Beat the Benzos

Campaign Launch Conference
November 2000.
  • Please note not all transcripts are complete and will follow soon.

    Chairman: Phil Woolas MP.

    Summing Up

    "The scale of the problem is so large, (this is the experience overseas as well) that it is beyond the grasp of many politicians and people in power to actually solve it. I think there's a paradox here, because you have this huge problem with a huge number of people involved and yet we seem as a society to be incapable of acting upon it. We can only cope with problems that are so big...we can't cope with this one."

    "We do, of course face an enormous mountain that we have to climb, I have felt increasingly frustrated over the last two to three years - often being a lone voice in parliament although we have got increasing support and, I think the point about an all parliamentary group is perhaps a timely one and perhaps we do need to get more advocates in Parliament, because whatever the newspapers say, Parliament ultimately holds Government and organizations to account.

    On the class 'A' and class 'C' point, I think there are some very valid arguments for and against the actual decision as to whether or not they should be reclassified. Central to my concern throughout all this procedure has been that as non-political people, as volunteers, as sufferers or members of families of sufferers, it is quite natural, understandable, that people concentrate on the real issue of the substance. In politics you have to campaign on the real issue and the substance and the presentation.

    It's a fact of modern life, and there is no doubt in my mind that the call for benzodiazepines to be reclassified as a class 'A' drug makes people think. It stops them and makes them think -' why are they calling for this drug to be put alongside heroin.?'

    Now, whether it should be reclassified or not, I don't really have an opinion as at the end of the day that's a judgment for the minister in the Cabinet Office I presume, but I do think that it's a very valid campaigning tool. I have a lot of sympathy for the point Candy made, I also think there's a valid point that you would create a new criminal fraternity because dealing in benzodiazepines would become a very lucrative business - These are the dilemmas of politics.

    The local inquiries point of view does seem to have some support; we will as a steering group - we are not a formal group, anybody is perfectly free to make some suggestions and come along if you can, we meet at the House of Commons.

    We will be taking this conference forward and where we go from here. In campaigning terms - broadly, there are two fronts on which we must fight. There is the judicial front and the political front.

    Ian Caldwell is leading the charge along with Michael in two separate actions and a lot of our hopes and expectations rest with Ian and Michael. I have to say to you (and I don't mean to embarrass them) that the courage and tenacity that they are both showing in the face of is a pretty dangerous thing to do - to take on a multi-national drug company. I have the protection of Parliament, I have the protection of parliamentary privilege, but Ian and Michael don't. We owe them an enormous gratitude and more power to your elbows gentlemen!

    On the political front we have two arenas in which we must operate - we have the local arena and we have the national arena. Locally our focus is the primary care groups who now employ GPs and the Health Authorities who are the funding bodies of the Health Service and decide policy on prescription. If you have a primary care trust and most primary care groups will become primary care trusts in the course of the next twelve months, now that is your focus. Primary care groups and Health Authorities have executive boards of lay members who are accountable to MPs, to the Secretary of State and most importantly to local people. You should identify who they are and you should lobby them in the same way as we talked about lobbying the members of Parliament. Local press is obviously a key factor.

    On the national stage, the national arena there are many objectives and we've tried th put them down. I as a Member of Parliament , as lone voice need support. I need a groundswell of public support, of local papers which will result in national coverage, we need national coverage, we need more MPs, most of whom are empathetic and sympathetic and prepared to do specific things; if we can educate them , ask them, they are not our enemy whatever party they are in - so we do need to do that.

    We will be producing a campaign pack which we'll be sending out to the participants at the conference on the hows and wherefores of these campaign ideas. The point Reg made about the website is extremely valid. The website is a fantastic tool for this campaign which doesn't have formal structures, not like a trade union or charity with local formal branches and operates within a structure. We are a disparate group and the website and compilation of the data is very very important."

    Thanks to all etc.

    Benzodiazepines and Babies.

    Dr James Robertson
    Arrowe Park Hospital, UK
    Beat the Benzos Conference 2000

    November 2nd 2000

    "I am a paediatrician, I look after babies and I also for the last six years, look after drug addicts. I think I am the only paediatrician who looks after them when they are pregnant and I look after them before they're born, to stop the problems after they are born. We decided to prioritise what we thought were the most dangerous drugs:

    • Top of the list, which has been mentioned very briefly today is actually alcohol and yet it is the only one that's actually socially acceptable [of the list].
    • Cigarettes - we just - everyone's on them, very dangerous unfortunately.
    • Benzodiazepines come third on the list above heroin and above methadone and five years ago we were having 50% of our babies withdrawing at birth. They were withdrawing - I think our maximum was 77 days which is two and a half months but I'm pretty sure it goes on for months longer than that and I think it used to be described as colic. You are all from an era when colic drops worked because they were 20% alcohol, but they've taken out the alcohol so they don't work any more.
      *[ transcript missing].

