Mental Health The UK's unfair rules on Benzos for Mental Health patients!

[evo4ever]

Hey all.

The other day I had two mental health crises in one day linked to 5 straight days without sleep which caused me to self-harm, I ended up in the emergency department so I could see the mental health team and they determined that I needed a short course of 5mg Diazepam to last me till the 27th till I seen the consultant psychiatrist so they could do a medication review. The mental health nurse that was arranging my care gave me 3x 5mg Diazepam tablets to take home prescribed by the psychiatrist as the hospital cannot give anymore than that and she said she will email my GP with instructions to prescribe me 28x 5mg Diazepam to be taken once a day as a temporary measure. After all this was concluded I phoned my GP so I could check if she had done my prescription and she said she could only give me 4x 5mg Diazepam tablets because they're "too addictive" regardless of what the psychiatrist had instructed her to do! She said I can only give you 4 tablets and we'll have a telephone appointment once they have ran out. Why is she going against specialist advice from my psychiatrist?? Bare in mind that im already on high dose Rx Oxycodone for chronic pain which are by far more addictive imo which they are quite happy to repeat prescribe to me but they simply refuse to give me a temporary 3 week course of much needed Diazepam at a low dose till I have a medication review at the end of the month!

Am I being treated unfairly here? Is my GP not doing her job properly by not following my psychiatrists instructions?

Cheers guys.

 

[THECATINTHEHAT]

1. Benzos are no less addictive than oxycodone, dont get confused about that.

2. From what you have said so far you havent actually see the consultant psychiatrist so far, it was just the mental health nurse who contacted the doctor? If that is the case it's not surprising that the doctor is using their own judgement, a nurse is not qualified to make that judgement unless they're a prescribing nurse in which case they would have just prescribed to you themselves.

3. Doctors are right to be careful with benzodiazepines, the UK can be perhaps overly sensitive around them these days bit that is because so many mistakes were made in the past. I dont know the specifics of your condition but it does seem a bit shit to only give you 4 x 5mg. A full months worth of 5mg daily IS enough to develop a very small habit in some cases, but it sounds like that risk could be justified in this case.

4. You are ALWAYS entitled to ask to be seen by a different doctor and get a second opinion, so if you think the response you are currently receiving is inappropriate I would encourage you to go ahead and do that.

 

[THECATINTHEHAT]

Also it's worth noting that at this stage they aren't refusing to prescribe you, just that they want to speak to again before they do. See what happens at this appointment before doing anything else.

 

[MsDiz]

Another point, you were in for a mental health crisis and self harmed. You’re on strong pain medication and I’d imagine the worry for the dr is that Benzos and opioids are a dangerous combination. What if you took too many? You really need to just speak to your dr on the phone and discuss it with them and see what they say. It is annoying to be turned down for a med that you find helps you but you need to see it from their side also. It’s a massive risk for them to prescribe it to you.

 

[F.U.B.A.R.]

IMO, very few GPs 'do their job properly' when it comes to mental health (or anything really). All the ones I've met inspire me with no fuckin confidence whatsoever. They are all so shit scared of prescribing anything that actually works and sit there googling your symptoms right in front of you.

@Wilson Wilson is your best bet for advice with prescribing in the UK. But it's going to involve going private...

 

[Flower Fairy]

Another point, you were in for a mental health crisis and self harmed. You’re on strong pain medication and I’d imagine the worry for the dr is that Benzos and opioids are a dangerous combination. What if you took too many? You really need to just speak to your dr on the phone and discuss it with them and see what they say. It is annoying to be turned down for a med that you find helps you but you need to see it from their side also. It’s a massive risk for them to prescribe it to you.

Exactly what I was about to say and I live in the UK, I was addicted after my first pack of 28 x 5mg diazepam I got for anxiety, then I was only allowed 14 x 2mg once in a blue moon, so I bought off the Internet and bought all sorts of weak ones, fake ones, legit pharma grade ones, MSJs etc then moved onto xanax, I was on 100mg a day of diazepam when I knew I had to stop, it was horrible withdrawl and paws lasted so long I had to go on an antidepressant called mirtazapine yet again

Don't touch a benzodiazepine, I'm almost a year clean off diazepam but recently bought xanax to come off mirtazapine, I can only advice, but what with your oxys ontop of vallies (diazepam) you could stop breathing or get a habit, not worth it

 

[evo4ever]

So far the Diazepam has helped me a lot for my sleep and god knows what would of happened if I never had them, I could of self-harmed again or worse, I genuinely think they saved my life. I've got 3 left to last me till Wednesday when I have my telephone appointment with my GP. It would be appropriate to prescribe me some more Diazepam in the interim until I see my psychiatrist at the end of the month.

