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Thread: Prescription stopped! :(

  1. #1

    Prescription stopped! :(

    I have been prescribed Diazepam 5mg x 28 every 3 months for the last around 2-3 years. But my gp today told me the lead dr in the practice has decided they will no longer prescribe diazepam at all (they have about 10 addicted patients who are being weaned).
    I’m absolutely gutted as it’s been such a big help in my mental health/autistic anxiety over the last couple of years.
    He said it was absolute they will not budge on the decision and I was welcome to leave the practice if I wasn’t happy (thanks non taken!!). I said are they not even prescribing it as a muscle relaxant or anything and he said no.

    Do I have any options here? Are they even allowed to do this? It’s been such a helpful medication. Would I be able to get it privately and if so what are the costs involved on average?

    ---------- Post added at 19:00 ---------- Previous post was at 18:44 ----------

    Also I’m freaking out thinking I will go into withdrawal I’ve taken around 15mg-30mg per week for around 2/3 years...would withdrawal happen on this amount?
    I’d say 3 out of every 7 days I have taken diazepam.
    Last edited by Talihina Sky; 11-02-19 at 21:09.

  2. #2
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    Re: Prescription stopped! :(

    They should offer you a withdrawal plan at least - did you ask about that?
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  3. #3

    Re: Prescription stopped! :(

    He said my dose was so low and Iím not taking it every single day, so withdrawal is not a concern. I was totally shocked so I didnít push further.
    I am going to make an appointment within a week and I will ask about s withdrawal plan.
    I am worried about withdrawal!! :(((

  4. #4

    Re: Prescription stopped! :(

    TS
    I am so sorry you have this worry. The Gp (I was one) in me says it’s not fair as it’s working for you and you are not “ addicted” to it.
    Though at 15 mg a week should really come down at ten per cent each two weeks. Great fun slicing up the bits ! The great thing is you can get your head round it and use other methods of coping.
    Two bags of camomile are equivalent in most folk to 5mg diazepam. Ten mg of phenergan is almost as potent as Diaz 5.
    I would try using half or 3/4 for a while with a camomile as the compete for receptors.
    Private GPS charge 80 quid a pop and the cost of the drugs on top.
    I have been on diazepam since 1976 - now 17 mg. put on it before they realised the danger.
    In Essex it is limited by the chief pharmacist.
    I am about to start the Dr Ashton reduction regime.
    You are in a much better place and good luck with it.
    Best wishes
    Dick. Please note I am a retired GP Psych WITHOUT insurance so anything I post is NOT a substitute for insured medical opinions
    Last edited by habari; 11-02-19 at 21:59. Reason: Had not read the PS properly apols.

  5. #5
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    Re: Prescription stopped! :(

    Diazepam is slowly being phased out in the UK. You can switch to another surgery but I fear in time this story will be repeated.

    You do have a right to be given an alternative med for your anxiety. I would say the nearest and best alternative is pregabalin, which some GPs are also reluctant to prescribe due to cost. However, in your case, this might be overlooked.

    You should also ideally be given a withdrawal plan but, again, this is at discretion of GP. Some might consider it unnecessary. But I would raise this issue all the same.

    Lastly, the herbal route discussed above is also an option. Magnesium is a good muscle relaxant but has a habit of causing diarrhoea, so dose must be titrated accordingly.
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    Re: Prescription stopped! :(

    The decisions to change this happened many years ago. It's probably more a matter GP's are being looked at more closely to ensure they are following what they are told.

    A withdrawal plan should be used by any doctor who has a patient with a dependency. The issue here seems to be the intermittent use but even then you can be dependent and that might be where a discussion needs to be had? I do question the understanding of GP's when it comes to the half life of drugs. You don't need to take a long half life benzo daily to become dependant due likely to the half life issue. Another member, dally, was dependant on intermittent use.

    https://cks.nice.org.uk/benzodiazepi...awal#!scenario

    NICE guidance also makes a point of treating the cause first to ensure there is some treating going on whilst withdrawal takes place. Has your GP discussed this?

