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  • EADD Moderators: Pissed_and_messed | Shinji Ikari

Question about disclosing to GP illicit benzo use - How confidential are they?

A

anonplease

Greenlighter
Joined
Feb 16, 2014
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2
I wanted to post this anon, but the sites down. So this will have to do.

(Long post, so only read if you're genuinely interested in offering advice.....the gist of it is I want to know whether my GP would inform my Medical School of illicit drug use if I disclosed it.)

So I've got myself in a pickle with diazepam, non-scripted. So therefor illicit use right?

Now I've only ever taken them for therapeutic/anti-anxiety reasons. Nothing recreational. Recently, I started taking more due to a lot of anxiety triggers (stupid I know), but I now feel "hooked". I'm going to try and cut-down/taper, but we'll have to see how that goes.

IF that doesn't work, I'd like to go to my GP and seek help. Obviously I'd have to disclose I'd been getting them illicitly. Now normally I'm sure this would be perfectly fine, probably happens fairly often. And normally I imagine the usual confidentially rules apply. But here's my problem....

I'm currently a medical student. And in 4 years will be qualifying as a Doctor. There's something called "fitness to practice" that the General Medical Council abides by, meaning so long as your fitness to practice is not impaired, you're registered as a doctor.

So I have a few issues:
1. Does what I have done impair my FTP?
Medically, no I don't think so. I'm getting good grades, function normally, socially active ect ect Plus I know plenty of practicing doctors will be on mental-health medication.
However once of the categories fitness to practice looks at is:
57. Fitness to practise may be impaired for a number of reasons:
  1. a. misconduct – this includes issues that raise a question about a doctor’s probity, trustworthiness or character
  2. and another

  1. c. a conviction or caution or a determination by a regulatory body whether issued within or outside the British Islands


(Fucked up the formatting here sorry)

Anyway, I've no conviction. But whether or not a GP has the authority to disclose a 'determination' of illicit use? I don't know?

2. This brings me to my second question:
Will my doctor breach confidentiality for this? The guidelines state:
"53. In some circumstances, it may be necessary for a GP or other doctor who is involved in the care of a medical student to raise concerns about the student’s fitness to practise."

In the guidelines under "frequent areas of concern relating to a students fitness to practice" it has as one of the categories:
[TABLE="width: 70%"]
[TR]
[TD]Drug or alcohol misuse[/TD]
[TD]Dealing, possessing or misusing drugs even if there are no legal proceedings[/TD]
[/TR]
[/TABLE]

Now I doubt anyone can answer this, but was just hoping for some informed opinions. Do you think my GP would view what I have done (essentially self-medicated and bought medication illegally) as impairing my FTP?

FTP is basically aimed at assessing whether a doctor is at risk of putting patients, themselves or the public at risk if allowed to practice.
I don't think my actions would lead anyone to think I'd be putting patients at risk?

What do you guys think? In your opinion would a GP possibly raise concerns about my FTP if I raised the issue now?
Are there any other things I can do? I'm looking into speaking with my universities confidential counselling team to ask their advice, who aren't medical professionals and can't make decisions on FTP, but obviously this might be even more risky, what with it being a part of the University I'm studying at.


(by the way, the reason I'm in this predicament and didn't immediately seek help once the anxiety started is for similar reasons above. It was during my application to my course, and I was worried it may impair my application. It wouldn't have in the end. They never asked for medical records :-( )

Thanks

Oh, here are some of the guidelines http://www.gmc-uk.org/education/undergraduate/professional_behaviour.asp#15gmcprov
 
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I really wouldn't know in a situation like this. The part you quote...

In the guidelines under "frequent areas of concern relating to a students fitness to practice" it has as one of the categories:
Drug or alcohol misuse Dealing, possessing or misusing drugs even if there are no legal proceedings
Click to expand...

... does look to me like a situation like yours would be covered though. However, I'd imagine there must be some discretion when it comes to applying and enforcing it. There are degrees of drug misuse. It's obviously a big risk though - you do have rather a lot to lose - if it were me I'd probably try to taper and quit myself. If you were to go to a GP they'd only put you on a taper plan anyway so it'd still be mostly willpower to not buy black market benzos on the side and stick strictly to the taper schedule. Drug and addiction support services vary wildly around the country but it may be possible to make use of such services without involving a GP. Or there's always 12 Step (which is based on anonymity) if that's your bag.

Honesty is generally the best policy, but with such a lot to lose I'd be nervous about owning up to illicit drug use if I'd already decided to stop with it and was working towards cutting it out myself. From what you said it doesn't sound like you're in too deep - you don't mention physical addiction and dependence and hopefully you're not at that stage. Dealing with the physical aspect of any addiction is relatively straightforward - just gotta taper and quit - but the psychological side will always be there and ultimately you have to choose not to acquire more black market benzos whether supervised or not.

