All posts by Aled Jones

We have an “app” for that!!

A big thank you to Peter Ruppert’s team for their diligent work developing a handy tool to track symptoms of adverse effects to medication and withdrawal.

Adverse Effects, Discontinuation and Withdrawal Symptoms Tracker

BrainZaps! Is a new solution for those who are on and thinking of coming off medication.

Discontinuation Syndrome can have some serious and uncomfortable effects, including Brain Zaps, a sensation of an electrical shock in the brain or throughout the body that can manifest in different ways. These symptoms stop many people each year from successfully weaning off of their medication, especially if they have been taking higher doses throughout the years.

Download it here

Go to the website at http://brainzaps.io/ for more information on the app (in beta currently).

or directly from

Brain Zaps at Google Play Store


Positive response from Welsh Gov to the issues of dependency with prescribed medication

Welsh Government have accepted nine out of ten of the recommendations brought forward by Stevie Lewis’s petition.

It is important we distinguish between substance misuse, as the harmful use of substances such as drugs and alcohol; and dependence arising from the therapeutic use of medicines whether they are prescribed or purchased.

This paragraph is so important – to distinguish between misuse and inadvertent dependency.

We commend Welsh Gov for it’s deliberation and thoughtful response to this petition

Petitioner Stevie Lewis
Prescribed Medication Petitioner

We have accepted nine of the ten recommendations set out in the report and a Government response to each is annexed to this letter for the Committee’s consideration.

The Summary

Recommendation 1.
Greater recognition should be given to prescription drug dependence at a national level in both policy and strategy, including within the next Substance Misuse Action Plan and the Substance Misuse Treatment Framework. This should include a clearer distinction between substance misuse and prescription drug dependence, and identification of specific actions to help prevent dependence upon prescription medications and support people affected.
Response: Accept

Recommendation 2.
The Welsh Government should confirm and explain its position on whether SSRI and SNRI antidepressants should be formally recognised as potentially leading to problems of dependence and withdrawal.
Response: Accept

Recommendation 3.
The Welsh Government should restate and emphasise antidepressants should not be routinely prescribed for mild depression in guidance to healthcare professionals, and should provide assurances that sufficient alternative treatment options, such as psychological therapies, are available across Wales.
Response: Accept

Recommendation 4.
The Welsh Government should ensure that additional guidance is produced and promoted in relation to safe tapering of prescription medications, both for patients and health professionals.
Response: Accept

Recommendation 5.
The Welsh Government should provide an update on the actions carried out in response to Recommendation 8 of the Health and Social Care Committee’s inquiry into Alcohol and Substance Misuse published in August 2015.

(This was not a matter brought up in the initial petition and has a different pinciple. ed AJ)

Recommendation 6.
The Welsh Government should determine whether SSRI and SNRI antidepressants should be added to the list of drugs targeted for reduction, and should introduce a national prescribing indicator to support closer monitoring of prescribing volumes and patterns across Wales. This indictor should be used to identify areas where further investigation or intervention may be required.
Response: Reject

(comment – Saddened this wasn’t accepted as it would be a huge leap to monitor how much and for how long SSRI and SNRI’s are prescribed for and therefore have foresight into how many patients will struggle and be affected by their withdrawal. Gov could then plan a coherent strategy in knowledge of how many will require assistance going forward. ed AJ)

Recommendation 7.
The Welsh Government should investigate, as a priority, the potential for a national rollout of a service based upon the Prescribed Medication Support Service operating within Betsi Cadwaladr University Health Board, in order to ensure that specific advice and support is available for people who require assistance with prescription medication.
Response: Accept in principle

Recommendation 8.
The Welsh Government should create opportunities for a coordinated strategy and greater information-sharing between health boards in relation to prescribed drug dependence, with a view to improved sharing of best practice and to ensure equity of services and support to patients.
Response: Accept

Recommendation 9.
NHS Wales should make better use of the expertise of pharmacists to support evidence-based prescribing, patient monitoring including regular patient reviews, and increased provision of help with tapering and withdrawing from medication.
Response: Accept


