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British Medical Association über Abhängigkeit und Entzug von Psychopharmaka

Verfasst: 15.10.2015 08:36
von Murmeline
Die British Medical Association (BMA) ist eine britische Ärzteorganisation und -gewerkschaft sowie Herausgeber des renommierten British Medical Journals.

Sie haben einen Analyse Report herausgegeben, der sich die Abhängigkeit und die Entzugsproblematik von verschreibungspflichtigen Medikamenten (Psychopharmaka, also Antidepressiva, Neuroleptika, Benuodiazepine, Z-Drugs, auch Opiate) genauer anschaut und zur Handlung durch Regierung, Ärztefachschaft und Forschungsgemeinschaft aufruft, um dieses große Problem anzugehen.
http://bmaopac.hosted.exlibrisgroup.com ... VG6EV7.pdf

Die übergreifende Alle-Parteien Fraktion zur Abhängigkeit von verschreibunsgpflichtigen Medikamenten (APPG for PCD) (siehe hier http://adfd.org/austausch/viewtopic.php?f=6&t=10074) schreibt in ihrem Newsletter dazu:
Die Verschreibungsstatistiken der Regierung zeigen, dass die Verschreibung von Schlafmitteln, Antidepressiva und Opiate in den letzten Jahren weiter angestiegen sind (107 Millionen Rezepte in 2014).

Die Analyse ergab:
  • Fehlendes Training/Weiterbildung von Hausärzten zu den Themen Abhängigkeit von verschreibungspflichtigen Medikamenten, was zu einem Defizit im Umgang mit Abhängigkeit und in einer fehlenden Akzeptanz/Unterschätzung von Entzugssymptomen mündet;
  • Signifikante Beweise für Langzeitverschreibung und möglicherweise schädigende Verschreibungen außerhalb der klinischen Richtlinien und Mangel an regelmäßiger Kontrolle der Verschreibungen;
  • Therapien, die nicht auf Medikamenten beruhen, werden zu wenig gefördert und finanziert, was wiederum zur Langzeitverschreibung von Medikamenten beiträgt;
  • mangelnde Bereitstellung und Finanzierung von spezialisierten, unterstützenden Anlaufstellen bei Abhängigkeit von Psychopharmaka;
  • hohe Notwendigkeit für mehr Daten, die das Ausmaß des Problems erfassen und mehr klinische Forschung zu Schäden aufgrund von Langzeitverschreibung.
Der Vorsitzende der APPG, Paul Flynn, sagte, "Viele dieser im Analysereport identifizierten Probleme bestehen seit Jahren und es ist ein öffentlicher Skandal im Gesundheitswesens, dass es so wenig Fortschritt gibt in der Hilfe für Betroffene."
Ich hoffe, diese Bewegung schwappt auch aufs europäische Festland über. Zeit wird es.

Re: British Medical Association über Abhängigkeit und Entzug von Psychopharmaka

Verfasst: 22.10.2015 11:27
von Murmeline
Mad in America berichtet ebenfalls über den Report. Ich erlaube mir mal, das wiederzugeben, weil es eine Zusammenfassung ist:


Report Calls For Policy Changes In Response To Dependence and Withdrawal From Prescribed Drugs
In The News October 13, 2015, Justin Karter, News Editor


Statistics from the UK reveal that prescriptions for painkillers and antidepressants continue to rise despite concerns over dependence and debilitating withdrawal effects. The British Medical Association (BMA) Board of Science has released a report that acknowledges changes to medical practice, research and policy necessary for addressing the dependence and withdrawal effects of benzodiazepines, opioids, and antidepressants.

The Board of Science conducted a review of the issue— Prescribed drugs associated with dependence and withdrawal – building a consensus—by soliciting evidence on dependence and withdrawal from governmental, support and charitable organizations.

The researchers collected all of the responses submitted from the various agencies and analyzed it for common themes and overarching patterns. The analysis revealed seven themes, which touched on the following issues:

Managing benzodiazepine dependence and withdrawal in general practice

It was reported that many general practitioners use a rapid tapering or “cold turkey” strategy to manage prescription benzodiazepine dependence and that these practices often force patients into support groups and withdrawal charities. Rapid tapering, according to the support groups, is often associated with the worst cases of withdrawal and it appears that general practitioners often underestimate the effects of the dependency and “impose unrealistic time scales on the pareing process.” Seventy-one percent of respondents reported feeling unsupported by their doctor after the dependency was acknowledged. In response, the report suggests that new guidelines should emphasize that “the rate of withdrawal tapering should be gradual and flexible around the patient.’

A subtheme identified for this issue draws attention to the long-term prescribing of benzodiazepines against clinical guidelines. Current guidelines suggest that benzodiazepines be used for only 2-4 weeks, including the tapering period, but many of the organizations reported that these parameters are rarely followed. The lack of funding and attention given to non-pharmacologic treatments and therapies was cited as one reason that many patients may end up taking the drugs over the long-term.

