You don’t have to go to a dealer to become a drug addict, try the NHS.

Doctors in America have, either by not reading the small print on the bottles, or ignoring the warnings sent out by their professional colleges, led thousands of their patients into become drug addicts. They think they are doing good by prescribing strong pain killers, but last year there were more deaths from prescription pain killer overdoses than there were deaths from road traffic accidents.

The habit of doctors prescribing more and more pain killers is coming to the UK. In 2017 over 22.75 million prescriptions for them were written by doctors working for the NHS

Doctors are making patients into drug addicts? Think I’m joking? Keep thinking. We all think we know what a drug addict looks like: like that chap you see on the way to the station wearing a dirty jacket; he’s usually got a dog with him. He’s skinny because he clearly doesn’t bother eating. Sometimes he asks you for money in an obsequiously polite tone and calls you Ma’am or Sir. Sometimes he’s simply passed out on the pavement.

Yet what about that friendly person you often see, sitting opposite you on the train, or in the café grabbing a quick coffee, clearly on her way to work? Yes, she sees her doctor regularly but what’s wrong with that?

Well nothing is wrong with her. But something is badly wrong with her doctor. He has arranged for that poor lady to be addicted to sleeping tablets.

Did you ever have trouble sleeping? Maybe it got bad enough that you asked your GP for sleeping tablets. If you saw a good doctor, you might have found the experience a bit annoying. Did they go on and on about sleeping in a dark room, bed time routines, not having a telly in your bedroom and then send you home empty-handed? If they did, then that was a mark of excellent clinical care.

Karen’s doctor didn’t. He thought he was being nice or maybe he was a bit busy that day and wanted to move Karen along. Maybe he was ignorant or simply out of date. But the upshot was he gave Karen a month of sleeping tablets (Valium, or ‘mother’s little helper’) even though all doctors know it only takes three weeks or less for someone to get stuck on them. After all, Karen had just suffered a bereavement, her husband aged 33, dying of leukaemia.

At the time, Karen really ‘needed’ those sleeping pills and she was grateful for the sympathy and continuing care she received from her GP. And, by God, that care has continued, because now she’s stuck on them. Yes, that perfectly nice lady that you see every day with the coffee has to visit her GP every 28 days and beg for a new batch; otherwise she suffers withdrawal symptoms from her sleeping tablet addiction.

Sleeping tablets are one thing, perhaps for those anxious sorts, but Bob is not one of them. He’s your builder and you know that he’s a decent chap. He helped you sort out your garden wall that time after a storm. But there was that time he broke his leg. Naturally it made sense to give him strong pain killers until he was healed and mobile again. Once the pain settled, he could easily stop taking the tablets.

Except that he didn’t. He still gets ‘pain’ from his completely healed leg and he has made an arrangement with his GP to pick up strong pain killers every two weeks as long as he stays on a stable dose. He probably doesn’t even think he is addicted. After all, he only takes what the doctor gives him. But this cycle of use and withdrawal, mistaken by Bob as pain and only relieved by the use of more pain killing patches, is a classic symptom of addiction.

Anyone who has tried a strong pain killer such as an opiate – a version of heroin – (and I have, after a fall from a horse), knows the warm and cosy, insulating, lovely feeling it gives you. That’s the quality of the drug. Snow White would get addicted to opiates if you gave her them. Cinderella, the prince, the ugly sisters; they would all get stuck on opiates if their doctors prescribed them.

Perhaps you think I am exaggerating; but in America, women are dying from prescription pain killers at an unprecedented rate – over 10,000 a year, four times more than from cocaine and heroin combined. More have died of prescription drug overdoses than from car crashes. America has had to announce a strong pain killer epidemic and declare it a national emergency; and the UK is heading in the same direction with everincreasing prescriptions and patients being dosed up on opiates in the A&E departments of NHS hospitals.

We have always known that strong pain killers are addictive. We have realised sleeping tablets are addictive and we are now starting to realise that even those fancy new modern medications for pain are addictive; these are all drugs of abuse. And who knows what else is out there dressed up as a kind friendly medication, something to shut you up and hurry you out of the GP surgery to save the doctor time.

Watch out for those addictive drugs your doctor dishes out. If you don’t want to become the latest tablet sucking zombie, constantly asking for more, be very very cautious if your doctor offers you a new tablet unless you want to risk the Big Sleep.

Berenice Langdon is a GP and the author of Learning Microbiology through Clinical Consultation OUP. Highly commended by BMA Book Awards 2017

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15 Comments on You don’t have to go to a dealer to become a drug addict, try the NHS.

  1. John Henry,
    I have obviously fallen prey to the contrived grievances of our day ( I overlooked your “Having fun” concluding remark in a fit of pique. Still, what do you think of my “Houdini- The Disappearing Leg” theory?

