Saturday, 26 December 2015

Approach to drug addiction

It is a common presentation in GP land. It is not as bad in the hospital system but once you step into GP practice. Every 5 patients, there is at least one person who is on opioid or benzo long term. How do we get to this stage ? What happened to our medical practice? The recent check program takes on addiction medicine and explores the complex issue of addiction. Personally, I think the best way to deal with this problem is to not prescribe benzodiazepam or morphine without a plan of stopping them.

Key points:

- In Australia, about sever million prescriptions for benzodiazepines are written each year. (7 million! This number is ridiculous) Of patients aged 65 years or older, 15% were prescribed at least one benzodiazepine. Of these, 45% were prescribed more than once and 15% of these for longer than six months.

- There is little evidence that long-term benzodiazepine use is effective for the management of insomnia, anxiety or depression, and other modalities have better effectiveness and safety.

- The effects of caffeine can be directly weakened by smoking. smokers traditionally drink more than twice as many caffeinated drinks as non-smokers.

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