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Q&A: Prescription drugs use, misuse and dependence.

Posted: Thu Sep 19, 2019 2:55 pm
by Vik
A special event: Q&A with a nurse about all things prescription medications.



Over the past 10-15 years there has been a significant increase in the harms associated with prescription medication use in Australia. The harms affect the whole community regardless of whether this is legitimately prescribed medication or illicit substance use. Often when people start medications they are unaware of the side effects and short and long term impacts of the substances involved. Prescribed medication use can become complicated, having significantly negative impacts on our health, relationships and communities.

We have seen an increase in people asking about these substances, both in our forums and through our counselling services, and wanted to create an opportunity for you to ask your questions, and gain some clarity for yourselves regarding prescription medications.

Elle Brown is our guest, here to answer any questions you may have. Elle is an experienced nurse, with a background in the alcohol and drug sector and is currently working within the SafeScript program – a Victoria-based government initiative involved in the monitoring of dispensing prescriptions from doctors and pharmacies.

There are no bad questions, and everyone’s welcome to contribute. This thread will be open September 20th - 30th for your questions, after which Elle will answer them for you. Perhaps you’re a person who has experienced difficulties relating to these drugs and have questions regarding health impacts, change, what to expect. Take advantage of this simple, anonymous Q&A. Select ‘Post Reply’ below while signed in to ask Elle anything.

Re: Q&A: Prescription drugs use, misuse and dependence.

Posted: Mon Sep 23, 2019 2:47 pm
by horsecrazy4eva

Thanks for your time!

Prescription drug uses:-

I sustained a injury to myself which has resulted in ongoing pain issues (nerve pain)

I was put on a “short term” pain prescription I would have been on it for about 6 months

I saw a chronic pain specialist who changed me from the short term pain medications, to one that is long term (nerve pain)

I basically went fairly well “cold turkey” from the short term pain prescription and started the long term nerve pain medications.

Unfortunately I believe I had a withdrawal that caused a one off “violent” outburst and caused depression symptoms.

Prior to my accident that resulted in chronic pain, I was already being treated with depression, anxiety, ADHD medications.

I have stayed well clear of pain medications since.

Any advice?

Re: Q&A: Prescription drugs use, misuse and dependence.

Posted: Wed Sep 25, 2019 2:33 pm
by Vik
Really interesting questions @horsecrazy4eva, Elle's looking forward to getting back to you and anyone else who might be experiencing similar concerns soon.

I think I would really love if Elle could share with us some information about the impacts of using these types of drugs in combination with others? I know in Australia we have a high rate of illicit drug users also using prescription drugs and think it's worth understanding more the risks and effects of this.

Who else has questions? We're open for questions great or small until Monday, would love to hear more!

Re: Q&A: Prescription drugs use, misuse and dependence.

Posted: Sat Sep 28, 2019 6:14 am
by Simply me
Hi Elle,

Thanks for the opportunity to ask a few curly questions...

I have been on prescribed antipsychotics, various brands and types, for about 20 years. I've heard that in one model, these medications are supposed to work on the levels of 'dopamine' in the brain, blocking receptors and thus dropping levels. That in doing so, the brain can actually change / respond by increasing the number of receptors for this substance in an attempt to I'm not sure what, rejuggle, but leading to a surge in dopamine levels when you reduce, or indeed, come off these meds. Which can then translate to a mimicry of the very kinds of experiences, and distress, that the drugs were first prescribed for. Hearing, seeing and sensations of things others don't experience, but which are real for the person living through them. That it can infact be worse after longer term use? Wondering if you know of strategies to ease and heal such changes? Any suggestions appreciated...

Is it a similar process for other prescription meds? That there can be physical changes to ones system meaning you then have to reexperience what they were originally prescribed for, and indeed reprogram, to some degree, as you come off them? Sounds like a major bummer I know, but just wanted to hear your thoughts....

I have also been prescribed benzodiazepines for PTSD / anxiety and it wasn't explained to me how addictive these are at the time. I've found reducing them I go through the very raised stress levels and agitation that they are 'designed' to block.

Having said, and asked, all that, I also believe the brain and body have an amazing capacity to heal. Folk do. Gotta.

Thanks kindly

Re: Q&A: Prescription drugs use, misuse and dependence.

Posted: Mon Sep 30, 2019 12:39 pm
by Crowman88
Hi Elle, I'm hoping you can help me.
I have been taking my benzodiazepine for 8 months, starting from February of this year to now, to control muscle spasms and anxiety.
I was taking a moderate amount from February to May.
My prescribing doctor is weaning me down.
I am seeing my GP and a psychologist.
I have never abused my dose, and take them every six hours or more when required.
I have tried to come off my benzodiazepine myself without success.
I went 11 days free, then had a huge CNS chemical-based terror attack. This was definitely not a standard panic attack. It was a panic attack x100.
As a result I am heavily dependent, and struggle to function without taking the benzo.
I have had hand tremors, panic attacks, depersonalisation and derealisation, stomach distention/bloating, crushing fatigue and sensitivity to lights/sounds.
I am desperate for some help. I would like to come off my benzodiazepine for good.
Many thanks.