Governance and service provision for patients suffering with prescription drug dependence and withdrawal
Nearly all responses indicated a gap in care for those who have become addicted to prescription drugs, according to the report. The support organizations claim that existing drug rehabilitation and withdrawal services that are designed for illegal drug use are not adequately trained or resourced to provide the services necessary for this patient group. The responses also criticized reliance on volunteer and private organizations to fill this gap and care.

Harms associated with prescription benzodiazepine dependence and withdrawal
Withdrawal charities, support groups and individuals affected by benzodiazepines reported a number of potential harms from the benzodiazepine use, including: “physical (seizures, headaches, palpitations), psychiatric (hallucinations, psychotic episodes, anxiety, panic attacks, suicidal intention), psychological (trauma) and social harms (loss of job, leave education, financial instability).”

In addition, research submitted by Catherine Pittman revealed that the length of recovery from dependence may be longer than previously recognized. Her study found “96 percent of long-term prescribed users continued to experience withdrawal symptoms for an average of 14 months after withdrawal and cessation from benzodiazepines.” There was also an indication that there may be enduring symptoms such as tinnitus, anxiety, motor symptoms, gastrointestinal issues, and paresthesia (a pricking sensation caused by nerve damage).

Attitudes towards the cause of prescription drug dependence and withdrawal
The report acknowledges a noticeable difference of opinion about that causes of prescription drug dependence between the governmental and practitioner organizations on one side and the support groups, withdrawal charities, and affected individuals on the other. The first group attributed patterns of dependence to individual differences in patients while the latter placed accountability on the inappropriate prescribing practices of the doctors. Research submitted by Pittman appears to substantiate the claims of the second group. The report states:

“Her research found no difference in the emergence and experience of withdrawal symptoms between those individuals prescribed benzodiazepines for psychiatric versus non-psychiatric (e.g., seizures, muscle tension, recovery from surgery) conditions. This suggests that long-term exposure to benzodiazepines per se may account for the severity of withdrawal experienced by prescribed users, and subsequently difficulties terminating use, rather than pre-existing individual differences in mental health status.”

The support groups, charities, and individual also indicate increased stigma from medical professionals after a patient becomes dependent on the drugs prescribed to them.

Research and data on prescription drug dependency and withdrawal
Many respondents pointed to the lack of research being done on prescription drug dependence with benzodiazepines, analgesics, antidepressants and Z-drugs. In addition to research on the drug effects, more work needs to be done to develop best practices and clinical guidelines for first identifying dependence and then deciding on the most advantageous course of action.

Opioids prescribed for chronic non-cancer pain

There are concerns about the increased use of opioids for chronic pain. The withdrawal symptoms from dependence on these drugs were recognized to be severe and potentially disabling. “Despite widespread prescribing, the safety and efficacy of long-term prescribed opioids for chronic non-cancer pain was reported to be unknown.” Similar to benzodiazepine prescriptions, responses again noted that while there are existing guidelines for opioid prescribing that they are not always followed and that more work needs to be done to understand why these practices are occurring.

Antidepressants

There was a widespread concern that antidepressants are being prescribed without a clinical need and that they may be unsafe and also cause dependence and withdrawal symptoms after long-term use. Respondents pointed to the research evidence that suggests that the drugs may be ineffective for mild and moderate depression and that their benefits are unclear even in cases of severe depression. Charity and support groups reported that antidepressants may cause severe mood disturbances, suicidality, and, potentially, dependence, but practitioners reported the long-term benefits and relative safety of antidepressants. For those that acknowledged the potential withdrawal effects of coming off of antidepressants, there was also agreement that there is no well researched or recognized approach for managing antidepressant withdrawal.

http://www.madinamerica.com/2015/10/rep ... bed-drugs/

Re: British Medical Association über Abhängigkeit und Entzug von Psychopharmaka

Verfasst: 07.03.2016 16:36
von Murmeline
Am 25. Februar gab es ein Treffen der British Medical Association und Repräsentanten verschiedener Organisationen, um über notwendige Aktionen zum Thema Abhängigkeit von verschreibungspflichtigen Medikamenten (Antidepressiva, Neuroleptika, Benzodiazepinen, Z-Drugs) zu sprechen.

