Cutting down

Thank you :-) Off to the mighty Google now

Hi Melanie,

Part of the reason that people are struggling to get this from their GP is because one of the prescribing instructions tell the doctor that their patient needs additional support alongside the medication.  This is to help ensure compliance and a successful outcome.

Some doctors are finding it difficult to get this additional support set in place, due to either the availability or the cost.

If you encounter this problem, I can provide you with this additional support as part of the services that C Three Europe offer.  We are a not for profit organisation that aims to raise awareness of the method, the medication and help coach people through it.

Our support meets the requirements as laid out by the manufacturers of the medication.  You can find more information on the C Three Europe website, including a PDF file pack that you can print out and hand to your doctor if required.

If you think this is something you might want to look further into, discuss it with your doctor.  If your doctor says that he/she can't prescribe it due to this support requirement, at least you can reply that you have it already available if he/she will issue the prescription.

Good luck with whatever method you chose to try

 

Many thanks for your reply Michael. It does indeed sound very encuraging. 

Hi Susan, you describe exactly my feelings as well. I love to meet with my girls to dine out or visit the pub. But most folks in my circle of friends like to drink as well, and I don't want to give up my social life, but if I could switch to softdrinks after the usual 2 or 3 glasses of wine, it would be great. I see if I can give the Nalmefene a try.

Hi travis, I've looked into this drug and thought it would be the answer. My GP had never heard of it. My key worker at ADS hadn't either! She looked into it and at my next meeting she said she had spoken to her manager who said they wouldn't recommend it. So back to a different Dr at the same surgery who said no way would the surgery prescribe drugs for 'some weird American drug trial'. I tend to agree with your last sentence, a bit like papering over the cracks, but on the other hand many people recommend it.

Hi Sophie.i have never heard of the medicatin - Baclofene-  I am intrigued and desperate to know more about it. Is it similar to Nalmefene ?? In fact anyone  involved in this discussion who knows please please reply.Thankyou in  anticiapation of some replys about - Baclofene.I will try anything to cut down on my consumption of Alcohol. (Do you get it from the G P?)

Hi. I've meantioned before on posts I was on baclofen for a few months in 2012. It was a disaster. You have to build up slowly to a very high dose and take a lot of them. It made me put on a lot of weight and I wasn't keen on side effects. I stupidly went on a binge on them and ended up in hospital for a week( inc life support for 4 days). This is a serious drug. I'm on Naltrexone now if I drink. Been sober over 4 weeks

Tho obviously I understand different drugs suit some and not others, like naltrexone and nalmefene doesn't suit some. I'm just saying be cautious and take with Drs approval

Hi Paper fairy. Thanks for the info. I won't be trying Ba......  How did you get on with Naltrexone-is it similar to Nalmefene?? I feel like a zombie taking that!!!nothing tastes right, can't sleep,I don't do anything except moan, feel agitated ALL the time. Do you think Nalltrexone is different?

Hi. Dr won't prescribe nalmefene. Last October I was in rehab and they put me on naltrexone. They do have side effects first few times you take them like a bad hangover, but not as severe as you've described. I'm not sure if Dr here would have let me have them if the Dr in rehab hadn't put me on them tho. Good luck

Susan, the brand name of naltrexone in the UK is Nalorex.  If I remember correctly from our phone conversation, you had some of those that had run past their use-by date so your doctor has prescribed them in the past.

If I may suggest, I think you should sit down with your doctor, take all the medications you have with you and discuss each - what they are for, what they do and how you feel when taking them. 

Naltrexone (Nalorex) and Nalmefene (Selincro) are different medications but they do exactly the same thing in occupying the receptors in the brain so the endorphins aren't able to attach to them and create the buzz - they are just processed differently in the body.

Once you have discussed with your doctor, take his/her advice and settle on one particular method of cutting down on your drinking and STICK with it until either it has worked, or until you can discount it as not for you for some reason. 

None of the available medications out there are magic bullets and don't work instantly - it takes some knowledge and effort on your part, whether that be total commitment to a method until proven it doesn't work for you, or going through the discomfort of some side effects knowing that for the largest majority of people, they will pass within a week or so. 

