Fiona’s letter published in the BMJ.

Re: What are your burning issues for 2018?

http://www.bmj.com/content/360/bmj.k9/rr-9

The issue of prescribed drug dependence must surely be urgently addressed in 2018.(1) The words “first do no harm” ring very hollow to the many, many thousands of patients harmed by these drugs and the medical code of ethics is now very seriously questioned by the online harmed patient community. Many of these patients regard their doctors only with the greatest of contempt, not simply because they have been so seriously harmed but because more often than not they are faced with a complete lack of honesty in the consulting room when attempting to discuss the cause and the nature of the harm already sustained. Patients are being denied appropriate help as well as relevant tests and scans in order to preserve the questionable reputation of the medical profession and to avoid further healthcare expenditure. The proliferation of articles and educational sessions on “Medically Unexplained Physical Symptoms” is clear evidence that a very deliberate and widespread strategy has been put in place to this effect.

After many decades, the terrible legacy of the mass prescribing of benzodiazepines is still with us and patients continue to clamour for a public inquiry as they have done for the past three decades.(2) Patients are emerging from the shadows having lost 10,15, 20, 30, 40 years of their lives or more to these drugs. I am one of them. Yet, in 2011, the immense harm caused by benzodiazepines were downplayed on national radio by the then Chair of the Council of the RCGP, Prof Clare Gerada. (3) Even today new patients are being started on these drugs outside the prescribing guidelines of only a few weeks.

The sheer scale of antidepressant prescribing fills me with alarm as more and more harmed patients seek help online, realising that their prescribing doctors have little or nothing to offer them. They have neither the knowledge or the expertise to safely taper patients off these drugs, despite the fact they have been on the market for decades. (4) Furthermore, most of these patients feel wholly deceived as they discover the poor evidence base for these drugs even in the earliest of drug company clinical trials (5) and the widespread mythology peddled for decades that depression is caused by a chemical imbalance in the brain.(6) Most were never warned of the risks these drugs carry, particularly after years of consumption and were wholly misled as to why they might need them in the first place.

Despite the call for a national helpline and specialist services by the BMA, (7) the UK Government has done nothing. Clearly resources are an issue, but the current economic and social costs to society of drugs of dependence must be massive. Patients are losing their homes, their families, their incomes and have to fight to be awarded disability benefits with a high risk of being refused. It is no wonder so many feel utterly betrayed and that there is nowhere left to turn. And so they turn online in increasing numbers, seeking information, help and support and a lifeline from others similarly harmed. At least there they will not be derided or disbelieved, offered another drug or labelled as “mentally ill”.

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