I terms of taking Oxy with Diazepam I haven't noticed any adverse effects plus I take my last dose of Oxy at around 7pm and then I take my Diazepam at around 11pm so theres a 4 hour gap between them which I consider safe.

 

[evo4ever]

IMO, very few GPs 'do their job properly' when it comes to mental health (or anything really). All the ones I've met inspire me with no fuckin confidence whatsoever. They are all so shit scared of prescribing anything that actually works and sit there googling your symptoms right in front of you.

@Wilson Wilson is your best bet for advice with prescribing in the UK. But it's going to involve going private...

Does going private increase ur chances of getting what u need? And when u say private do u mean joining Bupa Healthcare?

 

[Branggen]

I think he meant a private convo

 

[Specified]

Fuckers........they should be belted the fuck with a baton

 

[Wilson Wilson]

IMO, very few GPs 'do their job properly' when it comes to mental health (or anything really). All the ones I've met inspire me with no fuckin confidence whatsoever. They are all so shit scared of prescribing anything that actually works and sit there googling your symptoms right in front of you.

@Wilson Wilson is your best bet for advice with prescribing in the UK. But it's going to involve going private...

Absolutely right unfortunately. The bulk of GPs are terrible especially at mental health and just throw SSRIs in your face. Any mention of benzos is shut down with "they're addictive, can't script 'em." NICE guidelines also state that GPs should not script benzos long-term unless a long-term script has been referred by a psychiatrist. NHS GPs are required to follow NICE guidelines or they could get in trouble (i.e. be personally liable if something goes wrong) or even struck off in the worst case. However nothing in the NICE guidelines stops an NHS GP scripting a one month supply of diazepam without a referral. They can do that themselves.

But here in OP's case, that one month script for 28x 5mg diazepam was referred by an NHS psychiatrist. An NHS GP is OBLIGATED to accept a referral from an NHS psychiatrist. I want to make this absolutely clear that an NHS GP has absolutely NO RIGHT to overrule a referral from a relevant NHS specialist. See another GP, have proof of the referral, and get your fucking meds. No need to go private if all you want is the one month script that an NHS psych has already referred to you.

In OP's case it is also a bit more complex as he's scripted a high dose of oxy and has mental health issues. So @PrincessDiz is correct in those concerns - a doctor will be thinking, above the existing risk of scripting benzos and getting sued for addiction, they have to additionally worry about a patient on a strong opiate and who is exhibiting mental health problems being given a benzo on top. I imagine that is the concern for this GP.

But nonetheless, your diazepam script has been referred by an NHS psychiatrist, so you are entitled to those meds. Simple as that.

 

[MsDiz]

Absolutely right unfortunately. The bulk of GPs are terrible especially at mental health and just throw SSRIs in your face. Any mention of benzos is shut down with "they're addictive, can't script 'em." NICE guidelines also state that GPs should not script benzos long-term unless a long-term script has been referred by a psychiatrist. NHS GPs are required to follow NICE guidelines or they could get in trouble (i.e. be personally liable if something goes wrong) or even struck off in the worst case. However nothing in the NICE guidelines stops an NHS GP scripting a one month supply of diazepam without a referral. They can do that themselves.

But here in OP's case, that one month script for 28x 5mg diazepam was referred by an NHS psychiatrist. An NHS GP is OBLIGATED to accept a referral from an NHS psychiatrist. I want to make this absolutely clear that an NHS GP has absolutely NO RIGHT to overrule a referral from a relevant NHS specialist. See another GP, have proof of the referral, and get your fucking meds. No need to go private if all you want is the one month script that an NHS psych has already referred to you.

In OP's case it is also a bit more complex as he's scripted a high dose of oxy and has mental health issues. So @PrincessDiz is correct in those concerns - a doctor will be thinking, above the existing risk of scripting benzos and getting sued for addiction, they have to additionally worry about a patient on a strong opiate and who is exhibiting mental health problems being given a benzo on top. I imagine that is the concern for this GP.

But nonetheless, your diazepam script has been referred by an NHS psychiatrist, so you are entitled to those meds. Simple as that.

His script wasn’t on recommendation of a NHS psychiatrist though, it was a mental health nurses recommendation for up until the 27th when OP had their appointment with their psychiatrist.
You’re completely right in the guidelines and a Dr must follow them but only on the instructions of a psychiatrist not a mental health nurse.

 

[Wilson Wilson]

His script wasn’t on recommendation of a NHS psychiatrist though, it was a mental health nurses recommendation for up until the 27th when OP had their appointment with their psychiatrist.
You’re completely right in the guidelines and a Dr must follow them but only on the instructions of a psychiatrist not a mental health nurse.

Oops you are correct. I misread the OP, he said this script is to hold him over until he sees his psychiatrist. I thought he said the script was given by the psychiatrist. That's my bad.

