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Saturday, 10 September 2016

Iatrogenic Disease. A warning from a doctor

I am usually critical of doctors, not least because they are the people who give patients ineffective and unsafe pharmaceutical drugs. However, occasionally a doctor is prepared to raise his head above the parapet. Dr Des Spence is a GP in Glasgow, and a tutor at Glasgow University, and he published a blog, "Gabapentinoids - the new diazepam?" in the Pulse magazine (9 September 2016). He talks of the advice of 'experts' and 'media doctors', who tell doctors what to think "however mindless it might be".

          "We GPs are ‘seen’ to take on this advice, but then systematically ignore it. We won’t prescribe statins to everyone because it is irrational and stupid. We don’t accept that ‘pain is what the patients says it is’, because common sense dictates that it isn’t. Regrettably the infallibility of NICE and the deference shown to the ‘expert’ is creating overtreatment, medicalisation and iatrogenic harm. And iatrogenic harm is the worst of all  harms, for doctors are responsible and it is wholly preventable." (My emphasis).

A doctor who recognises the enormity of iatrogenic harm is an unusual doctor. This blog continually points out that the so-called 'side effects' of pharmaceutical drugs are for the patient new diseases, often diseases worse than the condition for which the drug is taken. My e-book, 'DIE's: The "Disease Inducing Effects" of Drugs and Vaccines' is looking at specific illnesses and diseases and examining the pharmaceutical drugs and vaccines known to cause the condition.

Dr Spence continues by comparing the use of the drug, Diazepam, and other benzodiazepine drugs (of which Valium and Librium are perhaps best known) "... peddled as a safe and effective treatment for anxiety by companies and experts alike", with Gabapentinoid drugs. He describes how, when he started work in the 1990s, he had struggled with the "consequences of ... thoughtless advice" that produced "herds of middle-aged patients zonked out and dependent on benzodiazepines", and that his surgeries were dominated with "dealing with the fall out of dependence and abuse", including "drug seeking behaviours, lies, confrontation, rebound agitation, insomnia  and withdrawal seizures. Just chaos".

Dr Spence says that it took the medical establishment decades to realise the psychological and physical harm that was caused (but fails to mention that Benzodiazipine drugs are still prescribed today)! He does mention, however, that doctors are still dealing with the 'radioactive consequences' of the "rapid, widespread and poorly controlled prescribing of benzodiazepines in the 1970s and 1980s".

And Dr Spence abhors the thought that the medical establishment has not learnt a lesson from the Benzodiazepine scandal. I have written about Benzodiazepine drugs elsewhere. But Dr Spence brings us up to date with what is happening in the doctors surgeries today with another class of drug, Gabapentinoids, which he thinks are equally harmful.

          "In the last five years my sensor has been off the scale with the gabapentinoids (gabapentin and pregabalin). Patients are actively seeking gabapentinoids using the familiar crude acting skills, that I had witnessed with benzodiazepines 20 years earlier. A cocktail of anger, tears and threats in equal measure. Constant requests for dose increases, fanciful stories of lost scripts and a tag team approach with friends who ‘corroborate’ stories. The signs and symptoms of a drug of abuse and stigmata of iatrogenic harm."

Gabapentinoids, of which the brand name Neurontin, is perhaps best known, is a drug used to treat epilepsy, neuropathic pain, hot flashes, restless leg syndrome, epilepsy, neuropathic pain, post-herpetic neuralgia, and central neuropathic pain. It has a considerable number of known side effects, including sleepiness, dizziness, drowsiness, ataxia, peripheral oedema, tremor, sexual dysfunction, suicide, and aggressive behaviour. It was first approved in 1993.

We live in a society in which conventional medicine encourages us to take drugs for our health. The difference between taking drugs for health, and taking drugs for recreation is small. Gabapentinoids have been described as the ‘ideal psychotropic drug’, producing ‘great euphoria’, ‘disassociation’, ‘opiate buzz’, and other mind enhancing effects so loved by those who crave to such mind-changing, but addictive effects. So prescriptions for these drugs are apparently soaring, doubling in just three years. De Spence says that many doctors prescribe them 'freely and loosely' on the basis of specialist endorsement, even though he claims there are more effective and less harmful alternatives.

Pregabalin is already a controlled medication in the USA (and there is debate about controls in the UK), the research base for the benefits of gabapentinoids is of a short duration and in a small, defined population where as few as one in 10 benefit [7].

Dr Spence ends his blog with an important question, do we want "another benzodiazepines-style disaster all over again?" The answer is, of course, 'NO'. Yet will we get suffer another one? The answer, from past experience, is that if pharmaceutical companies can profit from selling a drug, they will pressurise governments, health authorities, and drug regulators to approve it, and the medical establishment will press doctors to prescribe it. And they will continue to do so until it harms so many people that the media can no longer ignore it, and its dangerousness can not longer be kept from us. It is the way that the conventional medical establishment works!

And it is not just Gabapentinoids that will cause such disasters, iatrogenic disease is being caused daily by a multitude of pharmaceutical drugs.