Johanna Moncrief "Lasting damage from prescribed drugs"

[[La...]]

The article laments the lack of research into the incredible damage these drugs can do.  Unfortunately, it seems all research monies come from the pharmaceutical industry itself.  Now I ask you very intelligent, albeit wounded BB's...why would the pharmaceutical industry pay to research the damage caused by their own drugs?  Never going to happen.  That leaves it to government monies.  That ain't gonna happen either.

 

Welchie,

Check out this recent paper by two Canadian doctors. No drug companies involved.

 

"Deprescribing Is an Essential Part of Good Prescribing"

 

Abstract:

 

https://www.ncbi.nlm.nih.gov/pubmed/30600973 

 

Full Study:

 

https://www.aafp.org/afp/2019/0101/p7.html

[[Da...]]

The article laments the lack of research into the incredible damage these drugs can do.  Unfortunately, it seems all research monies come from the pharmaceutical industry itself.  Now I ask you very intelligent, albeit wounded BB's...why would the pharmaceutical industry pay to research the damage caused by their own drugs?  Never going to happen.  That leaves it to government monies.  That ain't gonna happen either.

 

Welchie,

Check out this recent paper by two Canadian doctors. No drug companies involved.

 

"Deprescribing Is an Essential Part of Good Prescribing"

 

Abstract:

 

https://www.ncbi.nlm.nih.gov/pubmed/30600973 

 

Full Study:

 

https://www.aafp.org/afp/2019/0101/p7.html

 

That is a good article, Lapis. Thanks. I wish most doctors thought like this.

 

"Polypharmacy is a clinical challenge because the health care system is geared toward starting medications, not reducing or stopping them, and guidelines typically include recommendations for initiating medications, but not stopping them."

 

This needs to be more widely known. The medications prescribed - especially those that directly affect the nervous system - can cause quite a few problems for people long term, which I think most on this site can attest to. But patients are under the impression that doctors simply want to improve their health, and have no particular bias towards prescribing more drugs. I don't think it should be left to the patient to have to figure out the drugs they are taking are causing their health problems. They should not have to endlessly research drug side effects before (to give informed consent) or while they are taking the drugs. When you hire a plumber, you are not expected to learn how their trade works so you can check their work. Same with dentistry, teaching, neuropsychology etc. Yet somehow that is the case with medicine. Maybe doctors should make explicit what their goal is in treating their patients? A goal of reducing suffering is much different than improving health. If there was an explicit mission statement to improve the health of the population, I feel it would be pretty difficult to justify much of what doctors do.

[[lo...]]

I am from Germany.

 

There is NO way to sue your doctor.

 

Even in a very easy case like I had 2 years ago. A dentist put plastic in my tooth, I nearly died cause I reacted on that. End of it - its my fault - because no one else nearly died. I could have sued and spend lots of money with the result that the same doctor would have to re-do his work. Can you believe that?

 

And them imagine I would sue my psychiatrist or the hospital in which I was polydrugged.

 

I know very few patients in the prescribed harmed community in the UK who have been able to take legal action, very difficult to find a solicitor who will take on cases, considerable amounts of money involved and of course doctors often deny that that the drugs have caused the damage.

[[Fo...]]

Very true looking forward

but the mass early retirement from GP work is largely due to the claim \ complaint culture. My ex colleagues live in fear.  I agree they make mistakes and cover each other’s errors, but by and large they manage to do a good job.

Though they missed my serious anaemia - I choose just to have a meeting with the PM and chill.

My wife’s doctor made a serious mistake in her last month of life of terminal care. I prepared a case to take the docs to the GMC and they were sent for retraining on the issue rather than suspension.

There are ways and I help folk present their cases.

Yours

Dick

[[Da...]]

https://www.propublica.org/article/doctor-confesses-i-lied-to-protect-colleague-in-malpractice-suit

 

"Doctor Confesses: I Lied to Protect Colleague in Malpractice Suit

A surgeon who lied about his partner’s skills on the witness stand has been haunted by the deception for nearly two decades."

 

This doctor felt so guilty about lying in a malpractice case that he actually later joined with the malpractice attorney for the patient in question to assist him.