Recommendation 10.
The Welsh Government should conduct and publish an assessment of the sufficiency of the advice available to people experiencing prescription drug dependence and withdrawal through the DAN24/7 helpline, including the adequacy of training for operators. The Welsh Government should ensure that the availability of advice related to prescribed drug dependence is promoted appropriately.
Response: Accept

For access to the full petition and its history
http://www.senedd.assembly.wales/mgIssueHistoryHome.aspx?IId=19952

https://past.wales/wp-content/uploads/2019/05/Government-Response-to-Committee-Report.pdf

Dependency v addiction!!!

Since our inception in March 2018 we have been highlighting the difference between “DEPENDENCE” and not “ADDICTION” to prescribed medication.

There is a difference

Patients did not make the choice to become dependent on prescribed medication – they followed the advice of their medical professionals to arrive at the point where they are dependent on medication – without being given an informed choice on how its impact would affect the brain and body, and how difficult and sometimes dangerous it is to discontinue taking these medications.

Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal. The latter reflect physical dependence in which the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal).

Physical  dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed. Thus, physical dependence in and of itself does not constitute addiction, but it often accompanies addiction. This distinction can be difficult to discern, particularly with prescribed pain medications, for which the need for increasing dosages can represent tolerance or a worsening underlying problem, as opposed to the beginning of abuse or addiction.

(https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence)


Informed consent is the process by which the treating health care provider discloses appropriate information to a competent patient so that the patient may make a voluntary choice to accept or refuse treatment.
It originates from the legal and ethical right the patient has to direct what happens to his or her body and from the ethical duty of the physician to involve the patient in his or her health care.

(https://www.benzoinfo.com/2016/08/27/what-is-informed-consent/)

Public Perception

The media adore using the sensationalist term “addiction” though to most of us who have lived experience of medication dependency it is an abhorrent term which gives the public the wrong impression of the damage caused by prescribed medicines.

Addicts make an initial informed choice to take a drug – dependent patients have merely followed medical treatment guidelines.

Addict or Dependent
Dependent – not Addicted

The perception of the public of the impact of medications is nebulous at best – to park the term “addict” on a vulnerable patient is a heinous issue, individuals struggling to live with conditions, to add the label of “addict” is extremely dangerous and could even be fatal.

A client was dubbed an “addict” by family and friends for medication dependence, it caused great trauma and reduced their self esteem to pieces. She felt alienated and indeed more suicidal.
After a lengthy discussion with the person with regard to the issue they did feel better as it was not their fault – she had only followed doctors orders and had become dependent, very different to an “addict” who begins a journey with an informed choice.

MJ’s story

Hi my name is MJ and i spoke to a member of your team on facebook messenger the other night , and due to my functional neurological disorder – fnd for short, i have severe speech problems , so i am emailing over a brief summary of whats been going on for me with the NHS and having concerns that my fnd may of been caused by medication, especially after watching your video for your awareness day that was in December 2018

Where do i start , always from a child (i am 44 now) i always had sadness and not quite fitting in and was severely bullied at home and at school , so by the age of 16 i found myself in a abusive relationship and had my first child at 17 by the time i was 20 after the birth of my second child i was on antidepressants not sure which ones they were like red smarties  and over the years following i was on various antidepressants Prozac or Citalopram were the drs favourite ones and to be honest they never did nothing apart from cause massive weight gain and lethargy.

Then in a bout 2003/4 after trying to turn my life around to be healthier and already losing about 7 stone in weight but then coming to a standstill weight wise i heard about these tablets that drs were prescribing called Sibutramine or Reductil , so i asked the dr about these and she put me on the highest dose and i agreed to visit dr regulary as they can cause heart problems , but i was so desperate to lose the weight and fit in (be normal , these days i realise it doesn’t matter your size and everyone has their own level of normal) so i started taking these tablets and wow at last something that worked.