    Alcohol is top of the list because we know it does cause permanent damage. It is not known if [BDZS] do cause permanent damage. It hasn't been proved yet in terms of proof proof that benzodiazepines do but there's enough evidence to say that they should not be used in pregnancy.

    Two areas which will eventually become very difficult to separate in terms of benzodiazepines is:

    • The effect during pregnancy
    • The effect after pregnancy.

    The only way you can prove it was during pregnancy is either, the mum stops as soon as the baby is born and is totally back to normal, but, as is so obvious here you are not back to normal just like that or the baby is adopted

    Our experience tells us that people on benzodiazepines can not be good mothers - because they're not in control - that is not a criticism of them as an individual but a criticism of them plus benzodiazepines.

    There is also very good evidence that your first 2 years of life are incredibly important, so if you haven't got good parenting, to what extent does that effect the rest of your life? What's going to happen at different stages - I don't know the answer, but I do worry about it... That's why we have benzodiazepines very high up on our list.

    To the people who say it's all the doctor's responsibility, (I have to admit I have a colossal 6 months experience of general practice), and I couldn't stand it because 90% of the patients I could do nothing for. As a doctor I felt very helpless because a lot of them had violent partners, had lost their jobs, they had money stresses, the house was awful etc. and unfortunately under the constraints of this country and every other country doctors do have (I think ours is 7 and a half minutes, which makes it one minute and a half more than America, but I did feel there was not a lot we could do and I don't know the answer. I also agree with the statement that a prescription is used at the end of the consultation, which if the antibiotics are anything to go by, if you don't prescribe antibiotics to somebody and explain that they're not necessary, they're less likely to see you next time. Now I don't know if that's good or bad - you have to think about that.

    The last thing I will say is that recently there's been evidence to suggest that the role of the 90's and the 80's seems to be that nobody is allowed to experience 'normal' on their own and if there's ever a major tragedy in this country, the first thing that happens is that 3,456 professionals and counsellors flood in followed by about 1,800 press people and it has come out in the last 6 to 9 months that that does more harm than good and if you could speak to people who've survived the war they would probably agree and they would have said "well we could have told you that 20 years ago". People are better at getting over things in their own way than some interfering professional. However it isn't the interfering professional who has created this, it is society, so it is a much bigger issue.

    So I am going to sneak to the back and run!
    Benzodiazepines should not be given in pregnancy, thank you."

    Neurobiological and Structural Changes in Benzodiazepine Users.

    Professor Stefan Borg,
    Head of of Addiction Medicine, Karolinska Institute, Sweden.
    Beat the Benzos conference, November 2000.

    As Professor Ashton said, I will share with you some of the results from our studies on benzodiazepine dependent patients. We started in 1980 - about 25 years ago, as the number of dependent patients in this area increased and we started to look at admissions and found that about 3% of admissions to psychiatric units at that time had a benzodiazepine dependency diagnosis and no other addiction. When we added the other addictions we came up to 12 - 15%

    We found when we looked at pure benzodiazepine-addicted patients that most of them had a high social incompetence. Less education,* for instance than other patient groups, but still, the results of our treatment were quite bad. A high percentage of relapses, high mortality - mostly suicides. So we started to think how to manage this situation and we went on some study visits here in the UK, looking at different patient organizations like Tranx and others and found that they treated themselves in a better way than we as doctors treat our patients **

    so we developed a long-term tapering programme and we used a scientific model to evaluate it, so the patients who came to us were randomly selected, one control group and one treatment group and after initial investigation they were in hospital care between 2 to 8 weeks where they were tapered and then were followed for one year in an outpatient care situation.

