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Does every pill you take still count?

Homepage » News » Does every pill you take still count?

Does every pill you take still count?

Posted on Tuesday 18th March 2014
benzo picture 1 couple

Does every pill still count? campaign poster


Family doctors in Cumbria are working together to help people reduce the number of unnecessary drugs they may be taking and improve their quality of life.

The main commissioner of health services in Cumbria, NHS Cumbria Clinical Commissioning group (CCG) is supporting GP practices to offer a withdrawal service for those who are inappropriately taking prescription tranquillisers, such as diazepam, temazepam, zopiclone, zolpidem and cholordiazepoxide - for in some cases decades.

Known as benzodiazepines and Z-drugs, the benefits for the majority of patients are only in the short term, and the drugs are actually only licensed for 2 weeks of use. The benefits rapidly reduce and side effects and dependency can affect the quality of patients’ lives.

The scheme involves a new prescribing strategy and education programme for patients and GPs. It looks at recommended dose reductions from each of the drugs and also invites patients to discuss withdrawal in an environment that doesn't treat them as though they 'have a drug problem'. These drugs are often taken without any realisation of the potential harm they can do and were prescribed in good faith, at a time when little else was available.

Benzodiazepines and z-drugs are cheap, so this is not a cost cutting exercise. NHS Cumbria CCG is investing in support to help people stop taking them inappropriately, gain a better quality of life and identify and treat the real underlying problem.

A poster campaign has been launched by NHS Cumbria CCG to encourage patients who are taking these medicines to speak to their GP practice . Patients will be advised if they need to continue taking the drug, and if not provided with the support to reduce and eventually stop taking them.

A pilot scheme run by GPs in Aspatria highlighted the benefits to patients, their families and friends of managed withdrawal from these highly addictive drugs.

Dr Julie Tarn said: "The aim of providing a withdrawal service like this is to give people the support they need to come off benzodiazepines and z-drugs.

"If people have been using these drugs for some time it may not always be easy, or indeed desirable, as they have provided a solution for the patient. The programme provides support through a controlled and managed withdrawal. It is about understanding why the drugs were started in the first place and looking at better ways of managing that problem”

The service has been welcomed by the partner of one patient who contacted the practice to say “Thank you for giving me back my wife”. After years of taking the prescribed drugs she had become confused, sleepy and withdrawn. However as she reduced her dosage, and eventually stopped taking the tablets she regained her zest for life, and returned to the alert, engaging person her husband thought he had lost.

Dr Tarn explained: “Each individual reacts differently to the withdrawal, for some people it may take a couple of months, and for others six to eight months. It has to be managed on an individual basis. To stop taking a drug like this suddenly is not advisable, we would always ask that people come in and discuss it with us. It is never too late to come off them and there are significant health benefits to reducing the amount you take.”

The doctors in Aspatria contacted all their patients who had been prescribed benzodiazepines or z-drugs over a long period of time and invited them to come into the surgery to discuss reducing their dosage and the benefits they could expect. Patients prescribed these drugs in specialist clinics for specific reasons were not included.

Dr Tarn added: “All but two of those invited came in to see me or my colleague Dr. Lyn Burnett, others preferred to see their 'usual' GP. We were able to explain how the benzodiazepines and z-drugs work and why we wanted to withdraw them. Many did not realise how strong or indeed how addictive the drugs were, which in some cases they had been taking for many years. Frequently asked questions were; why bother stopping them now? How will I sleep without them? The answer is that it is always worth stopping these drugs if possible, the benefits experienced were worth the initial difficulty in some cases. Many found that the drug didn't actually do anything to help them sleep and that they slept just as well without them."

“These drugs are not the solution in most cases; we took time to look at what the underlying problems were and identified an alternative way forward if needed. The drugs increase the chances of falling or accident as the patient has dulled reactions and decreased awareness. They can affect driving performance (check with the DVLA when on these drugs and also your motor insurer), memory, cause drowsiness and dizziness. The side effects can look like dementia."

Dr Tarn, explained how the Aspatria practice helped their patients reduce and in most cases stop taking these drugs.

She said: “Every patient who was on the withdrawal programme had a regular consultation each month with me or Dr Burnett. We set aside special time to give patients the support they needed to reduce and eventually come off benzodiazepine and z-drug based prescriptions. We created bespoke reduction plans for each patient, which they had input into and made sure that everyone in the Practice was aware the reduction was taking place, so that they could always get advice when needed. Our Medicines Manager and one of our Receptionists also played vital roles in recalling patients and setting up prescriptions."

“Of the 247 patients who were unnecessarily taking these strong drugs, just 19 are still using them today. And five of those who attended the clinics had been on benzodiazepines or z-drugs for more than 20 years."

“These drugs have a place in prescribing however they are not beneficial for anyone when taken long term. If you talk to your GP they will be able to support your safe withdrawal.”

Posted on Tuesday 18th March 2014


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