It was like my brain had been rewired in the space of an hour of taking the first one , i could think clearly i had so much energy , it was like “yey something at last that kinda makes me feel normal and fitting in”, needless to say i continued with these tablets for several years, then come 2005/6 when i was coming off the tablets as i found out 12 months should’ve been the maximum time i should’ve been taking them there was stress going on surrounding my daughter and i started getting these attacks which the drs at the time just said it was anxiety attacks that mimicked a stroke which i now know to be fnd and i had many visits to A&E in the early days of the attacks and being doped up on Diazepam and anti depressants , eventually i seen another gp at the surgery and he said it wasnt right and referred me to neurology at Lydney outpatients this was in 2006.

The day i met the neurologist i wasn’t having attacks so i had to rely on explaining to him and he agreed to send me for a MRI of my brain, and a test where they wire your head up and flash lights in your eyes i think its called an EEG, then i went back to Lydney outpatients sometime later for results, i walked into the neurologists room when i was called and the neurologist looking down messing with something not really paying attention muttered actually there is something wrong then looked up and said sorry wrong person.

He had no notes or computers files open in front of him, really at the time i should’ve questioned him but i didn’t as i just thought it must be me again my body over reacting and doing strange things , so I went on my way continuing of going back and forth to gps and mental health services for various anti depressants and therapies , like cbt and counselling, art therapy etc … and tablets over the years ranged from Citalopram to Prozac to Veneflaxine to Mirtazipine , some in liquid form some tablets these spanned over many years.

I soon learnt what mostly the triggers were for these attacks it seemed anything that would raise my heart rate , so things like stress , exercise , etc… so I just tried to avoid these these things as much as I could but sometimes the attacks would happen for no reason at all , also over the years I sought private therapy through NLP, EFT, plus I socialised through spiritual groups and learning techniques like meditation and other forms of healing the therapies all helped me one way or another but never made a difference to attacks.

In 2008 I saw my gp again about my weight as it was creeping back on, and she referred me for a gastric band which I had placed in 2010 , which was helping manage weight etc… then in 2013 I became very unwell with the band I won’t go into the gory details but after not being able to eat or drink for 3 months the drs decided to refer me back to the ones who fitted the band , and the drs gave me Lanseroprazole which helped to keep down very small amounts of soft food like runny mash or watery ready break , and the people at south mead who originally fitted it did a swallow X-ray and it turned out my stomach had pushed through the band , so I was given the option of having it corrected or removed , so I agreed to have it corrected as at the time I really didn’t want to be without it.

Apparently when it was corrected there was several hernias and loads of ulcers in or around my stomach , I was told it would never be able to be tightened again but that was ok as at the time as it was like a security blanket for me what with my ongoing issues with weight, so life moved on and in about 2014/15 I saw a neurologist again as I had been back to gp so fed up of attacks and really beginning to question the anxiety thing especially as I had worked hard with loads of therapies and adopting a spiritual attitude to life and having a good social life with some really good friends who accepted me for me.

I saw a different neurologist and he wanted to try and witness an attack so he called a nurse into the room and asked me to undress to my underwear and tested my reflexes etc by this time I was pretty nervous so I began to shake a bit , so he thought that was an attack and said it was a functional movement disorder and gave me a web address to look at he ordered some bloods to be done , several months later I still hadn’t heard nothing so I rang up about bloods and the secretary said they were clear , so I continued plodding on life the best I could finding part time work etc… more tablets from the drs etc…

In 2016 I had the band removed as problems were beginning to occur again and I had just come to the conclusion I would rather be fat and happy than put my body through anymore torture plus the stress on my family In 2017 things started going downhill fast , the attacks were getting more frequent and more random.

Then in March the Friday before mother’s day so I wasn’t stressed and I was looking forward to being pampered and a day off from cooking and housework etc… as I have now got 5 children , I had an attack in the evening that basically hadn’t stopped yet 2 years on , so when it started I kept telling myself it would pass and made visits to out of hour gps who gave me beta blockers which done no good so I stopped them and my regular gp gave me Lorazepam and Zopliclone which really altered my thoughts and mood and by April I took a massive overdose of them which I am ashamed of but my mind was so scrambled and I was so off my face on them but not making no difference to the ongoing attack.