    We did a lot of toxicological screening to get the *** information and we also had the opportunity to do investigations like EEG etc.
    [slide 1]
    These are the types of drugs that the patients were using and they show exactly the way of [sales* figures*?]in Sweden at that time. So the patients followed the general trend in drug taking.
    [Slide 2]
    Here we can see the outcome from this treatment programme. in the treatment group, 31 of our patients were free from benzos and 6 were not. In the control group, 5 were free from benzos and 22 were not free. The control group had to go to an ordinary psychiatrist or a general practitioner ***so they were not defeated ***

    So by using the long-term tapering procedure we were able to improve the prognosis quite dramatically in our patient groups.
    [Slide 3]
    Here are some figures of how the patients felt during the contact with us. You can see that before tapering 62% had concentration problems, 44% decreased memory capacity, 28% fatigueability and 22% indeciciveness.
    This is during the programme - here they are tapered, you can see that some of the figures are better, but still very high figures for this type of symptoms. So the patients are not much better after being off [the benzodiazepines].
    This is one week off drugs, 6 weeks, 50 to 60 weeks off drugs, you can still see quite high figures with these types of symptoms. And here we are coming back to 50 weeks, that's one year off drugs and then we are coming down to more normal figures and you can see that much is happening during the last 6 months of this observation period. So the message is quite clear here it takes a long time to change the psychiatric and cognitive symptoms.
    This is the same type of figure and you can see we have the global score of illness, of sleep disorders, sadness, excited, autonomic disturbances. Here we have the Newcastle Index with visual perception disturbances and auditory perception symptoms. You can see the same trend here that shortly after tapering there are very high figures, even higher than when patients started coming to us (starting their tapering).

    When we looked more in detail with these symptoms we could identify different types of patterns: The first one here just going down all the time, here you have pessimistic thoughts etc. The second pattern coming up, then going down with a peak quite soon after tapering and third pattern here with a late peak and the last pattern no significant difference at all all the time. This is ***showing this in another way, four different patterns.
    Now we are going over to some cognitive symptoms: decisiveness, fatigability, concentration ability and memory ability. You can that the impairment of these is starting up here quite high and then slowly going down during the total observation period and also it's evident that here, the last six months of the observation period it's happening the most for the patients, also stressing the long-term [effects?] For the patients. These were symptoms that were reported to us to the*** we also made a more objective investigation with different neuropsychological tests, you can see here, the test battery, this is synonyms, this is a typical test that is not very sensitive to 'brain dysfunction' and as you can see here:
    this is the first investigation, and this is one year off abstinence and these are the patients who are on continuous treatment, they have not bee able to get off their drugs and these are on withdrawal. You can see that they are about the same - these three groups, but when you come down to the more neuropsychological-sensitive tests, like the block design test you can see the differences. The controls, the steady state ones and the withdrawals. Both the steady state and the withdrawals are increasing. They are less impaired after one year but the patients who are in withdrawal are the ones who show a significant difference.
    This is the global score of neuropsychological impairment in our patients. Here you have the patients who have gone through withdrawal, the controls and the steady state group.

    So our conclusion was that a high number of our patients, about two thirds were impaired when they came to us and after treatment this decreased and it decreased more in patients who were more successful in their treatment.

    We haven't been able to follow up these patients with neuropsychological testing, however we have an impression that this improvement is going on for a number of months and maybe years afterwards. Some patients have reported that they are improving over time, for two, three or four years and we share that impression with Professor Ashton.

    What we are doing just now is working on ways to improve the withdrawal/tapering process and we have used a drug for this called Flumazenil, which is an antagonist to benzodiazepines. and works via the benzodiazepine receptor complex. We have injected this drug into patients and compared them with controls. As you can see here
    this is the patient group and this is the control group and the patients are reporting more symptoms than the controls of course. But when the patients get their Flumazenil, the negative symptoms decrease. When the controls get Flumazenil their negative symptoms increase so the groups are similar in the end here.

    This shows that it would be possible to use this drug, a non-addicting drug, to decrease the symptoms during withdrawal, especially the long-term withdrawal symptoms. All these patients have been off drugs for several months. It would also be possible to use this as a test if the patients are reporting negative symptoms like anxiety etc you could use Flumazenil to help you to understand whether a symptom is drug-related. If the symptom is drug-related - it should decrease, if it is not there should be no difference in the patient."

    That is where we are just now in our research and trying to help our patients in Stockholm, thank you.TOP

    A Carer's perspective.

    Maureen Barraclough
    Beat the Benzos conference, November 1st 2000.

