Doctors to crack down on prescription drug abuse with new guidelines

[Chip (OP)]

http://www.couriermail.com.au/news/queensland/doctors-to-crack-down-on-prescription-drug-abuse-with-new-guidelines/story-fnn8dlfs-1227462348546

Doctors to crack down on prescription drug abuse with new guidelines

DOCTORS have been ordered to crack down on the deadly abuse of prescription drugs by patients and their on-selling by pensioners.

The nation’s peak GP body, the Royal Australian College of General Practitioners, yesterday issued guidelines specific to benzodiazepine prescriptions.

The drug is commonly doled out for insomnia, anxiety, and drug and alcohol withdrawal.

Nearly seven million benzodiazepine prescriptions are written out in Australia annually, with a trend towards larger scripts for long-term use.

Chairman of the college’s Quality Care Committee, Evan Ackermann, said yesterday “manipulative” patients were doctor shopping by deliberately targeting young doctors, threatening female GPs, threatening suicide and inventing elaborate stories to score the prescriptions.

“It’s hard for a young female doctor to confront a muscular male bikie in the consulting room when there’s no one outside,” the Gold Coast GP said.

Dr Ackermann said the patients were “far more complex” than others and used fictitious stories and letters to back their pleas for drugs.

“There are those mum and dad-type people, (and) the elderly will come and ask for scripts of benzodiazepine and they will go and sell it themselves because they live on a pension, they’re onselling normal medications,” he said.

“It’s the easiest drug of abuse and it’s funnelling its way into inappropriate use, and that’s the problem.”

The guidelines recommend therapy as the first treatment rather than drugs, and prescriptions for most people should not exceed four weeks.

Also, GPs need to know a detailed history of the patient before prescribing the drugs and a patient with a history of addiction should not be given benzodiazepines or their prescription should be overseen by a specialist.

Dr Ackermann said people with a history of drug or alcohol addiction had a 30 per cent chance of becoming addicted to benzodiazepines.

AMA Queensland president Chris Zappala supported the guidelines and said misuse was increasing.

“Asking patients the right questions, knowing a medication’s risks and benefits, and recognising the signs of dependency are critical tools for medical practitioners in prescribing benzodiazepine,” Dr Zappala said.

Figures obtained by The Courier-Mail reveal benzodiazepine was the cause for more than 7000 patients being admitted to Queensland hospitals from 2012 to last October.

This far outranked admittance because of any other prescription drugs or illicit drugs.

[end]

[makita]

Chairman of the college’s Quality Care Committee, Evan Ackermann, said yesterday “manipulative” patients were doctor shopping by deliberately targeting young doctors, threatening female GPs, threatening suicide and inventing elaborate stories to score the prescriptions.

“It’s hard for a young female doctor to confront a muscular male bikie in the consulting room when there’s no one outside,” the Gold Coast GP said.

Dr Ackermann said the patients were “far more complex” than others and used fictitious stories and letters to back their pleas for drugs.

This sounds like full-on sensationalist bullshit.  Like there are maybe 5 people who actually fit this description and suddenly its a crisis.  Reminds me of the early days of oxycontin reporting.

Figures obtained by The Courier-Mail reveal benzodiazepine was the cause for more than 7000 patients being admitted to Queensland hospitals from 2012 to last October.

This far outranked admittance because of any other prescription drugs or illicit drugs.

[end]

Hmm gee I wonder if that could be because its the only drug where WDs can kill you?

"benzodiazepine" isnt a cause for admittance btw.  Benzo withdrawal, benzo overdose, etc those are actual causes.  You dont see this convo in the hospital:

DR: "what is the patient's condition?"
nurse: "it's terrible doctor.  The patient has an awful case of benzodiazepine.  You can see from these xrays, his organs are slowly forming themselves into the shape of a circle with a cut out V in the middle."
DR: "My god...better call the chaplain, I'll inform his wife.  Oh the humanity!"

What a shit article.  I feel sorry for benzo users where you are, Chip.  If this is at all indicative of the general media response they're going to be in for a rough ride. 

[Zoops]

Those poor young female doctors who have to confront big muscular "bikies" requesting benzo's in the exam room! No turn your head and cough there I guess!

Such bullshit.

[Chip (OP)]

I was with a mate seeing his bupe doc. when we heard the previous big scary aggressive patient threaten a doctor and get his way (he demanded more takehomes).

shit like that does happen probably more than you think "I know where you live etc."

[Zoops]

Maybe down there, but if you pulled that shit in a US doctor's office, the 5-0 would be there in minutes...and they would cut you off immediately.
(I mean saying something like "I know where you live" or something like that)

[Narkotikon]

Ditto what Zoops said.  That wouldn't fly here.

Chipper: are they stingy with bupe down there?  It's hard for me to imagine a US patient threatening the doctor to get more bupe.  It's quite easy to get at least 16mg/day here.  Some people get three or four 8mg strips per day.

It angers me that they say addicts should NEVER be given benzos, unless they're monitored by a specialist.  I'm guessing they mean guest-dosing at a pharmacy?  I think that's how it works down there.  You go dose at the pharmacy for methadone, bupe, etc., right?

Benzos are just too helpful in w/d.  Plus, a lot of doctors are only going to keep people on them for shorter periods.  I highly doubt someone's going to get addicted to benzos in a couple weeks, or even a month.  They're using that 30% figure like it's an overwhelming majority.   

Scare tactics. 

[Chip (OP)]

some docs. are tight with take homes - it was about that.

I'm lucky to get a week at a time and that's quite rare.

many docs. punish you for using and they like to play god.

getting on bupe is so much easier than MD.

[Narkotikon]

some docs. are tight with take homes - it was about that.

I'm lucky to get a week at a time and that's quite rare.

many docs. punish you for using and they like to play god.

getting on bupe is so much easier than MD.

That's horrible!  I've only had one doctor who was stingy with take-homes (and bupe dosing itself).  He was the head of an outpatient rehab, and he would only give me 12mg/day.  And I had to fight for that.  He wanted to keep me on 8mg.  Some people there were only on 2-4mg/day.  That's not even a full blocking dose.  That place also would only script one week's worth of Subs at a time.  I relapsed one time, only one time, and I got kicked out of there.  I thought that place was very strange. 

It's also horrible that doctors down there like to play god.  It's sometimes the same here though.  Depends on the doctor.  It just angers me that doctors in the addiction / recovery fields treat addicts like that.  If they want to judge addicts for past behaviors, they have no business being in those fields.  It's very sadistic IMO. 

Since one week's worth of take-homes is rare, I'm guessing monthly take-homes are non-existent.  That actually kinda surprises me.  I thought one of the major benefits of bupe was that it wasn't as dangerous as methadone.  Therefore patients could be trusted with at-home supplies a little bit more.  I'm sure it's part of the whole god-complex thing.  Doctors simply don't want to trust patients.