A group of mental health people visited my home on the following Monday which I now know was a assessment but wasn’t told at the time or received any copies of assessments but I will go more into that later as a lot has came to light about that more recently.

By May I had an appointment with the neurologist called Dr M__ S______ and before me and my partner had chance to sit down she blurted out your in a violent relationship aren’t you which is not true yes over 20 years ago I was but the man I am with now is such a good man , I tried to explain to her with my speech problems that this was not true , she just looked at my partner and said well you better not be , she did some standard neurological tests like reflexes although very difficult due to my movement and all over tremors and agreed to have me in as a inpatient ASAP for assessments and tests etc …and she prescribed pregabalin but after a week or so of taking it I recognised the feelings I had previously from meds that I stopped them and in a couple of days although still feeling awful the real horrible feelings went away.

In June I was called on a Friday night and asked if I could come in straight away as a bed had come free , so I did as the attack was still ongoing and really getting me down , it wasn’t a good experience at all , especially due to my speech problems , I even had a nurse taking the mickey out of my speech , the beds were set up weird and I wasn’t allowed to pull the curtains around me for privacy , I saw a physio once or twice and a health phsycologist once , Dr S______ saw me once or twice and one day she brought a colleague around with her with some student drs , he got me to do some things that I found really difficult like raise arms , then he said fnd we get a video done for dr S____ to go through with you to show you it’s fnd , then one of the students said to him how do you know it’s fnd and he grabbed my head and I started to feel electric shocks all through my body and making this weird humming buzzing noise then all of the drs went off to chat and go onto next patient , so great he started a new symptom of vile electric shocks in my body which I get daily now along with everything else.

So I was discharged and invited back the following week for the video to be made , the following week my partner booked yet another day off work and took me up for the video , we was left waiting for hours as somebody had cancelled it but eventually they got the video people to come over , they got me to sign a folded over peice of paper supposedly to say it was not for public use but I do question that now , the video was done which I found very stressful due to not being able to communicate and feeling unheard at one stage he rubbed his hand on my spine and I flinched with pain and he said in a loud voice for the camera oh I’m sorry that tickled I was so glad when it was over it was so humiliating, a few weeks later I had a appointment with Dr S___ , so again another day off for my partner but we thought we was going to go through video , but it wasn’t , it was more or less a discharge appointment.

My partner asked about the video and she was very awkward about it and said oh yes definitely fnd and quickly changed the subject  , so god know what happened to that video , so great discharged or so I thought I felt so alone so I turned to the internet and researched fnd and found someone talking about the Rosa Burden centre in Bristol and how they specialised in fnd , so I emailed Dr S____ through pals to ask wether she could refer me and she did ,so in the August I met Dr E__ M___ a neurologist from the Rosa burden centre and by the beginning of September I was a inpatient there on a four week rehab programme ,

I had some speech therapy there and physio and to input it was good there and great improvement was made there , towards the end you are set a task to walk to local Lidl ( about a 10 minute walk for average person ) but when I did it , it took me nearly 3hours as all symptoms returned but I managed to get back and just sit in a vegetive state for some hours after and pull myself out of it , so upon leaving they advised me to get a self referral for CBT, so I did even though it didn’t help things before , within weeks all of my symptoms were back worse and by the November I had to purchase a wheelchair for outings and by the February 2018 I was fully mute.