Re: Q&A: Prescription drugs use, misuse and dependence.

Posted: Mon Sep 30, 2019 1:25 pm
by Vik
Thanks everyone for these really interesting questions! I'll lock this thread now and pass them over to Elle, and will have some responses ASAP for you :)

ANSWERS - Q&A: Prescription drugs use, misuse and dependence.

Posted: Fri Oct 18, 2019 1:19 pm
by Vik
Elle's answers
(posted on behalf of guest)
Hi everyone! My name is Elle. Thanks for the very interesting questions about prescription medication use.

Dependence & prescribing rates
The use of opioid medication for pain relief has undergone huge changes in the last 10 years. Originally prescribed sparingly except for life ending disease they were then prescribed for every type of pain - acute or chronic, both short term and long term. One thing about these medications that has not changed is their ability to unwittingly create dependence in people. Dependence can create a situation where the absence of symptoms of withdrawal is perceived as analgesia (or absence of pain). This means that although taking this medication has managed the pain in the past, sudden absence of the medication causes a massive increase in pain. Dependence can be defined as neuronal adaptation to repeated drug exposure making functioning only possible in the presence of the drug. In other words a person will begin to need to use the substance to function ‘normally’ or function at all.

Withdrawal from opioids can include symptoms including anxiety, nausea, vomiting or abdominal pain. It is not life threatening. It can feel awful and endless and is recommended to be done under the care of a medical practitioner. They can help manage the physical symptoms by the prescription of other medications, facilitate referral to a psychiatrist and psychologist to assist with the mood and emotional symptoms and the provision of other supports through a challenging health issue. Depending on the individual and the type of prescription medication utilized they can either start a tapering regime or an opioid replacement therapy using buprenorphine or methadone. It is important to share your history of opioid use with prescribers into the future so that you can work together on an effective pain management plan. This means you should then be able to access the most appropriate health care you need.

Problems with use
Use of prescription and non-prescription medications can be problematic. One is a measured dose with known strength, the other is of unknown dose and strength. Prescription drug related deaths are overwhelmingly associated with the use of benzodiazepines and prescribed/non prescribed medications/alcohol use. Benzodiazepines are prescribed for a number of conditions and they also have potential for dependence. Depending on the length of time used and dose taken they can have a very long and debilitating withdrawal syndrome. Most prominent of the symptoms of this withdrawal syndrome are profound rebound anxiety and insomnia also featuring among the health issues for which they are prescribed. This was very eloquently described by one of the questioners on the forum as “a panic attack x 100”. Again it is important to be monitored and assisted by a medical practitioner during withdrawal from benzodiazepines. Reconnexion 1300 273 266 is a service that specializes in people experiencing dependency on benzodiazepines. Reduction and tapering of the dose is recommended, but not abrupt stopping.

Antipsychotic medications work on the uptake or availability of neurotransmitters serotonin and dopamine and the mucarinic and histamine receptors, the neurochemistry is varied and complicated. Again abrupt withdrawal without medical oversight and care is not recommended and as described the re-emergence of traumatic and distressing symptoms can disrupt the person’s life and health. Use of antipsychotic medications may require ongoing blood testing to ensure their safe use.

Medical support
I would encourage people to find a GP with whom they can have a trusting relationship, someone who you value as a partner in your care and who helps you make informed decisions about how to tackle health issues. Knowing the one practitioner over a period of time helps you both choose wisely and without judgement.

Resources I used in the answers were: NPS Medicine Wise, & Safescript.

Was this helpful? We can continue the discussion and talk through any questions below.

Re: Q&A: Prescription drugs use, misuse and dependence.

Posted: Mon Oct 21, 2019 2:43 pm
by Simply me
Thanks Elle!
I agree it can definitely be productive to work with a GP, or medical practitioner, for monitoring support, and for advice on 'tapering' amounts.
I do also believe that folks with a lived experience when it comes to prescription meds we become reliant upon, or which change our brains, inevitably have important knowledge about what we go through coming off them or making decisions around them.....
On the tangent of 'psych meds' (in which I'd include Benzodiazepines) I'd like to share a couple of free resources I've found useful and inspiring to my experiences...

The Icarus Project's 'Harm Reduction Guide to Coming off Psych Meds' which comes in several langauges and a print out n make a book version.... ... ithdrawal/

Also a YouTube film called 'Coming off Psych Drugs: A Meeting of the Minds' by Daniel Mackler

Hope their of interest to some folk...
Blessings n good vibes...

Re: Q&A: Prescription drugs use, misuse and dependence.

Posted: Mon Oct 21, 2019 5:24 pm
by Vik
Thanks @Simply me !!

Re: Q&A: Prescription drugs use, misuse and dependence.

Posted: Mon Nov 04, 2019 5:00 pm
by Rikki
I'm new to this ... Little nervous

Re: Q&A: Prescription drugs use, misuse and dependence.

Posted: Mon Nov 04, 2019 5:41 pm
by Bear33
Hi @Rikki

Welcome to the forum! It can be a bit daunting at first, but we hope you'll find it to be a safe and welcoming community :) Feel free to share your story on the 'Introduce yourself here- lived experience' thread here: viewtopic.php?f=2&t=77