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Experiences of Addiction and the Medical Profession

I'm please pjd555 has joined. We needed a doctor here. Someone who obviously has an interest in addiction is a massive bonus. There are loads of questions that I'm sure a lot of people have that he can answer and hopefully the understanding he gains from being on this site will improve the direct care he can give his patients.

Paramedics are pretty limited in what they can do (although the way the NHS is going we're being asked to do more and more.....hence the exams).

As a rule we only treat emergencies and trauma but having a real doctor on the site opens a whole load of avenues for the promotion of genuine understanding and harm reduction.

The forum can only benefit. :) <3
 
The only doc I met in a 'drugs' situation was at a meeting and he had been addicted to omnopom - sounded like a great drug and one I had never even heard of. A doc on the board will certainly help with some of the qustions asked here.
 
Omnopon is a trademark for papaveretum.

We've had medics here before and their input has been invaluable, though they tend to keep their day jobs very discreet for obvious reasons.
 
....mostly just morphine with some codeine and other bits n bobs, the med kits that milatry have contain amps of it but marked up as morphine.
 
Papaverine too, hence the name.

Why would the military do a thing like that?

Surely they can just use morphine alone, as they have done traditionally? Surely it's easier (and cheaper) to extract morphine than to manufacture papaveretum, which involves removing certain opium alkaloids and such?
 
Wahey congratulations Mr74!!!!!!!!!

That's really good news man, you managed to prepare for/do exams at the same time as your recent detox? You sir, are a fucking hero!
 
Many thanks folks...was just pleases that the three essays I learned were the ones that actually appeared on the paper cos I'd have been fucked if they hadn't haha!!

It's a big con really...they want you to pass so if something goes wrong and you kill someone they can cover their backs by saying "well we trained him how to do it properly and he passed an exam so it's not our fault "....

Not to worry though....I'm happy :)
 
englandgz74 said:
I'm please pjd555 has joined. We needed a doctor here. Someone who obviously has an interest in addiction is a massive bonus. There are loads of questions that I'm sure a lot of people have that he can answer and hopefully the understanding he gains from being on this site will improve the direct care he can give his patients.

Paramedics are pretty limited in what they can do (although the way the NHS is going we're being asked to do more and more.....hence the exams).

As a rule we only treat emergencies and trauma but having a real doctor on the site opens a whole load of avenues for the promotion of genuine understanding and harm reduction.

The forum can only benefit. :)
Click to expand...

Having both a paramedic crewed ambulance ad a doctor can be a lifesaver. A doctor on his own has limited options because I don't carry an ambulance around with me. I once had to perform an emergency fasciotomy on a patient trapped under rubble. He had no other injuries but he had been found 6 hours after the accident and the situation meant releasing the leg was going to take some time. He walks without a limp now.

Sorry I used jargon again. Fasciotomy is a procedure used to alleviate compartment syndrome which is where an injury has caused swelling of a muscle. They mostly occur in the legs following crush or impact injuries. The muscles exist within a compartment and the swelling nreaches a point where the compartment won't allow the swelling to continue and pressure builds up cutting off blood flow which destroys tissue and nerves which leads to another complication which attacks the kidneys. The fasciotomy is an incision along the length of the compartment to expose the muscle so the pressure is released.
 
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THECATINTHEHAT said:
Never going to happen (rightly or wrongly). It changes from area to area obviously but on the whole it's impossible to get a maintenance script for anything these days, especially benzos. You get given a script on the understanding that you are going to taper whether you like it or not.
Click to expand...

The current NICE guidelines are:

[h=3]Managing someone who does not want to stop[/h][h=4]How do I manage someone who does not want to stop taking benzodiazepines or z-drugs?[/h]
  • Do not pressurize the person to stop if they are not motivated to do so.
  • Listen to the person, and address any concerns they have about stopping.
    • Explain that for most people who withdraw from treatment slowly, symptoms are mild and can usually be effectively managed by other means.
    • Reassure the person that they will be in control of the drug withdrawal and that they can proceed at a rate that suits them.
  • Discuss the benefits of stopping the drug.
    • The discussion should include an explanation of tolerance, adverse effects, and the risks of continuing the drug. See Reasons for stopping for further information.
  • Review at a later date if appropriate, and reassess the person's motivation to stop.
  • In people who remain concerned about stopping treatment despite explanation and reassurance, persuading them to try a small reduction in dose may help them realize that their concerns are unfounded.

About half of my patients in such situation won't even discuss managed withdrawal. As I am typing out the prescription I say we'll discuss this again next time I see you. I cannot force a patient to undergo a course of treatment against their will.
 
Wow...well that's a very different experience to what I have had in various different areas. Got to say I'm pretty shocked, last time I went on a benzo script I got given it on the understanding of a very regimented reduction schedule (although things didn't play out like that for various different reasons).

Thanks for posting that it was an interesting read (if a little late for me personally), I'm happy to be corrected there. Do you have a link to the full set of NICE guidelines?
 
Very different to the experiences of other benzo addicts that I have met through groups like Battle Against Tranquilisers as well. Increasingly people are being forced in to reductions and a lot of the work that they do is helping negotiate slower tapers with prescribing doctors for the people that are coming to their group. I've only attended there rather than done service but the girl who went to my uni and helped run the group I attended said it was a lot of what they dealt with.
 
I am well aware that many doctors follow deserving and non-deserving patient approaches. They are wrong and if they ever bothered to keep up to date with accepted treatment protocols they would change their ways. The number one rule in dealing with addicts recommended by NICE is DO NOT PRESSURIZE THE PATIENT.
 
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