Author Topic: Over 60 years old and over 30years of use  (Read 3901 times)

[Buddie]

Re: Over 60 years old and over 30years of use
« Reply #60 on: February 03, 2022, 01:00:40 am »
Hi Gang, hope everyone is doing okay where you are in this process. 

My Dr. has been good about prescribing and my micro taper but it's clear that she doesn't understand it. She's young and smart so I had no concerns about her leaving...and suddenly she did.  I got an email on Tuesday that Monday was her last day! Shocking.  Luckily, I had built an adequate stockpile as I tapered so I will be fine and have enough supply to completely taper off.  It is alarming though and something we should all be thinking about.

As I read these stories, I realize how untrustworthy Drs and their NP's are.

I first saw a Dr for years, he got really busy and said an NP would see us.
I saw her for 7 yrs and she was just so chit chatty and nice knowing all along she was quitting....
I came in one day and had a new NP and she said she wouldn't prescribe Xanax.
I told her I was scared and could I go slow?
She was really nasty and said no, I was on a low dose (3 mg) and I'd be fine.

I had 3 wks to stop 3 mg a day. C/t it was brutal.

So yes, ppl should quit slowly on their own.
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Over 60 years old and over 30years of use
« Reply #61 on: February 03, 2022, 03:01:21 pm »

I first saw a Dr for years, he got really busy and said an NP would see us.
I saw her for 7 yrs and she was just so chit chatty and nice knowing all along she was quitting....
I came in one day and had a new NP and she said she wouldn't prescribe Xanax.
I told her I was scared and could I go slow?
She was really nasty and said no, I was on a low dose (3 mg) and I'd be fine.

I had 3 wks to stop 3 mg a day. C/t it was brutal.

I'm so sorry that this happened to you.  I cannot imagine how scary and awful that was for you.  It's so odd to me that the Dr's do not understand how bad the withdrawal of benzodiazepines can be.  Glad that you are okay. 
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Over 60 years old and over 30years of use
« Reply #62 on: February 03, 2022, 03:52:42 pm »
Oh my gosh..I am so sorry this happened to you. Doctors are seeing 30-40 patients a day. They don't keep up on literature, they don't dig into benzo withdrawal, period.  I think what we all have to come to terms with is to not hold onto the hope that any dr will help us slow taper off, especially if your long term prescriber leaves. The problem in my opinion is I didn't even think I had an issue after 35 years on Ativan. Same prescribing dr...never said a word except in passing a few times like"hey,you might think about not taking Ativan every night" And then on to the 6 month script. I would love to hear how all of us long time users are doing on their taper?

I continue to use MMJ at night for sleep...It is very helpful. My husband does all of the filing and weighing for me. 14 pills at a time. I think that has been helpful for me. He hands me the pills (which he puts in a capsule) and hands it to me. I only reduce my dose every 3-5 weeks. I have stayed on name brand Ativan this whole time. Same manufacturer. You have to specifically as the dr to say name brand. It is a lot more expensive. Less filler, more accurate in my opinion. I continue to stockpile with my new dr, as the old one retired. She cut my script immediately in half. It is still very hard for me to stay focused on things like reading and to stay motivated. I have some head tremors when I drive but nothing awful. I do not have any sugar other than what's in fruit. I still drink 2 cups of coffee a day.
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Over 60 years old and over 30years of use
« Reply #63 on: February 04, 2022, 01:43:21 pm »
Hi Gang, hope everyone is doing okay where you are in this process. 

My Dr. has been good about prescribing and my micro taper but it's clear that she doesn't understand it. She's young and smart so I had no concerns about her leaving...and suddenly she did.  I got an email on Tuesday that Monday was her last day! Shocking.  Luckily, I had built an adequate stockpile as I tapered so I will be fine and have enough supply to completely taper off.  It is alarming though and something we should all be thinking about.

That happened to me at an early point during my taper. Gotta love stockpiling! It saved my butt :)
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Over 60 years old and over 30years of use
« Reply #64 on: February 04, 2022, 11:33:34 pm »
Hi Gang, hope everyone is doing okay where you are in this process. 

My Dr. has been good about prescribing and my micro taper but it's clear that she doesn't understand it. She's young and smart so I had no concerns about her leaving...and suddenly she did.  I got an email on Tuesday that Monday was her last day! Shocking.  Luckily, I had built an adequate stockpile as I tapered so I will be fine and have enough supply to completely taper off.  It is alarming though and something we should all be thinking about.

That happened to me at an early point during my taper. Gotta love stockpiling! It saved my butt :)


It is not uncommon in the U.S. for younger physicians to purchase the private practices of retiring physicians. When this is done, the purchasing physician usually takes over the care of patients from the retiring physician. The patients are often referred to as "Legacy Patients". Here is an article entitled "Caring for Legacy Patients - Standards & Guidelines College of Physicians & Surgeons of Nova Scotia"

https://cpsns.ns.ca/resource/caring-for-legacy-patients/

"Professional Standards and Guidelines Regarding Caring for Legacy Patients
Preamble
In this document, legacy patients are defined as those whose care is taken over by a physician after treatment was initiated by another provider.

The purpose of this document is to guide physicians on the challenges of caring for legacy patients. Physicians must both manage the expectations of legacy patients and independently assess the risk and benefit of their existing treatment plan. These challenges are particularly difficult when involving medication regimes that do not conform to current best practice standards or guidelines.

Professional Standards
Physicians must:

not refuse to accept patients to their care because of the medical condition of the patient or their treatment plan; and
assess the legacy patient and provide patient-centered care, tailored to the specific circumstances and needs of the patient.
Guidelines
Good care should always consider the individual needs and circumstances of the patient. To provide safe and respectful care to legacy patients in particular, physicians should:

consider patient autonomy in shared decision making around treatment expectations. The College encourages the use of agreed upon treatment plans that are documented in the patient record;
regularly review medication regimes and discuss the risks and benefits of medications with legacy patients;
where appropriate, engage the patient in a discussion about tapering of medications to promote a shared decision-making approach;
where appropriate, implement a tapering program that is individualized to patient need and circumstances; and
recognize that tapering is not always possible or appropriate. Vulnerable patients should not be destabilized by the imposition of tapering. There will be circumstances where patients cannot tolerate the effects of tapering or refuse to engage in tapering.

Recommended Reading
College of Physicians and Surgeons of Nova Scotia:

Initiation of Opioid Therapy for Acute Pain
Professional Standard and Guidelines on Accepting New Patients
AMA Journal of Ethics: 

Reider, TN Is Non-consensual Tapering of High Dose Opioid Therapy Justifiable? August 2020 
Centre for Effective Practice in Ontario:

Managing Benzodiazepine Use in Older Adults
The 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain   

Choosing Wisely Canada

Legacy Drug Prescribing Patterns in Primary Care Mangin, D et al. The Annals of Family Medicine Vol 16 No 6 Nov 2018

 Document History

Approved by: Council

Approved on: October 15, 2021

Date of next review: 2024"
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.