drugs are stopped."1

 

"Together with the risks of rebound and withdrawal, the risk-benefit ratio for the benzodiazepines becomes adverse beyond about two weeks of continuous administration ." 2

 

And whom do you think told these patients to stay on them for a recklessly long period of time?  Why their GPs of course.  These people are not sitting in marble halls.  They sit in their homes.  Many cannot leave them.  Most have lost everything of value or meaning in their lives.  Their families, their spouses, their occupations, their finances, and lastly their faith in their GPs and the medical community as a whole.  Why are they going through all this?  They are suffering from Protracted Withdrawal Syndrome. PWS.  I, myself, am one of them.  Being a well informed GP, I am sure you know of this condition.  If not, here are some quotes to put it in perspective: 

 

 

"The benzodiozepine withdrawal syndrome is much longer than that of any other drug of dependence." 3

 

"In an attempt to establish whether prolonged withdrawal symptoms after stopping intake o f benzodiazepines is caused by return o f anxiety, hysteria, abnormal illness behaviour or the dependence process itself producing perhaps a prolonged neurotransmitter imbalance, a group of such patients suffering prolonged withdrawal symptoms (PWS) was compared on a range of psych ophysiological measures with matched groups o f anxious and conversion hysteria patients and normal controls. It was found that the psychophysiological markers of anxiety were not marked in

 

the PWS group; nor were the averaged evoked response abnormalities found to be associated with cases of hysterical conversion in evidence. The PWS group were hard to distinguish from normal controls on the basis o f psych ophysiological measures and thus it was felt to be unlikely to be an affective disturbance. It was concluded that PWS is likely to be a genuine iatrogenic condition, a complication of long-term benzodiazepine treatment."4

 

Doctor, in your country, you have an estimated 1.5 million people addicted to benzodiazepines.  Here in the United States we have similar numbers.  That is quite a substantial portion of your population.  Do you honestly believe that 1.5 million people deservedly needed to be on a benzodiazepine for an extended period?  Last year there were over 100 million prescriptions written for Benzodiazepines in the US.  Do you know how many were written in the UK?  Do you understand that you will eventually, as a GP, be dealing with the effects of this over-prescribing?  Have you any idea the cost to your treasury? 

 

While it is understood that Benzodiazepines do help a large number of significantly ill patients, the majority of the members of these support groups do not fall into that category.  They were prescribed these medications for situational trauma, temporary anxiety, relief from muscle pain, and other conditions which due not warrant an extended treatment with this class of drug. 

 

I am sorry you were offended by the BBC Radio 4 piece.  Perhaps they did a poor job in explaining this immense problem.  I recommend reading the works of Professor Heather Ashton for a better explanation.  I assure you her intentions are not to offend as she has dedicated her career to helping those like myself.  You are more then welcome to come read the success stories of those that followed her protocol in withdrawing themselves from Benzodiazepines. 

 

 

Regards,

Christopher

 

 

 

1. Professor Heather Ashton, DM, Clinical Psychopharmacology Unit, Department

 

of Psychiatry, Royal Victoria Infirmary, Newcastle upon Tyne, England.

 

"Guidelines for the Rational Use of benzodiazepines: When and What to Use."

 

Review Article from: Drugs 48 (I):25-40, 1994:

 

 

 

 

2. Lader, M., "Withdrawal Reactions After Stopping Hypnotics In Patients With

 

Insomnia," CNS Drugs, 1988, 10, 425-40:

 

 

 

 

3. Ashton, H., `Benzodiazepine Withdrawal: An Unfinished Story.' British Medical

 

journal, 1984, 288, 1135-40:

 

 

 

4.

 

A. Higgitt, P. Fonagy, B. Toone, P. Shine, `The Prolonged Benzodiazepine

 

Withdrawal Syndrome: Anxiety or Hysteria' St Charles Hospital, London,

 

United Kingdom, Source: Acta Psychiatra Scandinavia, 82(2):165-8 1990 Aug:

 

 

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I received a response from this doctor.  I will post it after I make a few comments first.

 

It's getting more and more clear that in order to solve this problem we need doctors more on our side then we need them against us.  It's only with wide spread cooperation that such a large issue can be tackled.  It takes quite a bit of patience on all sides.  That said, the enemy has never been more clear.  It is in fact the drug companies and their relentless PR campaigns.  This is a difficult beast to fight since it is two sided.  On the one hand,  the industry does produce medication that has proven to heal what in the past were deemed as terminal illnesses.  But on the other we see a more sinister side pushing for people to take expensive pills for something like Restless Leg Syndrome.  I am not  undermining the suffering of those who have this condition but is it really worth the risk of taking something so highly destructive?  Is there not an alternative way of coping?  The one that bothers me the most is the Abilify campaign.  If your AD is not working well enough, add this one to it.  By compounding pills you compound profits.  Does this not then discredit the entire range of ADs?  And if you listen to the lawyer talk at the end of the commercial, its quite disturbing.

