Can a GP force you to come off medication that works?

[Angelxna]

Hi all,

I was just wondering if a GP can force you to come off a medication without your consent?

For context, I take Cocodamol for my Fibro, and it enabled me to go back to work, go back to education & all around lead a semi normal life.

Now my doctors have decided that they want me to come off these. I have tried to be as flexible as possible regarding this but I feel as though I’m being treated like an “addict”!

Yes, I understand that I probably am dependent on them, but I’m not addicted.

I mean, surely this falls into the bracket of “informed consent”? I understand the risks but I also believe that the benefit outweighs the risk right now. I do intend to come off then eventually but I’d rather do so when I feel ready, not have my dosage & issue dates changed without my knowledge or consent.

Sorry if this is not the best place to post this, I tried to find another thread to post on but couldn’t find one.

Thanks so much for any help

[Hazel_Angelstar Administrator FMA UK Staff]

your gp is meant to have a conversation with you regarding the risks of medication - but it sounds like taking you off something that is helping, is going to have a significant impact on your quality of life. Being dependent on a medication that allows you to function is completely different to being addicted

Good luck - and hope you can stay on your meds

[CM1EDSUK]

Hi Angelxna - I think this is a difficult discussion, in part due to the National Institute for Health & Care Excellence (NICE) guidelines. Many patients, like yourself, take medications that have helped, are not addicts, just rely upon these meds. Unfortunately there have been some deaths due to patients taking some meds, & altho few, GPs have to take these into consideration following NICE's guidelines.

Your GP should work with you to taper you off your meds & look for an alternative. Please see: nice.org.uk/about/nice-comm...

[Chezzib]

On a monthly basis how many co-codamol are you prescribed? Im newly diagnosed but I've been prescribed 100 tablets monthly for general aches and pains before my diagnoses. Now my symptoms have heightened and im requesting more tablets on a monthly basis, they seem reluctant to give them to me and keep explaining i can't have more than 100 tablets at a time. Im waiting for my appointment to review my pain management. But i understand, i would be so unhappy and cheesed off if they did that to me. Are they looking at a different alternative pain relief? Or just paracetamol that does absolutely nothing, especially if you've been taking co-codamol for many years.

[Cat00]

How do people know when they are addicted or just dependant? Do you have to come off them and see how you feel to know?

[Billyboy2u]

sadly the answer is Yes. He can reduce or withdraw your medication if he thinks you're becoming addicted. I was on them years ago and progressed to Morphine now. However it's the Salt level/content I was told, in your meds that are doing the damage. Arrange a face to face and have it out with them. Quality of life played a large part in my meds and the slight withdrawal.

[Carlt]

You could ask this question another way.

"Can a doctor be forced to prescribe a medicine that, in his professional opinion, is harmful to you?"

[desquinn Partner Volunteer FMAUK Trustee in reply to Carlt]

It is always about clinical judgment. In palliative care dosages are given that would never be given to a healthy person but they are worth the benefit. The same argument can be made for chemo drugs.

But I agree that if there is no benefit, a physician should be cautious or indeed restricted in prescribing a treatment that is shown to be harmful.

But the evidence that NICE used for the CPP guidance excluded positive research that supported the effectiveness of gabapentenoids and opioids in particular tramadol that do show that they can help people.

[desquinn Partner Volunteer FMAUK Trustee]

From the NICE guidance on chronic primary pain that is driving these conversations there is the following: (nice.org.uk/guidance/ng193/...

1.2.11If a person with chronic primary pain is already taking any of the medicines in recommendation 1.2.10, review the prescribing as part of shared decision making:

explain the lack of evidence for these medicines for chronic primary pain and

agree a shared plan for continuing safely if they report benefit at a safe dose and few harms or

explain the risks of continuing if they report little benefit or significant harm, and encourage and support them to reduce and stop the medicine if possible.

[Yassytina FMA UK Volunteer]

Glad to read the helpful replies from people I hope this has helped somewhat, I agree with Hazels reply that medication can help a person have a quality of living as it did for you, but hopefully you will get a face too face with your doctor is the best way forward, take care.

[jhorsf]

The answer today is nice want people to go to pain clinics not have meds and waste there time waiting years for an appointment to a pain clinic that thinks you can talk about your pain and it will be better . Just my opinion of course.

[Sarahvit]

unfortunately if he is the one prescribing it he can d/c it (stop prescribing it). I had this happen to me at the pain clinic. You can always get a second opinion. I wish you the best. Maybe talking with your GP will help him change his mind and let you stay on it until you are ready to come off it. ❤️🦋

[Flutterbyca]

this is becoming an issue in the US. Medication that can be so helpful in giving us back our lives and some docs are worried that we will get addicted. a 75 year old woman like me! it’s ridiculous. Many people take medication they can never stop. is a heart patient addicted because he or she can never stop taking the medication. i would say to look for another doctor. a doctor who understands how difficult your situation is. i believe many drug deaths are people who were not allowed to have medication they need. some of these conditions we all battle are extremely hard to live with. without medication life can be over for some. good luck to you 🦋

[Purplebluebell]

Hi, I understand there is a shortage of Cocodamol and this will affect supplies until Dec.