I went to gp who sent me to A&E but I ended up leaving because the one Dr was so rude and shouting at me , my partner had to step in and tell him to pack it up , but by this time I was so distressed I just got my partner to get my wheelchair to take me home , and the Dr on the way out said quite sarcastically yes go to Bristol they will sort you they are much better , why he said that I don’t know there was no need of his attitude , anyway I went to se Dr M___ a few weeks later for a outpatient review ,and she did her best to get me speech therapy locally and she reassured me not to worry or blame myself relapse is common in fnd , so by April/May 18 someone from mental health visited and realised I was mute so they then had to think as talking therapy wasn’t going to obviously work , so when they went I emailed them and asked if a psychiatrist could see me as I just had gotten to the point where I think I had gone nuts , so off to a psychiatrist I was referred I met him 3 or 4 times each time he was very rude and very impatient with my speech difficulties and just kept on wanting to give me tablets the first lot was Sertraline well I didn’t even collect prescription and the next time it was a very high dose of Prozac

I collected the prescription but never took them as he said to me in the appointment if I didn’t have tablets there was nothing he could do even though I was explains that meds were having a negative effect on me even paracetamol or anti histamines have a negative impact these days , so the next appointment that was like 6 minutes long he wasn’t happy because I wasn’t taking tablets and he referred me to psycologist L__ M___, I met her several times and she seemed to get it until I received a report in the post where she had written that my man had committed suicide , which when I emailed her to ask her where this had come from as it was distressing to read and not true she wrote back to me saying she got it wrong it was my grandad which again was not true , she wished me all the best for the future in the letter and that was the last I heard from her.

In that time as well I seen the speech therapist who was stumped after 5 sessions what to do, and Dr S___ had sent a random appointment so I went even though I thought I was discharged from her even though i was a lot worse and fully mute she didn’t seem bothered or even examine me and I ended up in tears by the end of the appointment and all she said to my son who had accompanied me was it does them good to let it out and patted me on the back.

When the report came through the lies that was wrote in there I just broke down blaming myself again , so a few more waste of time gp appointments etc … after but I won’t go into all of it as I can appreciate I’ve gone on loads already.

February 2019 I had another appointment with Dr M___ who has now discharged me , and I’m stuck at home housebound , more or less mute and tons of other symptoms , feeling very lost and alone and not knowing where to turn.

It’s surprising how much we take things like talking for granted but when it goes you soon realise what an important function it is , I just don’t understand why I’ve been lied about ? Diagnosis have been made on my past traumas in life are things being covered up especially as my symptoms now match MS or Parkinson’s or other neurological conditions but no recent scans have been done to rule them out ?

How can they waste NHS money on prescriptions and so called therapies when a true diagnosis has not been made ? Because the way I see it how can you begin to fix something if you don’t know what is wrong as fnd is just a umbrella diagnosis and the leading specialists in fnd say it is unusual for fnd to be the soul problem.

Did the years of antidepressants and those diet pills mess my brain signals up ? Especially as Reductil was designed to surpress the appetite through messing with the brain signals , I tried to help the health professionals the best I could by typing up everything prior to an appointment as I can appreciate it was hard for them with my speech problems and the last thing I ever wanted to be was a nuisance or a burden.

Thank you for taking the time to read this there’s probably loads more I could’ve added but I can appreciate this is loads already and I would really appreciate any support or advice you could offer many thanks MJ. 

#NHRW2019 Harm Reduction Wales

On Thursday 21st of March more than 300 delegates attended the National Harm Reduction Wales conference at the Mercure Hotel.

Organised by Josie Smith and her team from Public Health Wales seminars covered:

  • Physical Health and Wellbeing
  • Integrated Care and Service Planning
  • Emerging Threats and Opportunities
  • Psychological Health and Wellbeing


Katie Stone (Public Health and Social Policy lead – Harm reduction International) opened the conference with a talk on “Global and European perspectives on harm reduction.”

Next to speak was Dr Owen Bowden-Jones (Consultant Psychiatrist and Chair of the Advisory Council on the Misuse of Drugs) on the topic of of “Challenges for the UK and a focus on Wales”

Conference then broke to the respective seminars to explore the subjects in more detail.