 

Getting back to benzos, there is quite a lot of anger in general about the current state of things.  Most of it warranted.  One thing I can understand is that just as we get upset when an article or news piece discredits us, so do doctors especially GPs who are relatively innocent.  Remember, not all GPs prescribe these things.   

 

Here is this GPs take on things.  I won't post any more of our correspondence unless something of important significance results. 

 

Christopher

 

 

Dear Christopher,

 

 

Thank you for the detailed and informative e-mail, that I read with great interest.

 

 

I wrestle with this problem all the time, and it is as difficult to get people off these drugs as opiates or alcohol. To understand the perspective I see, it is important to look at the history. Benzodiazepines were introduced in the late 1960s as a viable alternative to barbiturates, and ruthlessly marketed as such by firms like Hoffmann La Roche. I remember well the outrageous advertising for Nobrium, as I wrote a project on it that resulted in me getting a distinction at MB ChB.

 

 

The problems with benzodiazpines became more evident for ordinary doctors as time marched on, and these "wonder drugs" started to have problems. Barbara Gordon's book 'I'm dancing as fast as I can' (which I bought and read) was an early pointer to the problems.

 

 

It is now extremely rare for anyone to be put on benzodiazepines in primary care. The last one I remember doing was in about 1985, and he is still on them (although his crushing anxiety is partly controlled) despite many many patient hours trying to stop this treatment. Most of the patients I see on high doses of Benzodiazpines have had them started elsewhere, or as a recreational drug (freely available with a modest street price). I devote a considerable amount of my time to a small client group of around 12 people who are addicted; they come to me because I have a reputation for being very patient and non-judgemental [not sure how much this is merited], and my results over the last few years is - at best - patchy.

 

 

My efforts are not helped by ill-informed and judgemental pontifications by others (particularly in papers like the Daily Mail), and I was pleased to get your measured and well-informed e-mail.

 

 

It will certainly encourage me to continue with my efforts with this unfortunate group of patients who are dependent on these drugs.

 

 

Yours with thanks,

 

 

Jobbing Doctor.

 

 

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The fact that you got a response is amazing.  I remember 'I'm dancing as fast as I can' as I read it as a movie script when I worked for a large film company years ago. It was about a woman hooked on valium - it was horrifying and made a lasting impression.

 

I know my own GP is checking out BB site - I think doctors are in quite a difficult position because as you say benzodiazapines do have their uses. 

 

I don't know if attitudes of US doctors are different to those in the UK but I guess you can't generalise.

 

So happy you wrote that excellent email and got a reply though.

 

Angel

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Thank you Angel.  I believe it to be of great importance that a level of dialog be established between the medical community and those of us suffering through this.  Many on this site do not have access to an understanding doctor.  As if the anxiety of these medications is not enough, they have to deal with the anxiety of threats of being cutoff and other harsh treatment.  I have gone through much of this myself in twelve years.  I will continue to persue this and hope others will join. 

 

Christopher

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Yes I've noticed the medical system in the US is pretty harsh and dependent on whether you can afford insurance or not.

 

We are so lucky in the UK with our National Health Service where everyone can see a doctor.

 

Wishing you some relief from your symptoms.

 

Angel

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The one that bothers me the most is the Abilify campaign.  If your AD is not working well enough, add this one to it.  By compounding pills you compound profits.  Does this not then discredit the entire range of ADs?  And if you listen to the lawyer talk at the end of the commercial, its quite disturbing.

 

Back when I first started on AD's my doctor told me that often they have to try many different drugs, doses, combinations, etc to find something that works for the individual patient. I remember thinking to myself that it sounds like NOBODY really knows what the hell they are doing when it comes to treating anxiety and depression. Throw one drug at it, if it doesn't work up the dose. Side effects too strong? Add another or change to something else. It struck me as odd that this was the way they practice their "science".

 

And on top of that, these drugs were making me wake in the middle of the might drenched with sweat, making sex all but a waste of time, and giving me brain zaps that felt like someone was slapping my the top of my head as hard as they could out of the blue. All that screwing with my brain to try to be more at ease in social situations. Man, was I naive.