    [Apologies, introduction temporarily missing]

    six years ago, with the help of our current GP, who though readily admitting the subject was new to him, tried his best to assist by changing Michael gradually over ont diazepam. From day one, terrible symptoms appeared and when he eventually saw Professor Lader, he was told he was one of a very few people who suffered a cross-over intolerance from Ativan to Valium.

    For those six years, Michael has been in constant daily pain. Every nerve ending and every muscle in his body is affected, his liver is affected, he has extreme photophobia and a pain in his eyes resembling being stabbed with a screwdriver. [trans. missing] tests were all negative.

    His bowels and intestines are damaged and so inflamed as to cause regular, horrific abdominal cramps. I have had many times to perform manual evacuation on his bowels to alleviate constipation.

    The nerve endings in his legs are now so bad he can hardly walk. It's now over 12 months since he washed his legs as even sponging them causes unbearable pain. His feet are swollen up like balloons.

    He has to eat in a chair with his plate propped up to chest height as eating at a table causes vertigo. He suffers 69 known side effects, 40 of which her can have in a day, 6 at any one time. Some days he shakes so much on waking I have to hold his spoon to enable him to eat his cereal.

    Can you believe that such a situation is allowed to exist? I, as full time carer have also had my life turned upside down. Michael cannot undertake any normal household task involving standing walking or reaching. He has to be assisted with dressing and I have to fasten his shoes. Whilst I am here at the conference, he cannot go to bed until I return and will sit and sleep in a chair. His meals will consist of sandwiches because he cannot stand long enough to cook anything, the pain around his knees and thighs from muscle wastage is excruciating.

    We are both victims, not only of evil and amoral drug companies, but also of successive and corrupt governments. As for Mr Justice Kennedy, I suggest he pays us a home visit and see for himself exactly what British Justice means. He has lost his career and earnings and has no quality of life, he is now 56. Because he can only reduce by a quarter of a milligram, that is one eighth of a tablet every three months, he will be almost 70 by the time he finishes.

    Mention has been made of the setting up of centres which people can attend, presuming they can walk. Such places need funding and would themselves be dependent upon the whim of the political party in power. Could such a center stop the psychological trauma suffered by Michael after a dream of where he is 35 and fit and well and on waking realizes that his actual life is a real nightmare?

    We would like compensation for a life lost. Michael just wants to live a little before he dies and money would enable him to employ the care he would require to give him the holiday he has not had for 22 years. Any compensation should come out of the manufacturer's vast profits, not from the Government using tax payer's money, thus putting the public against us, compensation for so much trivia having made it a dirty word.

    I have in my hand a patient information sheet for Diazepam, which conveniently appeared with new packaging in June 1997. Bearing in mind that Ativan is 10 times stronger than Diazepam, had this information not been withheld, as we now know it was, had Michael not just been given tablets in a glass bottle with no mention of contra-indications, he would have known why he was falling asleep suddenly and without warning at his desk. Had the receptors in his brain, by now already damaged*?* Not affected his thought processes he would not have been afraid to approach his woefully inadequate GP, then I would not be here and he would not have had his life destroyed.

    Had these drug manufacturers, for example been producers of electrical goods, which were as faulty and caused half as much damage to people as these tablets have they would have been forced to pay damages and probably put out of business.

    We now have this vast amount of evidence of damage caused to people's lives, so how are they getting away with it?
    [I know Phil Woolas may not like this;]
    Will the following quote shed any light on it?:

    • Dateline, London: BBC 22nd of May a reporter stated that "no one takes much notice of Government Select Committees"
    • Teletext news, 20th July; a Foreign Office Minister, Peter Haines* insisted that: "Britain is a world leader on promoting human rights" - so where are Michaels'?
    • Robin Cook, 25th September speaking about a European leader; "be honest with your people, don't cheat them".
    • How strange that Paul Boateng, when in opposition, advodcated benzodiazepine victims having access through the courts to seek damages against the pharmaceutical companies concerned. Once in Government he conveniently changed his mind and then in the run up to the Mayor of London elections had the audacity to accuse Ken Livingstone of going back on his word.
    • Teletext News, 29th September: in the last three years miners have been paid one hundred million pounds in compensation for vibration white finger. Does this prevent their going on holiday, getting bathed or washed, eating their meals at a table, walking, reading or having a social life? Did any of them lose their career at 35? I think not. Michael cannot do any of these things he has lost his quality of life and will remain so until 70, if he lives so long.