Physical Health and Wellbeing
Preventing adverse consequences of substance misuse – Jan Keauffling (Healthcare for homeless people)
Sexual Health and Harm Reduction – Suzanne Williams
(Obstetrics, Gyneacology & Sexual Health) & Jane Fourweather (Sexual & Reproductive Health)
Achieving elimination of blood born viruses and tuberculosis – Dr Al Story (TB Find & Treat Service)


Integrated Care and Service Planning
Children and Young People Services – Meinir Williams-Jones (Barnardo’s Cymru)
Offender Health and Continuity of Care – Louise Forman (HMP & Probation Service Wales)
Models of Opioid Substitution Therapy Provision and Same Day Prescribing – Dr Mike Kelleher (Lambeth Addictions Consortium)

Emerging Threats and Opportunities
Online Prescribing Services – Aled Jones (www.PAST.Wales)
Benzodiazepines – Dean Acreman (Health Protection, PHW)
Changing Drug Markets & County Lines – DI Justin O’Keefe (TARIAN Reional Organised Crime Unit)

Aled Jones from PAST.Wales
Aled Jones from PAST.Wales
Dean Acreman PHW
Dean Acreman PHW/Wedinos

Psychological and Wellbeing
Alcohol and Longer Term Health Harms – Brian Robertson (Drink Wise Age Well)
Addiction and Dependence – Prof. Robert Rogers (School of Psychology, Bangor University)
Complexities in Mental Health and Substance Misuse – Dr Julia Lewis (Gwent Specialist Substance Misuse Service)

Dr Julia Lewis
Dr Julia Lewis

Conference then returned to the hall to hear from Tracey Breheny (Deputy Director Substance Misuse Government and Corporate Business, Welsh Government) on the direction the Welsh Government is driving Harm Reduction in Wales.

Q&A closed the conference with questions from the floor to the panel of speakers from the day.

panel during Q&A
Q & A session to close the conference
#NHRW
National Harm Reduction Wales

photographs coutesy of @jaystarphotography – many thanks

Britain loses medicines contracts as EU body anticipates Brexit

Britain’s leading role in evaluating new medicines for sale to patients across the EU has collapsed with no more work coming from Europe because of Brexit, it has emerged.

The decision by the European Medicines Agency to cut Britain out of its contracts seven months ahead of Brexit is a devastating blow to British pharmaceutical companies already reeling from the loss of the EMA’s HQ in London and with it 900 jobs.

All drugs sold in Europe have to go through a lengthy EMA authorisation process before use by health services, and the Medicines & Healthcare products Regulatory Agency (MHRA) in Britain has built up a leading role in this work, with 20-30% of all assessments in the EU.

The MHRA won just two contracts this year and the EMA said that that work was now off limits. “We couldn’t even allocate the work now for new drugs because the expert has to be available throughout the evaluation period and sometimes that can take a year,” said a spokeswoman.

In a devastating second blow, existing contracts with the MHRA are also being reallocated to bloc members.

Martin McKee, the professor of European health at the London School of Hygiene and Tropical Medicine, who has given evidence to select committees about Brexit, said it was a disaster for the MHRA, which had about £14m a year from the EMA.

The head of the Association of British Pharmaceutical Industry said it was akin to watching a “British success story” being broken up.

Mike Thompson, the chief executive of the association, said: “Clearly we’ve all been incredibly proud of the MHRA’s role over the last few years. They’d established themselves as one of the most respected regulators across all of Europe and industry. It’s been a British success story.”

The EMA said that because of the long lead-time involved in assessing medicines it could no longer award the lead contracts to British people since there was no guarantee they would be part of the EU after March 2019.

It is understood the MHRA bid for 36 EMA contracts this year but were only awarded two, and these were for drugs for which evaluation had already begun.

The situation is a stark contrast to 2016 when the UK was the lead assessor, known as the rapporteur, on 22 applications, and was joint lead or co-rapporteur on 19 multinational applications.

This made it the number one in Europe, with Germany’s regulator behind with 22 lead contracts but only 12 co-contracts.

…..