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The one that bothers me the most is the Abilify campaign.  If your AD is not working well enough, add this one to it.  By compounding pills you compound profits.  Does this not then discredit the entire range of ADs?  And if you listen to the lawyer talk at the end of the commercial, its quite disturbing.

 

Back when I first started on AD's my doctor told me that often they have to try many different drugs, doses, combinations, etc to find something that works for the individual patient. I remember thinking to myself that it sounds like NOBODY really knows what the hell they are doing when it comes to treating anxiety and depression. Throw one drug at it, if it doesn't work up the dose. Side effects too strong? Add another or change to something else. It struck me as odd that this was the way they practice their "science".

 

And on top of that, these drugs were making me wake in the middle of the might drenched with sweat, making sex all but a waste of time, and giving me brain zaps that felt like someone was slapping my the top of my head as hard as they could out of the blue. All that screwing with my brain to try to be more at ease in social situations. Man, was I naive.

 

Florida Guy this is such a good description of the random dart throwing of prescribing.  I wish I could spend more time on the issue of ADs since I've been on most of them during my 12 years but I want to focus on the task at hand.  I want answers to the benzo problem.  I want to know why someone just got a script in the last 30 seconds for something that can destroy their lives. 

 

Christopher

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Florida Guy this is such a good description of the random dart throwing of prescribing.  I wish I could spend more time on the issue of ADs since I've been on most of them during my 12 years but I want to focus on the task at hand.  I want answers to the benzo problem.  I want to know why someone just got a script in the last 30 seconds for something that can destroy their lives. 

 

Christopher

 

Although I wouldn't recommend anyone mess with AD's unless they are in serious need of something to protect their safety or the safety of others, antidepressants aren't even in the same universe as benzos when it comes to having the potential to ruin your life. For me the side effects were identical coming off the drug as they were going on, and they lasted the same period of time- 2-3 weeks. Then it was back to business as usual. The benzo reduced my quality of life substantially for a total of more than 3 years, and completely stole my life from me and made it a living hell for several months.

 

Benzos are the real deal.

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XII,

 

You never cease to amaze me.  That was an amazing letter.  If I were as eloquent as you, perhaps I could express how impressed I am by you.    I was also very surprised that you received the response.  Based on his initial blog/article and his defense of Claire (can't find her last name) I would never have expected not only a response but one where he actually listened and heard what you were saying.  You are a true warrior! Thank you for your continued pursuit.

 

WWWI

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Thank you Wise for you kind remarks.  Changing one doctor's disposition is not enough.  We have to change to culture of their prescribing patterns.  We have to stop their immediate inclination to disperse pills as the primary form of treatment.  Words are easy.  It's action that produces results.

 

Christopher

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The one that bothers me the most is the Abilify campaign.  If your AD is not working well enough, add this one to it.  By compounding pills you compound profits.  Does this not then discredit the entire range of ADs?  And if you listen to the lawyer talk at the end of the commercial, its quite disturbing.

 

Back when I first started on AD's my doctor told me that often they have to try many different drugs, doses, combinations, etc to find something that works for the individual patient. I remember thinking to myself that it sounds like NOBODY really knows what the hell they are doing when it comes to treating anxiety and depression. Throw one drug at it, if it doesn't work up the dose. Side effects too strong? Add another or change to something else. It struck me as odd that this was the way they practice their "science".

 

And on top of that, these drugs were making me wake in the middle of the might drenched with sweat, making sex all but a waste of time, and giving me brain zaps that felt like someone was slapping my the top of my head as hard as they could out of the blue. All that screwing with my brain to try to be more at ease in social situations. Man, was I naive.

 

I agree that the AD issue is disturbing (although not as upsetting as the benzo issue). I've struggled with depression for many years and have found your statement to be true in terms of how psychiatrists treat depression, but I tend not to fault psychiatrists for that. I think brain chemistry response is vary variable for ADs as is efficacy, and different forms of depression require different types of treatment. One type of drug that works for one patient isn't going to be right for another patient. Throwing benzos at the AD side effect problem is NOT a solution, but seems to happen too often with psychiatrists that maybe aren't willing to dig deep enough to find the right medication that truly treats depression.

 

I think adverts for ADs and supplemental ads should be banned, as they just encourage you to "talk to your doctor" about getting on some new medication that is likely just to mess up your system even more. I don't know how the psychiatric system could be better changed, but certainly informed patients educating their doctors on what they are willing to try and not try is a first step. Unfortunately, I've had so many experiences where the "doctor" knows better than the patient, and, probably like you, I end up on a cocktail of strange medicines that help some things, worsen others, and cause entirely new symtoms to appear.

