Some doctors will some doctors wont?

I was prescribed codeine for many years for pain relief however my doctor has suddenly stopped prescribing codeine quoting it is against national guidelines. The doctor in the next village to me is still prescribing codeine for pain relief however?

[Cazza2612]

Hi, I think you’re right not every doctor is the same as far as prescribing certain drugs go.

I have fibromyalgia and arthritis which causes me terrible pain. I get paracetamol and dihydrocodeine for fibromyalgia pain. I take arthritis anti inflammatory and sometimes also need to take ibuprofen which is given to me by my GP.

I know some people get much stronger pain medication such as morphine but my GP says opioids don’t work well for fibromyalgia pain. My GP is very understanding and knowledgeable and totally understands the condition very well. Fibromyalgia is a very difficult condition to manage and so many doctors don’t know enough about it.

[madcatlady58]

GPs are now under a lot of pressure to get patients off long-term opioid painkillers - including codeine and dihydrocodeine. This is partly because of some rather high profile sudden deaths in patients using these drugs for a long time, and also because of research indicating that they are not very effective long-term. They can still give it for short-term/intermittent pain. I have fallen victim to this, having been on dihydrocodeine for 10 years but now told to go away and wean myself off them.

Alarmingly, the latest NICE consultation recommends giving nothing for chronic pain!

[Poppy_Ann in reply to madcatlady58]

I don't know what you were on them for but there is no way on earth I could stop taking them it must be around 30 years that I have been taking them I have been on just about everything they make over the years and these are the best thing for long term, I also take several others along with them which I have swapped about as as you said they don't give relief after a long time of taking them if I thought I could stop taking them all I would as they are a pain in the backside having to keep taking them, the reason I take them is I was involved in a accident in the army in 1976 and my back is broke in 4 places plus almost all of my joints are damaged plus I now have arthritis in them all as my back is so bad the doctors will not give me new hip or knee joints they told me back in the early 80s that they were some of the worst they have come across in their time of replacing them but they are not willing to try as they think it would probably either kill me or paralysis me if they tried so just keep on taking the tablets and think my self lucky on the few days I don't have much pain.

Regards Poppy Ann.

[Poppy_Ann]

If you think you cannot get along without it then move doctors I also take codeine and know I cannot manage without it I have been taking it for many years at least 25 that I can remember and most likely a lot more than that I also take several others which I could stop but with a much higher pain level but if I stop or just reduce the codeine I end up a quivering lump of jelly on the floor as around 10 years ago I was away and realised I did not have enough for the time I was away and tried cutting the tablets in half but even then I was bad I went to a local doctor (I was in St Martin) and to start with he said he could not prescribe the dose I had told him I was on he said "the only way I was getting that dose was off the Internet" I said that it was from my doctor in uk but he still did not believe me so I went back to my boat and picked up the container and took it to show him he said can he copy the details down as he had never heard of them they are 120mg slow release and I take them twice a day in the end he gave me a prescription for some standard ones to tide me over until the others arrived the following week the cost visit to doctor $30 x 2 prescription $25 tablets $15.50 each x 21 tablets $325.50 total cost should have been $410.50 but the chemist let me off with the $0.50 as they were short of change, so now when I hear people complaining about the prescription cost I tell them to be thankfully that they don't pay the full cost.

[madcatlady58 in reply to Poppy_Ann]

Yes, I've had withdrawal symptoms (and rebound pain), even though I have cut them down slowly (am now down to 1 long-acting at night only and can't see what my next step should be). I will admit that the pain hasn't been as bad as I feared, once the rebound has died down, but I now have nothing effective that I can take when it does flare. I didn't do well with a lot of things I tried over the years - and NICE have pretty much rubbished everything anyway! All GPs within this commissioning group are taking patients off long-term opioids, so there is no point in changing surgeries; pain clinics have been suspended to due to the Coronavirus so we have just been left to get on with it . . .

[Amkoffee]

I am not sure what country you live in but I can tell you a lot about the rules and laws of America. But I suspect you live somewhere in the UK so I'm going to tell you this. In March of 2016 our CDC (Center for Disease Control) issued guidelines to GPs on how to prescribe opioids. What followed was a war on doctors who were prescribing opioids to their patients. The DEA (drug enforcement Administration) was arresting doctors who were prescribing more than what the guidelines said even though there is no law in the US dictating how much they can or cannot prescribe. Legacy patients are being pulled off cold turkey or like myself reduce down to meet the stipulated amount in the guidelines. While all this has been taking place the UK as well as some other countries followed suit and made their own rules and guidelines about prescribing opiates. Canada was one of them and has since change their stance once they realized the damage they were doing to people with chronic pain. Unfortunately I don't know what is happening in the UK but I can tell you that here in the US we have several organizations that are fighting for our rights to take these opiates and supporting the doctors who are erroneously arrested for prescribing too much. It's a tragedy and it is an assault on a particular class of citizen (the chronic pain patient) who has done nothing to deserve this. The opioid crisis is real but its was not caused by prescription opiates. The opioid crisis is from elicit Fentanyl and heroin. Unfortunately because the US government is going after the doctors the drug dealers are doing phenomenal and the overdose death rate has skyrocketed since the guidelines were published. You might want to consider seeing a pain management doctor. They are more likely to prescribe you something that will actually work. Codeine is nearly like baby aspirin of the opioid family. Good luck!

[Stobban]

Yea, Medicine in the UK is miles apart from the USA. The UK doctors come under very different set of rules. Thank heavens. Some doctors do prefer not to prescribe opioids as then they are ''tied'' down with increasing the drug over time, when trying not to make the patient a junky. Sadly, I have noticed that some doctors say pain is natural, it indicates disease, so lets not go against nature. When others understand us patients who do suffer severe pain daily, prescribe opioids so we can live and enjoy this life for once. These are the doctors who really understand PAIN. Good Luck.