Posted by Couleuvre on July 1, 2019, at 6:32:26
In reply to Re: xanax - whats going on, posted by rjlockhart37 on May 13, 2019, at 19:15:27
Because of the "opioid epidemic," doctors in the States are especially wary these days of prescribing any potentially addictive drug (opioid or otherwise). I suspect they're even more rigid about this with people who have mental disorders because we're at higher risk (statistically) for substance abuse than people who don't have mental disorders. If they even think beyond the statistics and their biases, they assume that we are all irresponsible, lacking in self-control, etc.
One thing that helps a lot is having a doctor who knows you and who knows that you can be responsible about how you use your meds. Once doctors understand that the reason I have been taking several [supposedly] potentially addictive meds for so long is that I have *not* gotten into trouble with them. A new doctor, though, is liable to treat you as "guilty until proven innocent" when it comes to prescription drug abuse. Among other things, the organisations that monitor prescription drug "diversion" and things, like the DEA in the States, are making doctors more fearful of losing their licenses if they don't try everything else before trying a "drug of abuse" - even things that aren't appropriate in the case in question, and even when the addictive drug is far more likely to be effective. I've known a lot of people who started getting stuff off the streets because their doctors refused to prescribe opioids for pain, or would only prescribe small doses that weren't effective. I know I've often felt afraid to ask for a higher dose of a benzo that isn't working well enough, whereas most doctors, if you ask for an increase of an antidepressant (the standard monoaminergic ones, that is - SSRIs, TCAs, MAOIs, and miscellaneous stuff like Serzone, Remeron, Effexor, etc.), would not even think about possible risks. It's really an obsession for a lot of them.
One other thing that is making benzos harder to get for some who need them is that there has been a lot of media attention to cases where people, especially elderly people suffering falls and breaking bones as a result of medications like benzos and the "z-drugs" like Ambien, Sonata, etc., prescribed for insomnia or anxiety, or where people get hurt or do something weird in their sleep (eating, having sex, etc.) after taking one of the z-drugs. Doctors are therefore doubly reluctant to prescribe these meds, especially to "elderly" people. It's really irrational and discriminatory; they judge you based on a general feature rather than your personal history and ability to use meds responsibly (e.g., not getting up after you've taken your sleep meds -- except of course to use the lavatory!). Older people who have no real risk factors for falls (except age), no history of them, and are in better general health than most people a fair bit lot younger than themselves will be refused appropriate treatments just because of their age. They're treating the patient as a statistic rather than as an individual. I'm all for evidence-based medicine and everything, but that's not what this is -- this is oversimplification, basing decisions on a risk factor that doesn't exist in isolation, but is one of multiple risk factors and is not significant in the absence of those others. Doctors need to be able to think, not just blindly follow simplistic rules. Patients who have one thing in common can still be very different otherwise.
poster:Couleuvre
thread:1104382
URL: http://www.dr-bob.org/babble/20190513/msgs/1105081.html