Then, if you've followed everything correctly and they have worked for you - fantastic!  If not, you can discount it and move onto another option.  There are lots of options out there but everyone is different and it's a case of finding the right one for you.... if you don't try each one in turn, then how will you ever find the right one for you?

You are seeming confused about all these medications that are being discussed and the most accurate way to settle that is to discuss them with a doctor.  Stabbing around in the dark at all these different options without understanding what the medications are supposed to do, and most importantly how to use them correctly, will not be benefitting you in the long term.  Getting a prescription for a medication is one thing, using it correctly is another.

I really don't mean to sound harsh so apologies if I come across that way with these words.  What I want for you is to find the method that suits you, and for you to get your drinking under control and less troublesome to you.

Hi Sophie,

this sounds so great. Exactly like what I want. Still being able to enjoy my wine in the evening but stopping the binges when going to the pub or to parties. 

Is this what you took? https://en.wikipedia.org/wiki/Baclofen

Hi susan

No disrespect to Joanna, but getting a 10 minute appointment with a Dr is like asking for gold in some cases. In those vital ten minutes you have to explain what the problem is and what treatments are available to you. For a full description and discussion regarding the different drugs would take longer than ten minutes. So if you're lucky enough to get a prescription, there just isn't the time to have a full in depth conversation on how to take each one, risk of what side effects you might get, contraindications about taking new drugs with existing meds. Consequently patients are handed their prescription on the assumption that they will read and understand the information leaflet for themselves.

ive got a double appointment with my GP this morning, which I had to book nearly six weeks ago. The policy at my surgery is that you're only allowed to discuss one ailment during your appointment. I want a different cream for my psoriasis, as the one I've got is making it worse not better. I also want to discuss changing from trazadone to another tablet for anxiety/depression, and to see if he/she will prescribe Naltrexone, nalfemene. I've read up on NICE guidelines and printed off information which should support my request ( curtesy of Joanna, many thanks) I will only show my dr what I've discovered and printed off and highlighted the salient points, as a last resort.

The drs have a buzzer which goes off after 10 minutes, 20 minutes for me today! I will  let the forum know how I get on

Really hoping the appointment goes well for you

Showing that you have done your research and are really interested in improving your own health will (hopefully) make a big difference.

If after all this, your doctor is still unwilling to even discuss medication for your drinking with you, then you have the choice of following the NHS choices procedure for asking them to look into the matter.  On their website page it says ''If you're not happy with the care or treatment you've received or you've been refused treatment for a condition, you have the right to complain, have your complaint investigated, and be given a full and prompt reply.''

But hopefully you will not need to do this!

I certainly hope I dont, as all my family are with the same surgery. I'm also friends with two of the receptionists. I used to work with them at another surgery where I was the assistant practice manager, and we meet up either for lunch or boozy night in town followed by dinner once a month. Although we try not to mention work or certain patients and doctors, something will come up. I would hate it if that had to stop. I'm fully aware they could see my medical records and test results, that's not a problem, but having my lack of treatment being investigated would be a different scenario.

Remember that everyone is entitled to a regular medication review with their doctor.  My surgery does this annually but I know of others that do the review every two years. 

The review is for the purpose of ''‘A structured, critical examination of a patient's medicines with the objective of reaching an agreement with the patient about treatment, optimising the impact of medicines, minimising the number of medication-related problems and reducing waste.’'

Sometimes, I think the reason doctors get away with so much is because we, the patients, don't know what we are entitled to!

Well I had my double appointment with highlighted info, stats, success rates all to no avail. To cut a long story short, the only way for me to get naltrexone/nalmefeme would be to go to a private physciatrist to get a private prescription. Or be referred to the community mental health team. This could take anything up to six months or more, (I'm not alcohol dependant, nor do I have suicidal thoughts) as I'm not classed as urgent, so I would be at the bottom of the waiting list.

by this time, I was not at all happy. She did at least glance at the info I had highlighted for about two minutes, then handed it back to me, saying there is no way that the surgery would prescribe those sort of drugs as it involves careful monitoring and they don't have facilities. I politely pointed out about NICE guidelines and she had a quick flip at her BNF and pointed out that the guidelines showed it was for those who are alcohol dependant, but the practice still wouldn't prescribe it.