 

While I'm sure it is terrible for doctors to be sued for trying to help people, it is much worse for patients who have their health ruined, are lied to and are left with nothing by people who are supposed to be their healthcare providers.

[[lo...]]

Very true looking forward

but the mass early retirement from GP work is largely due to the claim \ complaint culture. My ex colleagues live in fear.  I agree they make mistakes and cover each other’s errors, but by and large they manage to do a good job.

Though they missed my serious anaemia - I choose just to have a meeting with the PM and chill.

My wife’s doctor made a serious mistake in her last month of life of terminal care. I prepared a case to take the docs to the GMC and they were sent for retraining on the issue rather than suspension.

There are ways and I help folk present their cases.

Yours

Dick

 

Hi Dick

 

I know there are difficulties on both sides, I know a fair bit about what is happening in the UK and most of it is pretty negative.  My trust in doctors has been shattered for good and cannot be repaired.  Mistakes are one thing, lying is quite another and I just cannot tolerate it, whatever the reasons behind it. 

[[La...]]

The article laments the lack of research into the incredible damage these drugs can do.  Unfortunately, it seems all research monies come from the pharmaceutical industry itself.  Now I ask you very intelligent, albeit wounded BB's...why would the pharmaceutical industry pay to research the damage caused by their own drugs?  Never going to happen.  That leaves it to government monies.  That ain't gonna happen either.

 

Welchie,

Check out this recent paper by two Canadian doctors. No drug companies involved.

 

"Deprescribing Is an Essential Part of Good Prescribing"

 

Abstract:

 

https://www.ncbi.nlm.nih.gov/pubmed/30600973 

 

Full Study:

 

https://www.aafp.org/afp/2019/0101/p7.html

 

That is a good article, Lapis. Thanks. I wish most doctors thought like this.

 

"Polypharmacy is a clinical challenge because the health care system is geared toward starting medications, not reducing or stopping them, and guidelines typically include recommendations for initiating medications, but not stopping them."

 

This needs to be more widely known. The medications prescribed - especially those that directly affect the nervous system - can cause quite a few problems for people long term, which I think most on this site can attest to. But patients are under the impression that doctors simply want to improve their health, and have no particular bias towards prescribing more drugs. I don't think it should be left to the patient to have to figure out the drugs they are taking are causing their health problems. They should not have to endlessly research drug side effects before (to give informed consent) or while they are taking the drugs. When you hire a plumber, you are not expected to learn how their trade works so you can check their work. Same with dentistry, teaching, neuropsychology etc. Yet somehow that is the case with medicine. Maybe doctors should make explicit what their goal is in treating their patients? A goal of reducing suffering is much different than improving health. If there was an explicit mission statement to improve the health of the population, I feel it would be pretty difficult to justify much of what doctors do.

 

Hey Data_Guy,

Are you familiar with Deprescribing.org? It's a Canadian organization founded by two doctors/researchers -- Dr. Barbara Farrell (one of the authors of the paper I shared here), a pharmacist, and Dr. Cara Tannenbaum, a geriatrician. The focus is on reducing unnecessary medications, in particular, to seniors.

 

Definitely worth checking out:

 

https://deprescribing.org/ 

 

https://deprescribing.org/about/ 

[[Li...]]

Are you familiar with Deprescribing.org? It's a Canadian organization founded by two doctors/researchers -- Dr. Barbara Farrell (one of the authors of the paper I shared here), a pharmacist, and Dr. Cara Tannenbaum, a geriatrician. The focus is on reducing unnecessary medications, in particular, to seniors.

 

Definitely worth checking out:

 

https://deprescribing.org/ 

 

https://deprescribing.org/about/

Thanks for bringing this to our attention, Lapis.  I read the article that describes how the guidelines for benzo deprescribing were developed:

 

Deprescribing benzodiazepine receptor agonists: Evidence-based clinical practice guideline

http://www.cfp.ca/content/cfp/64/5/339.full.pdf

 

Possible points for consideration:

 

(1) Strong Recommendation Based on Low-Quality Evidence

The guideline makes a strong recommendation that all patients over 65 should be “offered” tapering but acknowledges that this recommendation is based on low-quality evidence.  (Check out Table 2 to get a sense of the evidence used.)

