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Showing posts with label addiction. Show all posts
Showing posts with label addiction. Show all posts

Tuesday, 17 June 2014

Re-classification of prescribed addictive drugs for insomnia, ADHD or pain

25th July 2014
Re-Classification of Certain Prescribed Drugs
Earlier this month zaleplon and zopiclone were reclassified under the Misuse of Drugs Act as Class C, Schedule IV substances, joining the same classification as the third member of the ‘z-drugs’, zolpidem. The Advisory Council on the Misuse of Drugs issued a statement that “these drugs have a legitimate medical use, but people should be under no illusion, taking them without prescription and medical advice can be dangerous.”
The drug reclassification has occurred to prevent misuse of the drug for recreational purposes and ought not to have implications for legitimate therapeutic users under medical prescription, which are most typically for the treatment of insomnia. 
With the change in legislation there have been fears that legitimate dosages might be reduced by prescribers, or patients will request a reduction or halt. However, withdrawal from z-drugs can lead to serious side effects when associated with high dosages and prolonged use. One study revealed the following symptoms from reduced dosage (Hajak et al., 2003):
• Anxiety
• Tachycardia
• Tremor
• Sweating
• Rebound insomnia
• Flushes and palpitations
• Derealisation and
• Convulsions
The National Institute for Clinical Excellence (NICE) is currently writing guidelines on prescriptions of controlled drugs to be published in December 2015 which will include the protocols for z-drugs. If you are a therapeutic user of one of the ‘z-drugs’ or other controlled drugs, and/or are concerned about this issue, please register as a stakeholder with the institute and submit your opinions: http://www.nice.org.uk/mpc/medicinespracticeguidelines/CDGPG.jsp.
References
https://www.gov.uk/government/news/acmd-advises-the-government-on-the-control-of-prescription-drugs.  

Abuse and dependence potential for the non-benzodiazepine hypnotics zolpidem and zopiclone: 
a review of case reports and epidemiological data, Hajak et al., 2003 Addiction, 98, 1371–1378

Sunday, 11 March 2012

Sleeping pills increase risk of death study finds

Sleeping pills increase risk of death, study suggests - published in the British Medical Journal

 Hypnotics' association with mortality or cancer: a matched cohort study

 In this open access paper by Kripke, Langer and Kilne, a study of electronic medical records of 10,529 patients who received prescriptions for hypnotic drugs were compared with 23,676 matched controls with no hypnotic prescriptions during a period of 2.5 years from 2002 to 2007.

 DRUGS PRESCRIBED included:
 zolpidem, temazepam, eszopiclone, zaleplon, other benzodiazepines, barbiturates and sedative antihistamines. 

  Conclusions were: Receiving hypnotic prescriptions was associated with greater than threefold increased hazards of death even when prescribed <18 pills/year. This association held in separate analyses for several commonly used hypnotics and for newer shorter-acting drugs. Control of selective prescription of hypnotics for patients in poor health did not explain the observed excess mortality. In the UK we are still trying to persuade the government of the long standing problem of involuntary tranquilliser addiction - take a look at the postings from the All Party Parliamentary Group on Involuntary Tranquilliser Addicton www.appgita.com


WARNING - DO NOT STOP TAKING ANY MEDICINE SUDDENLY 

Many medicines, including some pain killers, tranquillisers, sleeping pills antidepressants and other psychotropics can trigger serious withdrawal reactions
  •  For withdrawal advice about benzodiazepines,  and z drugs (like zopiclone), see Professor Heather Ashton's Withdrawal Protocol on www.benzo.org.uk
  • For Professor David Healy's SSRI withdrawal protocol email APRIL at SSRI at april. org. uk (email address displayed in this way to avoid spam).
  • For information about reducing antipsychotic drugs see www.comingoff.com

Tuesday, 14 June 2011

Adverse drug reactions: is the patient voice loud enough? London conference June 24

WHO’S LISTENING TO PATIENTS?

One of the biggest under-reported health problems is adverse drug reactions
(ADRs), the harmful effects of the medicines our doctors prescribe for us.
These can range from unpleasant rashes all the way to suicide.

In 2008, the European Commission estimated that ADRS kill 197,000 citizens
of EU member states, at a cost of€79 billion. That same year, the
centre-left think-tank Compass reckoned that the NHS alone was spending
nearly £2 billion a year treating ADRs.

And for every patient affected, there is a family in crisis, thousands of
working days lost, collapsed businesses and relationship break-ups.