  2. J. O’Connell:

    Our doctor writer (Langdon) is a GP. Are GPs now allowed to use the honorific “Mr”, instead of “Dr” in the country where I presume you write from? Not to mention that the given name of said physician is Berenice, not Bernie.
    (Just having fun)

    • On this occasion I duly accept your reprimand but will not rise to the crude baiting of of “the country from which you originate” which you can be sure will have been noted by others. If you are seeking attention or to score points is this rally the right site for you? Do not expect me to play the victim for you and hold your breath at the same time would be my advice.

  3. Mr. Langdon
    Unforunately” usually accompanied by a dog” is not that great an exaggeration. It is also unfortunate for the one-legged beggars that Romanian/Roma childern, I am not sure which, are taught/trained from an early age how to contort their bodies and can stand in one position for along time with one leg folded and pinioned to the upper leg.

  4. Our good doctor asks (rhetorically):
    “Did you ever have trouble sleeping?”

    So, I’m not off topic saying that when having trouble sleeping, I find reciting the many ritualistic prayers of my faith – Actus Contritionis, Anima Christi, Memorare, Angelus, Confiteor, Kyrie, Gloria, Acclamation, Credo – bring me to slumber long before I getting to the ultimate Pater Noster.

  5. “We all think we know what a drug addict looks like: like that chap you see on the way to the station wearing a dirty jacket; he’s usually got a dog with him.”

    Somewhat sexist, Dr Langdon, your using the pronoun *he* in reference to addicts. I don’t mind though, as I approve your observing grammatical convention; but I think you’re wrong in saying drug addicts are usually accompanied by dogs.

    Another thing to keep in mind is that, according to my chauffeur – the woman who drives me and others to and from our car repair shop – is that she sees *homeless* beggars every day at major intersections pleading for money, and has come to realize through her experience that beggary is actually a profession, and a well paid one, much like yours and mine. The fact that they spend their profits on drugs instead of on pilgrimages to Bayreuth each summer as you and I do should be of little concern. It’s a free world.

    There’s an excellent country hotel in my locale, “Langdon Hall”, named after a previous owner. Any relation to you, Dr?

  6. All true; but why do they never talk about people who have chronic, irremediable pain and what to do about it? My doctors are very strong about becoming addicted but they don’t give a flying fart about the problem of chronic pain. No doctor has ever expressed any interest in my ability to cope or otherwise.

  7. I have problems sleeping a lot and wanted to get sleeping pills, not to take every day but just for when my IBS wakes me up and I lose 4+ hours sleep.
    I didn’t get them – to be honest I am not that happy as I might lose my job because I fall asleep. I would rather be allowed to take my own decisions but sadly wasn’t trusted.

    • Your point is fundamental – especially to Conservative philosophy of liberty and free choice, free markets etc. (The IEA even argue for free markets in cannabis.) My experience was similar with tramadol for shingles pain – one doctor putting me off but another (in the hospital) prescribing, saying you’re 70, a little addiction will do no harm.

  8. >in America, women are dying from prescription pain killers at an unprecedented rate – over 10,000 a year, four times more than from cocaine and heroin combined. More have died of prescription drug overdoses than from car crashes.

    ‘Tis a consummation devoutly to be wished. If the pain becomes unbearable, I’d rather die of an opium overdose than have the medical profession keep me barely alive to experiment on my body and exposed to nosocomial infections and iatrogenic diseases.

    • Dear me, you two got out of the wrong side of the bed today.
      I’ve been having treatment for CLL for the past 11 years and have had nothing but perfect care and attention from nurses and doctors in that time. When I needed Tramadol, I got it, and gave it up of my own free will. (For old people, who cares if they’re addicted?)

      Doctors are pressed for time so short cuts are inevitable. And if they are faced with time-wasting or aggressive demands, who is going to help them. Not the police, busy with thought crimes, that’s for sure.

      • Michael says: “For old people, who cares if they’re addicted?”

        You may not (although like our good doc, you may be waxing rhetorical)) but there actually are old people about to leave this world who refuse heavy medication, wishing to take their final exit in full consciousness of what awaits them despite their pain.

        The “wrong side of the bed” is believing that the elderly are always given a choice, and can refuse pain pills and other medications of their own free will as you were allowed to do.

        Like a niece standing to inherit the family pile in Sussex might say: There, there, Auntie, just you swallow that pretty little pink pill I’ve left on the plate beside you.”

        • Some of us expect only our genes to survive in the constitutions of insects or whatever, or are convinced that if anything else awaits we cannot know it.
          As for your reference to naughty nieces (not a temptation for the 99.9% who lack family piles) it’s more complicated than that – as my brief article on unmerciful killing in Feb’s Review showed. The homeless problem is also more varied than it appears. The Northern coastal towns I visit have plenty A good chunk are as you say scroungers, often claiming to be ex-military with PHD (!). Most of those I talk to are plainly very low IQ and life’s losers – one I spoke to in Scarborough (a typically wealthy North Yorkshire town) who had lost a leg to a bin lorry had nowhere to live, no money, and did not know he could have a prosthetic. I think we all know what Jesus, Buddha and Moses would say was needed.