 

(2) Definition of “Very Gradual Dose Reduction”

“Very gradual dose reductions to lowest available doses (eg, 25% reduction every 2 weeks and a slower taper of 12.5% every 2 weeks near the end of stopping), followed by periodic drug-free days were used successfully in clinical trials.”

 

(3) Conclusions re: Withdrawal Symptoms

“Our systematic review found that there was no difference in overall BZRA withdrawal symptom scores for tapering compared with usual care or continuation of BZRAs. The tapering group reported more trouble sleeping at 3 months compared with continuation of BZRAs .... but any difference in reports of trouble sleeping was no longer present at 12 months.”

 

“In many cases, when withdrawal symptoms occur they are mild and short term (lasting a few days and up to approximately 4 weeks).”

 

Withdrawal symptoms identified for monitoring were:

“Insomnia, anxiety, irritability, gastrointestinal symptoms”

[[La...]]

Hi Libertas,

I don't recall when I first heard about this organization, but it was at least a few years ago now. There are specific guidelines (logarithms) that were developed for each of (at least) four different types of medications (benzos/Z-drugs, PPIs, antipsychotics, antihyperglycemics), and they're available on the website. As well, there is ongoing research taking place (again, check the website), so that's also good news. Lots to check out on the website, including materials for patients and health care professionals.

 

https://deprescribing.org/resources/deprescribing-information-pamphlets/

[[Fi...]]

 

Competing interests

 

Dr Farrell received research funding to develop this guideline; received financial

payments from the Institute for Healthcare Improvement and The Commonwealth

Fund for a deprescribing guidelines summary; and from the Ontario Long Term Care

Physicians Association, the Ontario Pharmacists Association, and the Canadian Society

of Hospital Pharmacists for speaking engagements. Dr Boyd received funding from

Patient-Centered Outcomes Research Institute for a project related to improving

patient-centred care for people with multiple chronic conditions and funding from the

National Institutes of Health for a project related to medication regimen complexity

in home health care. Dr Sadowski is the primary investigator on an unrestricted grant

from Pfizer Canada related to finding novel strategy to address the underdiagnosis

and undertreatment of overactive bladder and urinary tract symptoms and is a member of the Alberta Expert Committee on Drug Evaluation and Therapeutics. None of the

other authors has any competing interests to declare.

 

http://www.cfp.ca/content/cfp/64/5/339.full.pdf

 

Also noteworthy:  I see no mention of "Quality of Life" during withdrawal or after cessation ... (especially for Senior Citizens)

in this apparent lopsided, conflict of interest ridden "Deprescribing Campaign" best wishes

[[La...]]

The only thing that concerns me there is Pfizer, a drug company.

[[Fi...]]

The only thing that concerns me there is Pfizer, a drug company.

 

Does not the "quality of life" during and after cessation from benzos and other drugs  especially the "quality of life" of senior citizens, perhaps one of the most vulnerable groups of people, concern you?

 

It concerns me. Of what use is life if it cannot be enjoyed by oneself and by others?

 

It is well acknowledged that withdrawal and cessation of these medications may and very likely will cause severe and debilitating symptoms that may last months, years and perhaps will not end until one's death.

 

If one is well informed of all the risks and discomforts associated with withdrawal and cessation and chooses to proceed, that is their choice. But I am opposed to advocating, persuading and/or coercing uninformed persons, especially senior citizens, to commit to a protocol of almost certain suffering for an undetermined amount of time.

 

I have read this deprescribing group's literature and I do not see adequate disclosure of the risks and discomforts associated with withdrawal and cessation.

 

 

[[Li...]]

I agree with FA.  I also am concerned about their definition of a “very gradual” tapering rate (way too fast) and the statement that withdrawal symptoms will be mild and short-lasting.  Anyone else?

[[La...]]

The only thing that concerns me there is Pfizer, a drug company.

 

Does not the "quality of life" during and after cessation from benzos and other drugs  especially the "quality of life" of senior citizens, perhaps one of the most vulnerable groups of people, concern you?