    Why have others been so successful in their claims? they are backed by strong unions, they work together not as separate entities, not running little individual groups with no cohesive whole, but working as a team.

    The time for little meetings in widely dispersed groups has long gone. I ask you to put aside geographical and political differences and unite to become a force to be reckoned with. We have to consider something high profile, such as protest en masse to the high courts of justice.

    If each sufferer could get just one person to join and thus create a protest march we could become a voice to be heard and our demands for justice could not so easily be swept aside as so many letters have been. The Countryside Alliance have managed it, the gays have managed it, we can do it. Weak or able-bodied we must start here and now to create much more noise and nuisance on behalf of those who have been so damaged.

    To go on without more notice forced upon government and drug companies, means we shall achieve nothing. I for one do not intend to sit back quietly and accept what Wyeth and Roche have inflicted upon Michael. We have to become the attackers instead of the attacked - thank you.TOP
    Maureen Barraclough, November 1st 2000 Reproduced with kind permission. [Apologies for missed items due to technical problems.]

    Withdrawal Treatment and Support

    Ian Singleton.
    Bristol and District Tranquilliser Project.
    Beat the Benzos Conference, November 2000.

    I'm going to say something in a bit of detail about counselLing in withdrawal, I realize I'm going to repeart some of the things already said by Melanie and Pam, so bear with me.

    Considering how to counsel those who are addicted to benzodiazepines I've always been very much guided by my own experiences of addiction and withdrawal and how I was helped through them.

    My experience of taking Lorazepam for just over a year in the mid 1980's was of living in a twilight world of pain and exclusion, out of touch with myself and the world around me. Gradual withdrawal brought terror, sickness and regular panic attacks.

    Eventual cold turkey withdrawal, brought a major epileptic fit and over two months in Swiss Psychiatric hospitals, which believe me were absolutely as clueless as our own about how to treat me. I then came back to England, as I saw it, to die, or to end up incarcerated, crazy for the rest of my life. Instead I spent 18 months at home, feeling suicidal, unable to look after myself, to sustain any relationships or friendships, unable even to read or watch television. Every night of those 18 months I prayed not to wake up the next morning. I never in all that time expected to live a normal life again. I felt totally, irretrievably mad.

    What did help to sustain me through that terrifying period was the support and advice of a tranquilliser withdrawal group in Bristol. Only with them did I feel safe and able speak openly about what I was going through. At least temporarily, when I was with them I was given to believe that I might one day escape from the agony and live some kind of a normal life again.

    So My first principle of counselling is to bear in mind just how difficult it is for clients to take on board the message that it is possible to get off these drugs and get well. In most cases their lives will have been blighted, their relationships will have been wrecked, they may have lost houses, and jobs and they will have lost all sense of enjoyment, happiness or fulfillment.

    They will have been given the impression by all those around them that they are strange, different, suffering from a kind of mental illness, from which they are not expected to recover. The medical services will almost certainly have long since written them off as hopeless cases. Almost certainly no one will have told them that the root of their problem lies squarely in the 'helpfu'l drugs that they have been taking religiously all that time.

    My second principle in counselling, therefore is that it needs to be more directed and interventionist than with most other forms of counseling. There is just so much ground to be made up, and there is so much ignorance on the part of the person you are trying to help. It will probably take several sessions before they are able to trust you and what you are saying and realize that you are not just another of those well-meaning professionals who secretly label them and send them away with another worthless solution.

    The element of personal identification here is so important, that is why self help groups can be such a help. Clients can hear and observe others who have exactly the same symptoms as they have suffered from for years, the same messed up life, the same emptiness and despair. They can come to realize that the private hell hole they have been living in all these years is no different from the place all these other people have been living in too. This dawning realization can be huge step away from hopelessness towards solidarity and commitment.

    My Third Principle of counseling is the providing of articles by people like Heather Ashton and some individual case histories. They will also need to have their eyes opened about just why they took those strange decisions while on the drugs, or why they hate Christmas, or cannot bear to have their family around them. They need to understand that above all, what has happened to them is not their own fault.

    This is my forth principle, reassurance. People will have suffered under the false assumption that they are inherently sick, weak, misguided and even that in some strange way, they have brought all their torment down on themselves and that they are responsible for it. The daily task here for the counsellor is to try to absolve them of guilt and to awaken healthier assertive feelings and a determination to start to put things right.