    I have always had the impression, from seeing cases like yours, that there are kneejerk reactions by doctors. I also question whether they say no to all cases simply because they want to remove all patients and a patient who challenges them, who knows their rights too, may find they back peddle? I think it all first came to light in 1988 when they decided GP's should stop long term prescribing but how many just carried on rather than have the hard conversation with their patients? And then they get picked up or maybe are afraid they maybe and they jump to a kneejerk reactions.

    They won't prescribe it at all? Cost reduction maybe? There is nothing wrong with GP's prescribing Diazepam and they know that is the NHS stance. They will see it in all the clinical guidance for a start:

    https://www.nhs.uk/conditions/genera...der/treatment/
    https://bnf.nice.org.uk/drug/diazepa...ngInformations

    Long term treatment is for psychiatrists these days so they could refer you?


    ---------- Post added at 04:36 ---------- Previous post was at 04:35 ----------

    Quote Originally Posted by KK77 View Post
    Magnesium is a good muscle relaxant but has a habit of causing diarrhoea, so dose must be titrated accordingly.
    That's often because people take the types of magnesium that are used as laxatives. The other types are less likely to cause gastric issues. Citrate is one example. Oxide the other, which turns to Milk of Magnesia when it hits the stomach. Both are cheap and commonly found on the shelves.
    Last edited by MyNameIsTerry; 12-02-19 at 04:50.
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    Re: Prescription stopped! :(

    Quote Originally Posted by MyNameIsTerry View Post

    That's often because people take the types of magnesium that are used as laxatives. The other types are less likely to cause gastric issues. Citrate is one example. Oxide the other, which turns to Milk of Magnesia when it hits the stomach. Both are cheap and commonly found on the shelves.
    Certainly avoid laxatives containing Mg

    Stick to the citrate and start on low dose until you know results of above effect!
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    Re: Prescription stopped! :(

    Change practice.

    If they are determined to take you off it then demand/request taper (10% drop every 2 weeks) and you'll be fine - they have a duty of care regardless of your situation.

    With anything there's a risk of withdrawal especially if a medication is taken over a long period - always found that duration rather than dose is the key.

    The numbers you are talking about then it's likely to be, at worst, a bit uncomfortable but then everyone is different and with the risk of physical withdrawals coming off any level of Diazepam should be treated sensibly.

    If I was you i'd take this an opportunity to get off it completely. Replace it with mindfulness!

    You could give valerian a try as it's a very weak GABA-A agonist - it's unlikely to do much but that's the point; you really don't want to hop from one thing to another.

    Slippery slope n' that.
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    Re: Prescription stopped! :(

    Quote Originally Posted by unfitwellhappy View Post
    Change practice.

    If they are determined to take you off it then demand/request taper (10% drop every 2 weeks) and you'll be fine - they have a duty of care regardless of your situation.

    With anything there's a risk of withdrawal especially if a medication is taken over a long period - always found that duration rather than dose is the key.

    The numbers you are talking about then it's likely to be, at worst, a bit uncomfortable but then everyone is different and with the risk of physical withdrawals coming off any level of Diazepam should be treated sensibly.

    If I was you i'd take this an opportunity to get off it completely. Replace it with mindfulness!

    You could give valerian a try as it's a very weak GABA-A agonist - it's unlikely to do much but that's the point; you really don't want to hop from one thing to another.

    Slippery slope n' that.
    That's going to be hard too considering GP's were supposed to have done all this decades ago. The new GP is going to be cautious due to the doctor shopping of substance abusers. If you drop on a doctor who is more concerned with the patient than the box ticking then it's always possible.

    It's certainly complaint territory though. Their decision is not inline with NHS guidance and on that basis it can surely be challenged with the local complaints procedure.

    ---------- Post added at 02:37 ---------- Previous post was at 02:35 ----------

    Quote Originally Posted by KK77 View Post
    Certainly avoid laxatives containing Mg

    Stick to the citrate and start on low dose until you know results of above effect!
    Citrate alone is used as a laxative above a certain dose so the question is always whether you can get enough benefit if you stay under that threshold or spread it across the day maybe? The other forms are not always as absorbable but they won't give the laxative effect barring a couple so there is always that.
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