Drug safety is taken very seriously by drug regulators, but there is a
crucial gap in the chain. Does anyone really listen to the one person who is
really expert: the patient who is taking the drug? What happens when
patients do get a chance to report their own symptoms directly? And do we
really know how important the patient voice could be in improving drug
safety?

Come to a special one-day conference on Friday 24 June which will address
these issues – and brainstorm suggestions about how to make the future
safer.

ADRS: Is the patient voice loud enough?
The first International Conference on patient reporting of suspected Adverse
Drug Reactions

Friends House, Euston Road, London NW1 2BJ

PAY ONLY £20 AT THE DOOR ON THE DAY!


Among the speakers will be:
* real patients, telling their own stories
* top UK academics, talking about the first study of direct patient
reporting (http://www.hta.ac.uk/fullmono/mon1520.pdf
)
* government regulators explaining their problems and concerns
* open panel discussion: what can health professionals learn from
patients?

REGISTER/COFFEE 9.30
For full programme see: www.primm.eu.com

Organised by PRIMM/Drug Safety Research Unit

SENT OUT BY MILLIE KIEVE – organizer of the patient experience section of
the conference. If you would like to speak about your own experience, please
contact me asap

Saturday, 27 June 2009

* Deaths linked to prescribed medicines


  • Michael Jackson’s and other deaths linked to prescribed medicines

Sudden death is difficult to cope with, and difficult to come to terms with.
The loss of a beloved family member, leaves us in a state of disbelief, asking ourselves if there is a mistake or is it a nightmare we will wake up from.
When the death was preceded by concerns for the health or lifestyle of the person we loved, we then feel guilt and wonder if there was something we could have done to prevent the tragic loss.
The death of Michael Jackson on Thursday, should not come as a surprise to those who had knowledge of the cocktail of prescribed medicines he had become dependent on. Michael’s friends expressed concern and gave warnings it seems.
Alternatives to drugs that may help some people
The human body has remarkable powers of recovery from damage and pain and the drugs no doubt help in the immediate relief following injury or surgery. Pain can be relieved, in my experience, by experts in manipulation, using a Tens machine, or I am told, acupuncture.
People under stress who cannot sleep should try first tranquillity teas and avoid caffeine drinks. Taking up Yoga and breathing exercises can help relaxation too. However in too many cases the first resort is drugs

UK Government Inquiry into prescribed drug addiction

A recent House of Commons Inquiry organised by MP Brian Iddon, highlighted that addiction to pain killers, tranquilisers and antidepressants leads to people taking them for years longer than required for the original problem. Involunatry addiction following careless prescribing leads to devastation of lives. Careers are ruined and family life destroyed in many cases.

Other celebrity deaths linked to prescribed drugs

Prescribed drugs were implicated in several celebrity deaths. 27 year old actor Heath Ledger died from combined effects of tranquillisers, sleeping pills and antihystemine.
New York City medical examiner's office stated Heath Ledger died as the result of acute intoxication by oxycodone, hydrocodone, (pain killers) diazepam (Valium), temazepam (Restoril/Euhypnos), alprazolam, (Zanax) and doxylamine (an over the counter anti-hystemine),
When Elvis Presley died he had no previous cardiac problems and the death was due to the cocktail of addictive prescription drugs, including: Valium, Codeine, other painkillers, tranquillisers and sleeping pills.
Other celebrities deaths due to the same or similar drugs include Marilyn Monroe, Jimmie Hendrix, Dorothy Dandridge, Bruce Lee and Howard Hughes

Medicines led to deaths of ordinary folk too, my daughter, my friends brother and Helen in Manchester due to Dianette the drug I campaigned about, to name a few.

For every celebrity who’s death is linked to prescription drugs, there are thousands of ordinary folk who die and get no publicity. In many cases the drug implication is not even recorded as the cause and seldom reported to the regulator. It is estimated that over 100,000 people die in the USA due to adverse drug reactions (ADRs). A study in the UK By Liverpool professor Pirmohamed found that one in 16 emergency admission into hospital is due to ADRs. That figure excludes psychiatric, maternity, paediatric and ent admissons. So the true total may be much higher. Many prescribed drug related deaths are not even picked up by naïve coroners.