    This is the fifth principle, hope. These people will have lived without hope for so long that they can scarcely recognize what it is. It will be hard to ignite this flame and even harder to keep it alight in the weeks and months ahead. The client will lose sight of it constantly as I did myself. They will continually come back to the idea that they are different, damaged and that they will be the only one not to recover. So the counsellor must constantly remind the client of the prize at stake to be drug free and well and make it seem attainable.

    So much work may need to be done even before the clients make their first cut. There is no point in people starting to cut down if they have no understanding of what the drugs have done to them, or what will lie ahead through the long process of withdrawal.

    People who cut down on the drugs without this understanding will almost certainly fail. It is hard enough to come off, even when in possession of all the facts and with maximum support. They may well have tried to come off before without proper understanding and support so they will have yet another sense of failure to overcome.

    The reasons for this previous failure - most likely too quick a reduction, will need to be gone into and explained. S oyu may need to actually restrain the client from starting to cut until you are satisfied that their thinking is clear. The first cut is of course crucial and clients are always nervous about making it. It is helpful to go through possible withdrawal symptoms with the client before they make the cut, when they might expect a reaction, how long it might last, when they might expect to get over it.

    In this way the process can be demystified and the client can begin to exercise a measure of control over their situation. This is really the key to the whole withdrawal process, helping the client to regain control of their own life. Once the client has made that ****[ it is difficult to] predict what effect each cut will have.

    Some cuts have a devastating effect, others leave the client feeling little different and this is when cutting the same amount of benzodiazepine at the same interval can veer from times of near despair in bad cut to other times when the ultimate goal seems quite attainable. So the counsellor needs to be flexible, tailoring "[Cut off ***here] TOP
    With kind permission form the author

    Ian Singleton, November 2000.

    Audience Comment(1).

    Beat the Benzos Conference

    November 2nd, 2000

    "My husband has been on benzodiazepines for 18 years now, he started on lorazepam and he certainly was not the first person not to know it had any effects at all. I didn't even know what tablets he was on.

    For 13 years he became increasingly violent, uncaring , no interest and ignoring his friends.

    Eventually I was fearing for my life, so it was me, it was the family, probably it's happened to a lot of people here as well.

    After 12 years I said "there's a problem" - the doctor didn't say there was a problem, the patient didn't say there was a problem. It's often the relatives who are the closest and they, the people who accept all this strange behaviour blame themselves. They blame what the patient says and they are the first people, I think, to discover there is a problem.

    There is such a time lapse from the time that people take these pills intil the time that the problem is discovered.

    My husband is here today. He is upstairs in his hotel room - he cannot come down as he's in such a state. He said to me, "tell them that I'm withdrawing now, I'm on 5 tablets a week, but I feel I'm in danger of killing sombody".

    I a normal everyday situation [such as] driving a car, nobody stops him driving a car, he's a big man,and very forceful - he could easily injure someone. If somebody upsets him in any way, just a normal member of the public, or if someone 'cuts him up'when he's driving. If someone does something that he interprets as an expression of anger or agression he will react.

    He says someone should him - he says "I'm going to kill someone in the end and and it's the only time anyone will listen to me.

    I'm sure that this is such a problem - somebody here mentioned crime - we should be investigating some of the causes.
    I hope that rings a bell somewhere..."


    Audience Comment (2).

    Beat the Benzos Conference
    November 1st - 2nd,2000

    "I don't think the doctors do understand what informed consent is if something like the Bristol children's heart scandal is anything to go by. Here parents gave their, what they thought was informed consent, only to find out that actually, parts of their children had been disposed of in quite a digusting way. I think we've got to rethink the whole idea of informed consent.

    I want to say that during this whole conference I have had a sense of a slight swing towards the patients being expected to take responsibility for what they were being prescribed. We were talking about having the patient information leaflets put into the packs of drugs. Now I think that's fine, that's an aide memoire for the patients. We can all have a look at it and see what's going on, but I think that the first level of responsibility is with the doctors. They are the people who have the power to prescribe - they should take responsibility for that prescription. I just don't think it's good enough.

    We heard the last speaker this morning, and there was a sense of the GP somehow being coerced by the paients to give them something. Now this is absolute nonsense. There is a very little word - no, now if the doctors can't use that word, they should be trained to use it. You cannot have a GP turn round and say "well I'm sorry Mrs so & so put pressure on me"- that is absolute, if you'll pardon the phrase, bullshit."
    Thank you.


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