Ergebnisse:
- Forderung nach Einrichtung einer nationalen Telefonhotline als erste Hilfe
- Schreiben an NICE (National Institute for Health and Care Excellence), damit eine Übersicht zu Entzugssymptomen von Psychopharmaka erstellt wird
- Einrichtung einer Arbeitsgruppe mit dem Ziel, multidisziplinäre Qualitätsstandarts für die Verschreibung zu etablieren
- ein Pilotprojekt anzustoßen, wie am besten lokaler Organisationen zur Begleitung von Entzug finanziert und fortgeführt werden können
- Lobbyarbeit, damit es Veränderungen im universitären Unterichtsfach "Beurteilung von Verschreibungsssicherheit" gibt
- Patientenerfahrungen in relevante Programme aufnehmen
- Forschungsbereiche an Stiftungen vorzchlagen, um Erforschung von Entzug und den Schäden durch Abhängigkeit durch verschreibungspflichtge Medikamente zu untersuchen

Teilnehmer:
Royal College of Psychiatrists,
Royal College of GPs (Hausärzte),
Royal College of Physicians,
NICE,
Public Health England,
Royal Pharmaceutical Society,
Royal College of Nursing,
General Medical Council,
Projekte, die Entzug begleiten (REST Project, BAT, The Bridge Project, ADS, Recovery & Renewal).

Dr Joanna Moncrieff (kritische Psychiaterin), Dr James Davies (Psychologe) und Prof Peter Kinderman (Psychologe) - alles Mitglieder des CEP (Council of evidenz-based Psychiatry) - waren auch anwesend und in den Aktionsplan involviert.
http://cepuk.org/2016/03/07/british-med ... ependence/

Re: British Medical Association über Abhängigkeit und Entzug von Psychopharmaka

Verfasst: 07.03.2016 17:08
von Oliver
Wow, danke Murmeline,

das klingt ja tatsächlich, als ob da jetzt mal richtig was passieren würde. Bin gespannt, wie sich das entwickelt und ob das auch hier rüberschwappt.

Alles Gute
Oliver

Re: British Medical Association über Abhängigkeit und Entzug von Psychopharmaka

Verfasst: 20.03.2016 12:06
von Horni
Das klingt sehr sehr interessant,
vielen vielen Dank murmeline!
Grusse
Horni

Re: British Medical Association über Abhängigkeit und Entzug von Psychopharmaka

Verfasst: 25.03.2016 22:43
von Murmeline
Hier noch ein Ausschnitt aus der Rede von Luke Montagu bei der Sitzung. Luke ist selbst vom Entzug betroffen.

With gritted teeth, I would have accepted my status as an outlier on the bell curve. But I went online and discovered communities of thousands of sufferers from all over the world.

If you are among the many in the medical community who continue to deny this issue, then I urge you to visit some of these sites. Go to benzobuddies.org or survivingantidepressants.org.

You cannot fail to be moved by the suffering and loss; the effects on mothers, children and marriages, on good people who have worked hard to build good lives, only to see them implode as they struggle to cope with quite intolerable symptoms.

And then listen to them describe the double injustice of having their suffering denied, of doctors refusing to accept that it could possibly be the drugs.

It can take months or years just to taper off. Once off, it can take several years to recover from the neurological damage leading to the complete devastation of lives. Some don’t make it; every other month I come across someone who has taken their life rather than put up with one more day of extreme suffering.

And the situation is clearly getting worse. Does anyone in this room really believe that we need almost 60 million prescriptions in England for antidepressants alone, enough for one for every man woman and child, an increase of 500% since 1992? Why is this number going up? Because – like benzos – people can’t get off these addictive drugs, more and more are hooked.

There are a handful of charities helping these sufferers, and yet two of these have recently been forced to close due to lack of funding.

And just to be clear – there are virtually no NHS services for this cohort of patients, yet surely the NHS has a particular moral duty to help patients who are suffering because of NHS treatment?

Promises are made by successive health ministers and yet they fail to follow through, saying that it is now the responsibility of local authorities to provide these services – services which of course never materialise in this age of austerity.

I have been campaigning on this issue for a few years now, and have concluded that the only way we are likely to see change is by persuading the medical establishment that it is time to put your hands up and do something about this issue. Ministers and governments will come and go, but your institutions are permanent fixtures with the power to change prescribing practices.

http://cepuk.org/2016/03/07/cep-co-foun ... ependence/

Re: British Medical Association über Abhängigkeit und Entzug von Psychopharmaka

Verfasst: 23.10.2016 10:10
von Murmeline
Die BBC berichtet:

The British Medical Association has told 5 live Investigates it wants urgent action to tackle prescription drug addiction. It's calling for a 24 hour helpline, specialist treatment services across the UK and more information for doctors about withdrawal. The drugs include Benzodiazepines which are generally prescribed for severe anxiety and insomnia. 10 million prescriptions for them were issued in England alone last year and there are estimates that more than a quarter of million people are using the drugs long term - even though in most cases they should only be prescribed for up to four weeks. 5 live Investigates has spoken to people who have been using the drugs for decades.
http://www.bbc.co.uk/programmes/b07zxrdb#orb-footer