My daughter Karen’s death and a missed opportunity at the inquest

My daughter Karen died, at the age of 30, unwell and suffering dizzy spells, she slipped against a window with a faulty catch and died in an accidental fall from her bedroom window. The emphasis of the inquest was on the broken safety catch and danger of swivel windows in apartment buildings. Little attention was paid to the fact that Karen had suddenly stopped taking the highly addictive drug Temazepam and was, in error, over prescribed, for months, three times the recommended dose of a drug to deal with side effects, the anti-parkinson drug Kemadrin (procyclidine).

A verdict of ‘misadventure’ this week in Manchester at the inquest of 33 year old

A verdict of ‘misadventure’ this week in Manchester at the inquest of 33 year old Helen Schofield.
This verdict not adequately record the true cause of death or explain the inappropriate prescribing of Dianette (cyproterone acetate & ethynlestradiol) for a girl with known family cardiac risk. The drug has 4 times the risk of other drugs used for contraception, for deep vein thrombosis (dvt). Helen had lost her father at a young age due to heart attack. She had also gone with her mother to the doctor with concerns about the safey of Dianette, having read the information leaflet. She was suffering aches and pains and a sudden hacking cough. These early warning signs were dismissed by doctors in the practice. Helen was told she should stay on the drug. Her sudden death due to dvt has devastated her mother Kay who persistently asked the doctors if the drug was safe for Helen. Kay wants others to be aware of the increased risk of dvt with Dianette and is concerned that the doctors had little knowledge of the risk to her daughter.
Kay had not connected the fact that Helen had been prescribed Seroxat (paroxetine) for anxiety, another possible side effect of Dianette, as she was so perturbed about the risk of thrombosis which the health professionals ignored.
Dianette is not licensed as a contraceptive and only recommended for short courses to treat acne that failed to respond to antibiotics, or hirsuit problems. The reason for the refusal to license Dianette as a contraceptive is the 4 times greater risk of dvt, about which Helen and Kay Schofield were never warned.
APRIL’s Dianette campaign
I was distressed to hear of Helen’s death as I had campaigned for the regulatory, the Medicines Healthcare Products Regulatory Agency (MHRA) to issue a further warning to doctors about the risks of psychiatric as well as blood clots for Dianette. For years I had been writing to the MHRA and had meetings with and told Dr June Raine that Dianette is being over prescribed and for too long without warning the patients about the side effects. They reviewed the drug in 2006 but did not issue a specific warning to GP’s as they had in 2002 in their publication ‘Current Problems in Pharmacovigilance’.
The death at 27 of Daniel Galvin
Another concerned mother was Gillian, the mother of Daniel Galvin. Gillian was introduced to me by psychiatrist Dr Phil Thomas, a member of the Critical Psychiatry Group. Gillian had concerns about Daniel's deteriorating health due to the adverse effects of psychotropic drugs. Daniel had seizures linked to Olanzapine/Zyprexa and had developed Neuroleptic Malignant Syndrome (NMS), a well know side effect of psychotropic drugs that can be fatal. Gillian knew how important it was to get Daniel off the drugs and single handed, she did this. Withdrawal has to be slow and there are many problems with withdrawal effects. In the care of doctors these effects may lead to further prescribing of more and more drugs.
I think the stress and pressure led to Gillian's sudden death.
Without his mother, Daniel had to go into psychiatric care and was prescribed drugs again. I had been to visit him with his sister Ana due to her concerns that Daniel was having fits. Ana did her best to persuade the doctors to keep medication they perceived as necessary, at the lowest possible level. She told them her mother had been concerned about raised CPK levels so they agreed to do a blood test.
However Daniel was found dead in his bedroom. The drug Olanzapine / Zyprexa has been suspected of causing fits when Daniel was first treated for anxiety some years before and he was prescribed this with Sodium Valproate at the time of his death.

Bed Push Demo in memory of Daniel Galvin

I took part, with Daniel’s sister Ana, in a street demonstration in memory of Daniel. The ‘Bed Push’ demo was organised by psychologist Rufus May against the over dependence of our mental health system on the use of drugs for mental distress.
The use of psychotropic drugs may be considered by some people as helpful for an immediate crisis but suddenly stopping or increasing the doses beyond the level of human tolerance can lead to sudden death, aggressive behaviour and suicides. Cocktails of drugs are often prescribed with no reference to how the particular person can metabolise or disperse these from the body.
Pharmacogenetic tests to evaluate whether we have the enzymes and potential to successfully utilise any benefits or cope with any risk from toxicity could be used. Toxic levels of drugs not successfully dispersed by the liver enzymes can lead to the aforementioned disasters.