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Thank you Wise for you kind remarks.  Changing one doctor's disposition is not enough.  We have to change to culture of their prescribing patterns.  We have to stop their immediate inclination to disperse pills as the primary form of treatment.  Words are easy.  It's action that produces results.

Christopher

My belief is that the immediate inclination to disperse meds is in good part to do with re-imbursement by the insurance companies.  GP's are limited in both time and scope as determined by the insurance companies.  If there really is to be any change, the insurance companies should not only be held accountable, in a perfect world they would be required to run not for profit.

 

Currently they can charge patients and reimburse MD's what they want with limited restriction.  And as with any corporation, money is the bottom line.  So if insurance companies can charge patients a "premium" premium and reimburse MD's at the most minimal rate while requiring unteniable coding systems and inaccessible pricing structures for comparison with no oversight, you, as the insurance company maximize your profits.

 

As the insurance companies are charging us more and the GP's are receiving less, as a GP, pushing a pill is a lot easier and faster than actually takng the time to figure out whats really happening.  Simple math, the more people they see the more money they are reimbursed.

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Thank you Wise for you kind remarks.  Changing one doctor's disposition is not enough.  We have to change to culture of their prescribing patterns.  We have to stop their immediate inclination to disperse pills as the primary form of treatment.  Words are easy.  It's action that produces results.

Christopher

My belief is that the immediate inclination to disperse meds is in good part to do with re-imbursement by the insurance companies.  GP's are limited in both time and scope as determined by the insurance companies.  If there really is to be any change, the insurance companies should not only be held accountable, in a perfect world they would be required to run not for profit or at the very least there should be a panel, group, whatever that has the barganing power to cap their profits and insure that the costs for all meds, procedures etc, follow a standard and that that information is public.

 

Currently they can charge patients and reimburse MD's what they want with limited restriction.  And as with any corporation, money is the bottom line.  So if insurance companies can charge patients a "premium" premium and reimburse MD's at the most minimal rate while requiring unteniable coding systems and inaccessible pricing structures for comparison with no oversight, you, as the insurance company maximize your profits.

 

As the insurance companies are charging us more and the GP's are receiving less, as a GP, pushing a pill is a lot easier and faster than actually takng the time to figure out whats really happening.  Simple math, the more people they see the more money they are reimbursed.

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Thank you Wise for you kind remarks.  Changing one doctor's disposition is not enough.  We have to change to culture of their prescribing patterns.  We have to stop their immediate inclination to disperse pills as the primary form of treatment.  Words are easy.  It's action that produces results.

Christopher

My belief is that the immediate inclination to disperse meds is in good part to do with re-imbursement by the insurance companies.  GP's are limited in both time and scope as determined by the insurance companies.  If there really is to be any change, the insurance companies should not only be held accountable, in a perfect world they would be required to run not for profit.

 

Currently they can charge patients and reimburse MD's what they want with limited restriction.  And as with any corporation, money is the bottom line.  So if insurance companies can charge patients a "premium" premium and reimburse MD's at the most minimal rate while requiring unteniable coding systems and inaccessible pricing structures for comparison with no oversight, you, as the insurance company maximize your profits.

 

As the insurance companies are charging us more and the GP's are receiving less, as a GP, pushing a pill is a lot easier and faster than actually takng the time to figure out whats really happening.  Simple math, the more people they see the more money they are reimbursed.

 

You make some excellent points. With health plans structured the way they are today, a lot of people have limited mental health coverage and may go to a GP for issues related to anxiety and depression. With limited time and resources, its easier to write a script, especially for a med that's been heavily marketed by pharma reps that make continuous calls to advertise their latest and greatest, than to get to the root of the problem. GPs don't always know how best to treat complex issues related to anxiety and depression. Even with mental health coverage, psychiatrists know how to use their prescription pads very well and sometimes do good work. But with the health care system being what it is, things like talk therapy, CBT, etc., which are lengthy and costly to insurance companies, but are often more effective than drugs, get shoved by the wayside, because it's faster and easier to write an Rx.