You gave it your best shot, and you should feel proud that you did your best.  At least you showed your doctor that it isn't in fact some 'wacky American trial' or whatever it is that she originally told you.

The 'careful monitoring' bit is the additional support that C3Europe could provide you, (we hear a lot about practises not having facilties to do this which is why we offer it) but sadly it seems as if your doctor simply doesn't want to be moved on nalmefene.  She has it in her head that despite all the recomendations from NICE, her practise is not going to prescribe it.

Normally, your next step would be to use the NHS Choices to have this looked into and see what they say, but I understand your reluctance to rock the boat because of family and work connections.

You should perhaps try the CRI org website to see if there is a CRI facility near you.  This is a not for profit organisations similar to the community health team, but you can self refer youself to them so don't need to wait 6 months.  If there is one near you, they help people with alcohol issues and each office has a prescribing doctor in place. You may find that this organisation would be more willing - however, they may equally turn around and tell you that a GP should be prescribing, since that is how they may interpret the NICE recommendations (ie they would be the ones interpreting it correctly!).

But I can understand you must be utterly fed up and frustrated now. 

 

Thank you Joanna for the help and advice you've given me and which has probably helped other members of this forum too

That is so annoying, I am so sorry.  Good for you for trying though, you did your best.

Pat.

Thank you Patricia, yes I was annoyed. Felt like going out and getting a couple of bottles of wine! Resisted the urge though

Well done you!!!  I am sure I would have downed at least one bottle of wine.  It's just so annoying that someone who is sensible and seeking help could be fobbed off like that.

I admire you so much....I always read your posts and your replies to others and you are a valuable contributor to this forum.  Thank you for all your input, it helps so many people.  Thank you.

Keep up the good work.

Pat.

Patricia, what kind words and a very big thank you. In fact you made my day. I have low esteem and always think I'm useless at everything.. Up until yesterday, I had been on trazadone 300mg and was convinced I'd been taking it for such a long time that I was convinced it was no longer helping me.  The doctor I saw yesterday is new to the practice and seemed very shocked I'd been taking it for 7 years without ever having a medication review. It was a consultant on the mental health team who put me on it and I just kept getting it on repeat prescription. I'd even been taking it wrongly, on prescription it said take two 150 tablets at night. Apparently the consultant had written take 1 each morning and one at night. I'm now taking citalopram from next week and 100mg of trazadone at night.

thanks again for your comments. Are you currently drinking or are you one of the 'reformed' members? 

Still drinking I am afraid, but I did cut down after joining this forum.  My main fear is not sleeping, I cannot bear the thoughts which invade my mind when I go to bed.  I need a switch to turn my brain off, and alcohol does the trick.  Never drink during the day, never feel the need, but come 8pm and I HAVE to have a drink.  Perhaps it isn't just the need to sleep, but more the need to shut down.  I find the world a hard place to live in, I see so much cruelty and I can't do anything about it, I try, but there is so little I can do.  It's terrible.

Anyway, I am glad that you seem to be sorting your medication out, it could be the making of you.  Fingers crossed.  Keep us informed about your progress.

You surprised me so much when you said you had low esteem, you always sound so confident and assured in your posts.  Don't underestimate yourself my friend.  You have so much to give.

Love to you

Pat

Hi. I also have a terrible time sleeping. Unless I'm drinking. I find its almost impossible to set a schedule. Quite often no matter what time I finially manage to fall asleep, I'll wake up at like 3 with massive anxiety and my mind going a million miles an hour. I am not giving advice, just sharing what has been helping me. I've been just taking an over the counter sleeping aid. Not while drinking! And as I find I can get very bored in my moments of abstinence, I don't mind taking it at like 8 and putting on a movie and letting it do its job. They're not for long term use, but the idea is to get on a sleep pattern. It's one more day☺ bol