An MHRA statement said:

“We want to retain a close working partnership with the EU to ensure patients continue to have timely access to safe medicines and medical devices. This involves us making sure our regulators continue to work together, as they do with regulators internationally, and we would like to explore with the EU the terms on which the UK could continue to participate in the EMA.”

 

more on this story here

 

 

Trusting the “medical” system?

This five minutes could be the most important for your health & honest statement spoken about the medical “industry”.

 

 

The full two hours debate here

Super session in the 2-hour European Parliament meeting on Thursday – so many issues raised by Dr. Aseem Malhotra, MEP Nathan Gill, Sir Richard Thomson, Professor Hanno Pijl and Sarah Macklin. Now edited with HD footage and clear sound. Let’s get the message out – MEP Nathan Gill and Aseem reckon a million views would be a great goal – only if it gets shared like hell !

To allow doctors to be honest and give best advice for our health, the medical and pharmaceutical industry needs transparency and movement away from profit orientated business and poor medicine.

Withdrawal – What we Know and Don’t Know

Antidepressant Withdrawal – What we Know and Don’t Know

My Doctor/Psychiatrist told me that I have to take an antidepressant to correct a
chemical imbalance in my brain, is this true?

No, it is a myth, we cannot test or measure the state of neurotransmitters in your brain, the
American Psychiatric Association disavowed this myth in 2011(1). It is a pharmaceutical
company invention (2).

How many people experience withdrawal effects?

It varies according to which drug is used, at what dosage, and for how long. Recent
studies (3) are showing the number affected to be greater than 50% of those taking the
drugs. The UK Royal College of Psychiatrists did their own survey (4) (now removed) which
showed that 63% reported withdrawal effects.

Why does my doctor/psychiatrist keep saying ‘discontinuation syndrome’ when I
mention withdrawal?

Discontinuation syndrome is an invented term (5) which minimises the role of the drug in the
harm caused and steers users away from addiction terminology. While dependence and
withdrawal have some features in common with addiction, they are not accurately
described using just this approach. What you are experiencing is an effect of withdrawing
from a drug, not of discontinuing treatment.

Why does my doctor insist that ‘once the drug is out of my system’ I will be fine?

Because not all doctors understand the effects of antidepressant drugs on the brain (6). A
heavy drinker or smoker may suddenly stop drinking/smoking, but the effects on their brain
and nervous system continue to be felt long after they have quit. Antidepressant drugs
change the brain in ways we don’t currently understand. These adaptations (7) to the drug
are responsible for withdrawal effects.

What does withdrawal feel like?

It’s a highly variable experience ranging from mild symptoms which pass quickly, to
profound symptoms that sometimes persist for many years. In a 2017 survey (8), 46% of
those reporting withdrawal symptoms described them as ‘severe’. Most common reported
symptoms (9) are insomnia, dizziness, fatigue, digestive problems, anxiety, panic,
depression, agitation. Withdrawal symptoms can sometimes mimic depressive or anxious states but should not be confused with relapse (10).

I am worried about dependence, what should I do?

The most important thing is never stop your drugs suddenly, this can be dangerous. Talk to
your doctor but be prepared as many doctors do not have the information to be able to
help. Withdrawal is a unique experience, with no fixed rules.

There are some excellent and
reliable online sources for help including:
• theinnercompass.org
• madinamerica.com/drug-withdrawal-resources
• survivingantidepressants.org
www.jfmoore.co.uk August, 2018
Antidepressant Withdrawal – What we Know and Don’t Know

References (to read these online visit www.jfmoore.co.uk/ltw.html)
1. http://www.psychiatrictimes.com/blogs/couch-crisis/psychiatry-new-brain-mind-andlegend-chemical-imbalance
2. https://www.scientificamerican.com/article/is-depression-just-bad-chemistry/
3. http://roar.uel.ac.uk/7402/
4. RCPsych survey (now deleted)
5. https://www.psychologytoday.com/gb/blog/side-effects/201107/antidepressantwithdrawal-syndrome
6. http://time.com/3399344/antidepressant-changes-the-brain-study-finds/
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4118946/
8. http://roar.uel.ac.uk/7402/
9. https://www.karger.com/Article/FullText/370338
10.http://www.stacommunications.com/journals/diagnosis/2006/Diagnosis_sep_06/DS.pdf
www.jfmoore.co.uk August, 2018

What we know about antidepressant withdrawal V1

James Moore

Three mental health centres in the Vale of Glamorgan are set to close down

 

 

 

Three centres which support adults with mental health difficulties are set to close down, it has been revealed.