 

After seeing a horrid psychiatrist, who kept putting me on various meds and changing the dosages every few weeks, I eventually stopped taking everything c/t and then, surprise, felt suicidal. I was hospitalized for safety precautions for a week to be re-stabilized on another AD, but my health insurance company refused to provide any further outpatient treatment to get to the root of the problems that were causing my depression and suicidal thoughts. The hospital sent me home with a bottle of 90 Klonopin tablets for "anxiety," which I subsequently used to OD in a suicide attempt. My family had to pay out-of-pocket (not cheap) for me to go to a treatment facility specializing in intense therapy, etc. so I could begin to recover. But the doctors and health insurance company absolved themselves in working on effective treatment strategies that weren't just 10-minute appointments involving throwing drugs at me.

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An added incentive to this cycle is that once your doctor has given you a generalized diagnosis followed by an AD, you now have a preexisting condition.  Should you lose your insurance or abandon it,  you will find it hard and or really expensive to replace it.  Insurance companies do not want us on these pills.  Or at least they don't want to insure us on them.  The risk reward is not in their favor.  They would be better served to increase incentives to doctors to say, " There is nothing wrong with you.  You are simply going through a stressful period and you need to manage your anxiety/ depression better. In time, it will pass.  No pill I can give you will make these problems go  away.  You have to find a way to make them go a way yourself.  Now go home."  Anyone ever been told this by a psychiatrist?

 

Christopher

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An added incentive to this cycle is that once your doctor has given you a generalized diagnosis followed by an AD, you now have a preexisting condition.  Should you lose your insurance or abandon it,  you will find it hard and or really expensive to replace it.  Insurance companies do not want us on these pills.  Or at least they don't want to insure us on them.  The risk reward is not in their favor.  They would be better served to increase incentives to doctors to say, " There is nothing wrong with you.  You are simply going through a stressful period and you need to manage your anxiety/ depression better. In time, it will pass.  No pill I can give you will make these problems go  away.  You have to find a way to make them go a way yourself.  Now go home."   Anyone ever been told this by a psychiatrist?

Christopher

My ex-p-doc I used to pay in cash because I didn't want my insurance tracking me as having a pre-existing condition.  My doctor was only more than happy to have me come in monthly for $110 and suggested that perhaps twice a month would not be a bad idea.

 

Fast forward to my new p-doc who I've seen for 4 months.  Since I'm a lot poorer as a result of my benzo adventure, I decided to let insurance pay.  So I provide a minimum copay and they determine the balance that she gets.  Last month, she suggested that perhaps since things were going so well, did I really think I needed to come see her? And if not, she'd be happy to call in whatever dose I need for the taper.  I just needed to give her a call if I need meds or there is a problem.  Initially I thought perhaps she had such confidence in me and my tapering that she was doing the ethical thing by not wasting my money.  I then got a notice from my insurance co that said the compensation for her was only an additional $35 dollars.  Makes a person wonder...

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An added incentive to this cycle is that once your doctor has given you a generalized diagnosis followed by an AD, you now have a preexisting condition.  Should you lose your insurance or abandon it,  you will find it hard and or really expensive to replace it.  Insurance companies do not want us on these pills.  Or at least they don't want to insure us on them.  The risk reward is not in their favor.  They would be better served to increase incentives to doctors to say, " There is nothing wrong with you.  You are simply going through a stressful period and you need to manage your anxiety/ depression better. In time, it will pass.  No pill I can give you will make these problems go  away.  You have to find a way to make them go a way yourself.  Now go home."   Anyone ever been told this by a psychiatrist?

 

Christopher

 

This happened to me, not with insurance, but with attempting to obtain long-term disability coverage through my employer. I didn't want to lie on the application, so I did check the little boxes (depression & anxiety). The disability coverage was denied based on those conditions, and then when I had to take a leave of absence b/c of severe depression, I had no coverage for lost income.

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I had it happen to me as well.  At an oh so convenient time as well.  I had moved across country and applied for new health insurance.  It was granted to me.  I didn't tell my insurance company when I applied that I had any conditions.  My first trip, with the new insurance, was to a new PCP.  I told my new doctor what I had been on.  She put it in her notes.  I didn't ask her to continue my prescriptions.  Just did a full disclosure.  I was recommended to a pdoc who continued my Rx's.  In the three months that followed I broke an arm, had a small surgery, and had a sleep test done.  Realizing how expensive these were, the insurance company requested all medical records from my doctors.  The only one who responded was my PCP with a paragraph regarding my  condition.  They labeled it as a preexisting condition, rescinded my policy, and I was responsible for the medical bills.  Total cost? about 12 grand.  Borrowed from a recent movie, my new policy towards doctors is to treat them like mushrooms.  Feed em s*** and keep em in the dark.

 

Christopher

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