 

It concerns me. Of what use is life if it cannot be enjoyed by oneself and by others?

 

It is well acknowledged that withdrawal and cessation of these medications may and very likely will cause severe and debilitating symptoms that may last months, years and perhaps will not end until one's death.

 

If one is well informed of all the risks and discomforts associated with withdrawal and cessation and chooses to proceed, that is their choice. But I am opposed to advocating, persuading and/or coercing uninformed persons, especially senior citizens, to commit to a protocol of almost certain suffering for an undetermined amount of time.

 

I have read this deprescribing group's literature and I do not see adequate disclosure of the risks and discomforts associated with withdrawal and cessation.

 

Fi,

If you didn't understand my comment, I was referring to the list you shared. I'm sorry if that wasn't clear to you.

 

As far as your other comments go, I don't believe these doctors are doing their research in the area of deprescribing to seniors in order to make people's lives worse. That's doesn't make sense. Here's the definition of deprescribing, according to the website:

 

Deprescribing is the planned and supervised process of dose reduction or stopping of medication that might be causing harm, or no longer be of benefit. Deprescribing is part of good prescribing – backing off when doses are too high, or stopping medications that are no longer needed.

 

The idea is to improve quality of life. Seniors, in particular, metabolize medications more slowly than younger people due to changes that naturally occur over time, e.g. liver and kidney function. So, for instance, seniors might need less of a given medication in order to achieve the same effect. In other cases, there may be interactions between numerous medications that they're taking, as seniors often have a number of health conditions.

 

In the literature above, I don't see anywhere where they state that people will be forced to get off medications against their will.

 

As far as warning people about the terrible things that will happen to them, you have to remember that some people have few issues getting off medications. Not all people have a terrible withdrawal. Some do. It's highly unpredictable, and that's problematic. But let's hope that continued research might help us understand who will and will not have a tough time of it. Most of us should never have been on these meds in the first place. I shouldn't have. Too many risks. I was greatly let down, as were many around here.

 

Most of us came to BB for support in getting off medications that were causing us problems. I, for one, am grateful to have found this site, as I would not have known why I was dizzy. Benzos are "vestibular suppressants", and there's zero chance of getting "undizzy" if you stay on them. That means, for someone like me, there was no option but to get off and see if my brain could heal from the damage the medications caused. I would have liked to have been informed of these issues by a knowledgeable doctor and then supported during a taper, but unfortunately, I had to do it by myself. I think many around here are in the same boat.

 

I'm all for people staying on the meds, if that's their choice. There are risks involved in staying on the meds, and risks involved in getting off them, and there are no guarantees either way. Such is life, right?

 

[[co...]]

My local clinic has instituted a 'get 'em off Benzos' policy.  I've been upfront about my experience, and my provider has assured me they aren't just jerking people off.  I mentioned to her just last week that given the length of MY post withdrawal issues, that perhaps it would have been better for me to have just stayed on them...the rest of my life not looking too fun.

 

I think all these programs that are bubbling up right now to get folks off 'addicting' drugs brought on by the Opioid Crisis TM.  It's *fashionable*....

[[La...]]

My local clinic has instituted a 'get 'em off Benzos' policy.  I've been upfront about my experience, and my provider has assured me they aren't just jerking people off.  I mentioned to her just last week that given the length of MY post withdrawal issues, that perhaps it would have been better for me to have just stayed on them...the rest of my life not looking too fun.

 

I think all these programs that are bubbling up right now to get folks off 'addicting' drugs brought on by the Opioid Crisis TM.  It's *fashionable*....

 

Hi cookienose,

I'm sorry to hear that. I'm lucky not to have been forced off but to have gotten off because I wanted to. But certainly, the opioid crisis is front and centre these days, and there are certainly parallels between the benzo and opioid issues.

 

Someone in my family currently takes a low dose of an opioid, but it was determined that the small dose she's on (at age 79) is safe in her case and still providing useful benefit. She does, however, have to adhere to certain rules about how often she gets a prescription and the required paperwork, etc. That seems okay to me, given the current situation. I worry about her well-being, but I understand her situation too (a fused spine, due to surgery 50-some years ago, which has deteriorated over time).