In that case yes he has a weaker case as far as obligations the GP has goes, but it's still a good idea to see another GP anyway. A patient who has had a diazepam script referred to by someone who works in mental health should be able to get that script, even if it's from a nurse not a psych. They're still mental health specialists. NICE guidelines don't make this mandatory to my knowledge, but he can still calmly speak to another GP and show the referral.

I wouldn't recommend the private option (at least not yet) in OP's case because he is lucky enough to have an NHS psychiatrist already and that psychiatrist may very well be more understanding than his GP. If another GP still won't give the script, well it's not exactly difficult to buy boxed and blistered diazepam is all I'm saying... obviously the ideal situation is getting it legit from a doctor, but if they're not doing their jobs right and giving you the script literally already written for you, you gotta get your meds somehow...

 

[MsDiz]

Yeah I wouldn’t go the route of buying your own diazepam at all. Honestly, it might help in the interim and that’s great for the OP but they need to speak to their psychiatrist properly. Benzo addiction is a bitch and withdrawing from that would be worse than what OP is going through now. It’s all too easy to pop a few more to feel better and it’s a slippery slope. Mix that in with the Oxys and it really is a dangerous combination.

I get it, I get the fact that Benzos do help and it does feel like it saved your life and that probably is the case for the short term but having a long term script for them isn’t worthwhile in my opinion. Tolerance grows to both them and the pain medication and they won’t go past a certain point when it comes to that. Then you’re stuck, having to use meds that do nothing for you and being advised to come off them which I see happening.

OP, speak to your GP when you’ve run out, explain you only want them until you see your psychiatrist, remind them it was on the recommendation of the mental health team at the hospital. Hopefully you’ll get a script until you speak to your proper psychiatrist and then discuss with him/her. There is a lot to consider here for you and for them. There’s risks both ways but you need clear and concise information to help make that decision as does your psychiatrist.

 

[Wilson Wilson]

Yeah I wouldn’t go the route of buying your own diazepam at all. Honestly, it might help in the interim and that’s great for the OP but they need to speak to their psychiatrist properly. Benzo addiction is a bitch and withdrawing from that would be worse than what OP is going through now. It’s all too easy to pop a few more to feel better and it’s a slippery slope. Mix that in with the Oxys and it really is a dangerous combination.

I get it, I get the fact that Benzos do help and it does feel like it saved your life and that probably is the case for the short term but having a long term script for them isn’t worthwhile in my opinion. Tolerance grows to both them and the pain medication and they won’t go past a certain point when it comes to that. Then you’re stuck, having to use meds that do nothing for you and being advised to come off them which I see happening.

OP, speak to your GP when you’ve run out, explain you only want them until you see your psychiatrist, remind them it was on the recommendation of the mental health team at the hospital. Hopefully you’ll get a script until you speak to your proper psychiatrist and then discuss with him/her. There is a lot to consider here for you and for them. There’s risks both ways but you need clear and concise information to help make that decision as does your psychiatrist.

I get you and you make good points. If OP gets a single box to hold him until he sees his psychiatrist, which is what the script is for to begin with, I don't think addiction is likely personally. Especially since OP is voluntarily coming off his legit oxy script despite having mental health concerns. That to me doesn't paint a picture of someone with an addictive personality. But obviously this is only my opinion.

I am not at all suggesting OP self-medicate with benzos as a long-term solution to be 100% clear on that. This rarely ever leads anywhere good.

OP should absolutely speak openly with his psychiatrist. But as per the OP he won't see the psych for a month and the diaz was scripted to hold him over until that appointment. So he should have that diaz.

Like I said though, speak to another GP first. Someone with a diaz script should be able to get their bloody diaz from the doctor.

 

[MsDiz]

I get you and you make good points. If OP gets a single box to hold him until he sees his psychiatrist, which is what the script is for to begin with, I don't think addiction is likely personally. Especially since OP is voluntarily coming off his legit oxy script despite having mental health concerns. That to me doesn't paint a picture of someone with an addictive personality. But obviously this is only my opinion.

I am not at all suggesting OP self-medicate with benzos as a long-term solution to be 100% clear on that. This rarely ever leads anywhere good.

OP should absolutely speak openly with his psychiatrist. But as per the OP he won't see the psych for a month and the diaz was scripted to hold him over until that appointment. So he should have that diaz.

Like I said though, speak to another GP first. Someone with a diaz script should be able to get their bloody diaz from the doctor.

I don’t see where OP says they are coming off their Oxy script anywhere? Have I missed it? OP says they dose 4 hours after their oxy which is sensible I understand. Edit: just read OPs previous posts. OP is tapering down their oxy themselves without GP knowledge I’m assuming. Is this why you went 5 days no sleep and had a health crisis?

