All posts by Aled Jones

#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

Podcasts & Audio Files

Episode 1 Professor John Read on the epidemic of psychiatric overprescribing, the lack of research on withdrawal and pharmaceutical marketing and lobbying

Episode 2 Claire talks about antidepressant withdrawal, tapering and SSRI discontinuation syndrome

Episode 3 Giovanna talks about her SSRI antidepressant treatment over 23 years and her attempts to withdraw

Episode 4 Professor Peter Gøtzsche on why prescription drugs are now the third leading cause of death and the pharmaceutical manufacturers dominance of mental healthcare

Episode 5 Daryl on being prescribed antidepressant drugs at 9 years old and his experiences with OCD, Tourettes syndrome and PSSD

Episode 6 Doctor Terry Lynch on the myth of the brain chemical imbalance and why Psychiatry has pursued a purely medical approach to distress with terrible consequences

Episode 7 Doctor David Healy on prescribing practice, medicine safety and pharmaceutical regulation

Episode 8 Dede Moore on how the Emotional Freedom Technique (EFT) help her with antidepressant withdrawal

Episode 9 Christopher Jump talks about his transformational journey from psychiatric hospital to woking in peer support and wellness

Episode 10 Kevin P Miller talks about his documentary films Generation Rx (2009) and Letters From Generation Rx (2015) which tell the powerful stories of families harmed by their psychiatric medications

Episode 11 Nora talks about her extreme adverse reaction to an antidepressant which started almost immediately and left her with physical, emotional and psychological problems

Episode 12 Doctor Lucy Johnstone on how the underlying causes of emotional distress are often unexplored, and why that might be

Episode 13 Susie talks about stopping her antidepressant cold turkey after 2 years and how her doctors failed to recognise antidepressant withdrawal

Episode 14 Tina talks about her experience with depression, her use of antidepressant drugs and how a change in her medication led to her withdrawal problems

Episode 15 Robert Whitaker talks about the astonishing rise in mental ill health despite the availability of psychiatric drugs

Episode 16 Megan talks about how she came into contact with psychiatric medications and how she approached her antidepressant withdrawal after two failed attempts

Episode 17 Doctor Joanna Moncrieff on psychiatric drug mechanisms of action, antidepressant/antipsychotic withdrawal and the RADAR study

Episode 18 Simone talks about her experiences of postnatal depression, fibromyalgia and her treatment with antidepressants

Episode 19 Marion Brown talks about psychiatric drugs, Human Givens therapy and medically unexplained symptoms (MUS)

Episode 20 Gemma talks about her experiences with antidepressants and benzodiazepines and the difficulties that parents of children with special needs encounter when they seek treatment for emotional or psychological distress

Episode 21 Doctor Gary Sidley talks about his years of experience within NHS mental health services and alternatives to bio-medical psychiatry as ways of responding to human suffering

Episode 22 Meghann describes her experiences of being prescribed antidepressant drugs for OCD at the age of 9 and how she approached stopping them some 17 years later

Episode 23 David talks about his sanguine view of antidepressant drugs and his own experiences of the mental healthcare system

Episode 24 Doctor Peter Groot from Maastricht University talks about his own experiences of antidepressant drugs and his novel, practical solution for those who want to withdraw safely: Tapering Strips

Episode 25 Sinead describes her 16 years of treatment with antidepressants, her attempts to withdraw and how she feels about starting medications for her emotional distress

Episode 26 Judy Meyer talks about her experiences of the psychiatric system and how she became a holistic mental health practitioner and mental health advocate

Episode 27 Elaine talks about her experiences with antidepressant and stimulant drugs, her withdrawal and how she felt judged rather than helped by psychiatry

Episode 28 Chaya Grossberg talks about her experiences of the psychiatric system and her naturopathic approach to mental health and wellbeing

Episode 29 Stevie talks about her experiences taking the SSRI antidepressant Seroxat and her severe and protracted withdrawal from the drug

Episode 30 Holly Higgins talks about her own experiences with psychiatric drugs and withdrawal and how she became a nutritional therapy practitioner and healed her depression and anxiety with real food

Relevant Mad in America episodes

Mo Hannah: Changing the Teaching of the Biological Model

World Benzodiazepine Awareness Day: Raising Global Understanding

Will Hall: A Harm Reduction Approach to Mental Health and Wellbeing

Irving Kirsch: The Placebo Effect and What It Tells Us About Antidepressant Efficacy

Olga Runciman: Moving Beyond Psychiatry

Dr. David Healy: Seeking a Cure for Protracted, Medication-Related Sexual Dysfunction

Dr. Jennifer Bahr: Treating the Whole Person

Johann Hari: Lost Connections

Dr. Joanna Moncrieff: Challenging the New Hype About Antidepressants

Laura Delano: Connecting People Through the Inner Compass Initiative and Withdrawal Project

Peter Breggin, MD: The Conscience of Psychiatry (part 1)

Peter Breggin, MD: The Conscience of Psychiatry (part 2)