This is purely personal opinion though - I really have no idea about how these guidelines would actually affect anybody. Good luck <3
 
try and cut down as much as you can on your own. Where did you get the illicit benzos from? Regardless of that I personally think the best thing to tell your GP (but only if you need to see them) is thata family member gave you theres, then there's no bad bad acquisition of the drugs through any dishonesty and it's a bit like a "family matter" .
 
third eye squeegee said:
edit: regarding confidentiality, given the recent reports of GPs selling your medical records to pharma and insurance companies, I wouldn't be too keen on reporting your problem as it stands..
Click to expand...

Very true - nothing is confidential about anybody's medical records now. And even the opt-out doesn't actually opt you out of anything. Fukkin' disgusting so it is :|

And you're correct, the chances of being scripted benzos in the UK run from slim (as in pro-ana slim) to nil. Ironically enough, unless you have a pre-existing benzo habit. But for anxiety, no chance. Most likely be offered SSRIs (naturally 8)) or possibly CBT if you don't want medication.
 
NO! dont tell him anything. why would you want to chance it like that. you probably know more how to taper and help yourself off a drug than he does. dont leave it to what ifs. people dont look at you as someone who enjoys a little head change, they look at you like a unpredictable addict thats about to go on a life ending bender. theres no point in telling him and nothing good will come of it. if you tell him he is gonna say you should stop taking them. usually, doctors dont tell you what you dont know already.
 
.....I dont really understand why you would want to tell the GP anyway - esp if there is a risk it could ruin your future. If you want to come off do a taper - its not too hard but not knowing how much you are taking its hard to call.
 
This

legalizeall said:
NO! dont tell him anything. why would you want to chance it like that. you probably know more how to taper and help yourself off a drug than he does. dont leave it to what ifs. people dont look at you as someone who enjoys a little head change, they look at you like a unpredictable addict thats about to go on a life ending bender. theres no point in telling him and nothing good will come of it. if you tell him he is gonna say you should stop taking them. usually, doctors dont tell you what you dont know already.
Click to expand...

Plus this

Shambles said:
Very true - nothing is confidential about anybody's medical records now. And even the opt-out doesn't actually opt you out of anything. Fukkin' disgusting so it is :|

And you're correct, the chances of being scripted benzos in the UK run from slim (as in pro-ana slim) to nil. Ironically enough, unless you have a pre-existing benzo habit. But for anxiety, no chance. Most likely be offered SSRIs (naturally 8)) or possibly CBT if you don't want medication.
Click to expand...

Plus yeah, why the fuck would you want to tell him? It's like you're investing GP's with some Hippocratic notion of empathy and working for your best interests.

Welcome to the war on drugs.

Get clean, on your own. You can taper yourself. You don't need a political boot kicking its way in to your life.
 
Try tapering yourself first. If you cant access any more diazepam, get some etizolam/similar online and use that.
 
StoneHappyMonday said:
This



Plus this



Plus yeah, why the fuck would you want to tell him? It's like you're investing GP's with some Hippocratic notion of empathy and working for your best interests.

Welcome to the war on drugs.

Get clean, on your own. You can taper yourself. You don't need a political boot kicking its way in to your life.
Click to expand...

why the fuk uwould u want to get Clean ? G man that word ain't in your diction
 
Because he's a doctor (in training) and I'm talking to him in his own language.

Other than that, yep ok. 1-0 to you. ;) I shouldn't have used that word/phraseology.
 
Here's my advice.

Start taking Etizolam....instead of your diazepam.

I think this will substitute ? - Correct me EADD if im wrong.


this gets rid of any ilegallity. Any GP will understand that you self medicated due to anxiety.
 
swedger77 said:
Here's my advice.

Start taking Etizolam....instead of your diazepam.

I think this will substitute ? - Correct me EADD if im wrong.


this gets rid of any ilegallity. Any GP will understand that you self medicated due to anxiety.
Click to expand...

Swapping a short-acting benzo for a long-acting one is a very good way to massively increase your tolerance and habit. Generally with benzos you go the other way if trying to cut down. The legality of etizolam is handy but would probably make more sense to go for one of the long-acting ones like flubromazapam - that has an even longer half-life than diaz itself which is no slouch in that department. Big problem with legal, internetz benzos is that it's incredibly easy to order a fuckload cos they get so much cheaper in bulk which is less than ideal if trying to control usage.

Some docs are okay with the self-medicating thing, most aren't. I got quite lucky with mine cos he is rather supportive of benzo use - unlike the vast majority of docs for whom they've become the devil incarnate. It's definitely worth approaching a GP and/or and addiction service though. The worst they can do is refuse you a script, but in most cases (particularly with an addiction service) you will get a reducing script of diaz. Problem is you need to be down to a "reasonable" level as far as daily dosage goes cos there's no way on Earth they'll step in when people are dosing in the multiple hundreds of mg per day (which is surprisingly common - particularly with folk that have gone the etiz route with such a short half-life combined with high potency).

Also, The Ashton Manual - pretty much The Benzo Bible.
 
Telling them you sell it, are going to cause some form of harm they'll be kicking the silent alarm before you can get yer nob out.

I openly told one of my docs during CBT and she told me to stop there n then.

I told my GP I do Mephedrone cos I hate drinking and I saw his nostril flare - he said continue use of.
 
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