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Most of us have been to our GP at some point complaining of pain. It’s not uncommon – back pain or a persistent neck pain following a bad night’s sleep. The purpose of our GP visit is to hopefully find an answer to what is causing the pain and to make it go away. Most GPs will start by prescribing painkillers before undertaking further investigations to identify the cause of the pain. For some, however, the pain can persist and the root cause is not easily identifiable. For those patients, long-term painkillers are prescribed to enable them to function on a daily basis. These patients, however, can be easily forgotten about – they attend routinely to pick up a repeat prescription but are not always questioned on whether the pain is still present. Opiate based painkillers can be extremely addictive and when patients attempt to slowly withdraw their medication, some frightening side effects can ensue. These patients require slow, supervised withdrawal of these painkillers to avoid these side effects.
Over the years I have dealt with numerous cases involving prescription medications – from gambling addictions as a result of Parkinson’s medication to those who have been given medication to alleviate pain.
Recently I settled a case for a lady who was prescribed the benzodiazepine, clonazepam in the early 90’s for pain in her hip. She had 4 years previously undergone a release of the right fascia lata due to clicking hips. Her pain returned 4 years later and she was advised by a pain management consultant that she would probably need to take the drug for life as it allowed her to function on a daily basis. Her pain eventually disappeared and she tried to reduce the dose of the medication, but suffered bouts of anxiety and chronic bowel problems. She received very little help from her GP and the NHS in withdrawing from the drug.
In 2003 she found a clinic in Salisbury where she went and was slowly weaned off the drug alongside alcoholics and recreational drug users. She suffered from withdrawal side effects including chronic IBS, anxiety, pain, pins and needles, and insomnia.
In 2005, her symptom of anxiety had not improved and she was placed under the care of a psychiatrist. She asked to be prescribed clonazepam again, as her life seemed easier when she was taking the drug. As she was no longer experiencing any pain, there was no clinical basis to prescribe the drug and her psychiatrist, understandably, refused on several occasions. She then saw a locum who willingly prescribed the drug noting “...sometimes as doctors we have to accept that it is pointless proposing new medications against the patient’s wishes because in the end it is up to the patient to accept or ignore the advice of a doctor.”
My client soon realised that she should not be taking the drug, and again tried but failed to wean herself off it. The medication was not as effective as it had been previously and she craved higher doses. She lied about taking her medication and losing tablets, so her GP would prescribe her more. When he refused, she took over-the-counter medication and began drinking heavily to try and avoid her cravings. She hit rock bottom, lost her job and was essentially cared for by her husband 24/7. Due to receiving very little help from her GP or the NHS she admitted herself to the Priory in 2010, at considerable cost to her family, where she underwent a withdrawal programme. The withdrawal process was successful, however her withdrawal symptoms still persist to date.
Liability was admitted by the Trust, court proceedings were issued and the case settled just before Christmas 2015 for £200,000. The case not only highlights the serious effects of prescription medication but also the divergence between Doctors in prescribing certain medication.
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