The Amy Evans Centre in Barry , Hafan Dawel in Penarth and Cowbridge Health Centre will all shut in September, with their respective teams joining forces and moving to Barry Hospital.

While mental health charities say the decision will lead to a more comprehensive service being provided under one roof, there are fears moving them further away from some people’s homes could cause harm to patients.

Full Story

Opioid Epidemic UK

It is not easy to get a comprehensive picture of the overall situation regarding the prescribing of OP and the purchase of codeine-containing OTC formulations, but piecing together the evidence from various datasets reveals that the UK population is consuming considerable and increasing amounts of OP:

 In 2012, some ten million people in the UK were prescribed an OP, more than double the next nearest EU country France at four million

 In 2013, the UK had the highest sales of morphine by volume than any other country in the EU

 In 2013, the UK had the highest sales of opiates like codeine by volume than any other country in the EU and between 2010-2013 the UK had a 6% growth in sales, against the next largest margin increase in the EU.

 In 2011, Northern Ireland has highest annual prevalence of prescription opioid use in the world (8.4%)

 In the period 1994-2009, Tramadol prescribing increased tenfold and all OP showed significant increases in level of prescribing during this period with the exception of dihydrocodeine. Just in England, the number of prescriptions rose from around three million in 1991 to 23 million by 2014.

 Defined Daily Doses for Tramadol in England have increased from 5.9 million in 2005 to 11.1 million in 2012.

 Between 2001-2011, prescription for co-codamol almost doubled from 8.8 million to 15 million

Since the early 1980s, the extensive professional, political and media discourse about drug misuse and addiction has centred on the use of a wide range of illicit drugs such as heroin, cocaine, cannabis, amphetamine, and ecstasy. There is also a public and professional awareness about the dependency potential of tranquillisers and antidepressants highlighted, for example, by class actions brought against pharmaceutical companies, media reports and articles, popular and medical books, TV documentaries, and guidelines produced by the medical profession to advise against over-prescribing. That said, the very existence of this APPG indicates continuing and very real concerns not only about the startling level of prescribing of tranquillisers and antidepressants3, but also the lack of specialist help underlined by the recent closure of some of the few charitable helping agencies that do exist.

In recent years too, there has been a growing awareness of the dangers of OP, most notably dependency and overdose. The evidential base is most developed in the USA where celebrity revelations including Michael Jackson, Burt Reynolds, Melanie Griffiths and Jamie Lee Curtis have served to foreground the risks demonstrated by the epidemiological evidence and clinical case reporting.4 It has been suggested that much of the problem has derived from the progression from only prescribing OP for acute pain and cancer treatment to more generalised chronic pain conditions which has led to more widespread misuse and rising mortality in many Western countries.

In the UK, public and professional awareness in the UK of the potential dependency and overdose risks of OP has been patchy. Despite some sporadic press coverage going back into the 1990s, the subject really didn’t hit the headlines until 2009 with the publication of the All Party Parliamentary Group on Drugs report, An inquiry into physical dependence and addiction to prescription and over-the-counter medication. The remit covered tranquillisers, anti-depressants and OP and MPs took evidence from campaigners, doctors, clinical researchers, government agencies and the pharmaceutical industry.

Exerpts from

Opioid painkiller dependency (OPD): an overview.
A report written for the All-Party Parliamentary Group on Prescribed Medicine Dependency by Harry Shapiro