 

[Wilson Wilson]

I don’t see where OP says they are coming off their Oxy script anywhere? Have I missed it? OP says they dose 4 hours after their oxy which is sensible I understand. Edit: just read OPs previous posts. OP is tapering down their oxy themselves without GP knowledge I’m assuming. Is this why you went 5 days no sleep and had a health crisis?

Not in this thread, he has made other threads in OD and BDD discussing it. He is scripted 120mg and so far has tapered down to 60mg last I checked. He's doing so of his own fruition. And if someone is going through a mental health crisis and voluntarily tapering down from a repeat script of oxy I'd say that deserves some mad respect and shows strong willpower.

He did also say that he wasn't getting bad withdrawals yet so I'm not sure if this is the reason for his mental health crisis, it is possible but his previous posts didn't indicate that at least. If it is the reason, well a little month supply of diaz would certainly help. I would normally recommend cannabis instead, but someone who has just had to go to A&E for self-harm probably shouldn't smoke weed. He has kratom already, and that would certainly help too if it's withdrawal related.

 

[MsDiz]

I’d honestly say it was downright dangerous to reduce a 120mg oxy dependence whilst going through a mental health crisis. How can OP decipher what withdrawals are if they are going through mental health issues? No sleep is classic withdrawal symptoms.

Honestly, if I were OP I’d be honest with my GP and say I want to come off my oxy with a proper taper schedule. OP is also on pregabalin so I can see where the GP is coming from more now. All red flags, oxy, pregabalin and benzos does not a good script make ya know?

 

[evo4ever]

Sorry guys I've been preoccupied with other stuff atm. I've actually taped down to 40mg of Oxy a day now and I'm still taking the Kratom and I'm not getting any WDs thankfully, the only problem I've got is I'm sitting on a shit load of Oxy's! I was scripted a total of x7 diazepam tablets from the hospital and my GP and they will run out on Wednesday, I've got a telephone appointment on Wednesday with GP cos she wants to see how im getting on. BTW I'm seeing a locum GP my actual GP is on holiday. The Diazepam has really helped for sleep and it's reduced my thoughts of self-harm, I've been cutting again over the past few weeks .

This has nothing to do with the Oxy taper and I know what Oxy WD feels like trust me, I've had mental health problems for 5 years now.. it's an on-going thing. I've been prescribed Zopiclone and Diazepam in the past while on my current meds without any problems. Going back to the Oxy I might not be able to come off them after all cos my neuropathy in my arm has come back its probably got something to do with the reduced Oxy dose. This is why I didn't want to tell my GP I'm reducing my Oxy dose incase my pain came back because if it did which it has I'd have to jump through hoops to get the Oxy scripted again.

 

[MsDiz]

Sorry guys I've been preoccupied with other stuff atm. I've actually taped down to 40mg of Oxy a day now and I'm still taking the Kratom and I'm not getting any WDs thankfully, the only problem I've got is I'm sitting on a shit load of Oxy's! I was scripted a total of x7 diazepam tablets from the hospital and my GP and they will run out on Wednesday, I've got a telephone appointment on Wednesday with GP cos she wants to see how im getting on. BTW I'm seeing a locum GP my actual GP is on holiday. The Diazepam has really helped for sleep and it's reduced my thoughts of self-harm, I've been cutting again over the past few weeks .

This has nothing to do with the Oxy taper, I've had mental health problems for 5 years now.

Please be honest with your GP, tell them you want to taper down your oxys. Give your remaining oxys into a pharmacy for disposal. The fact you’re happy to reduce your oxys will show your dr that you’re less of a risk in regards to addiction. It will look good on your file.

I’m really sorry you’re going through it at the minute but I honestly think even though it might not feel like it that the oxy taper has probably accounted for some of your symptoms like the lack of sleep which will make your mental health issues worse. You’re a trooper for wanting to reduce your oxy but it’s probably best to do it with medical supervision especially when you’ve mental health issues, ya know?

I would imagine if you told your dr about wanting to taper your oxy and spoke to your psych about things they would give you a short script of benzos to see you through. At the minute your Dr is seeing a 120ng oxy with pregabalin and they would be really uncomfortable with prescribing benzos on top. Your willingness to reduce your oxy would go along way to show your dr you’re not a risk with benzos.

I hope you get sorted, I’m sorry you’re going through such a rough time. A good list of distractions might help, when you’re feeling the need to self harm try move your thought pattern to something else. I have an eating disorder and I purge quite regularly after eating so I have a list of distractions like having a shower, going for a walk, doing laundry etc etc. When I’m going up the walls after eating and wanting to purge I get my list and go through it. It helps sometimes and of course it doesn’t other times but sometimes is better than none.