Time-limited methadone – guest blog by Paul Molyneux

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The topic of time-limited opioid prescriptions has been discussed before on Recovery Review. More recently, the issue has garnered increased attention after Liberal Democrat MP Norman Baker wrote to the ACMD on behalf of the Inter-Ministerial Group on Drugs. In the letter, Norman Baker requested that the ACMD review “whether the evidence supports the case […]

Pain needs painkillers – right?

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Overprescribing of opioid painkillers has caused harm to many people. Problems include addiction, loss of social functioning and increasingly, though still relatively uncommonly in the UK, to death. Concerns have been raised about deaths associated with tramadol in particular. I’ve written before about the lack of evidence of effectiveness for opiates in chronic pain, but it […]

Quetiapine abuse

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Quetiapine (often branded as Seroquel) is an antipsychotic drug used for schizophrenia and bipolar disorder. It’s also prescribed off-license in the UK for anxiety. That means that a fair few people with alcohol and other drug dependence end up on it. Recent experience makes me wonder if prescribers are as aware of the risks as they […]

Recovery and the randomised controlled trial

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In terms of strength of evidence, the randomised controlled trial (RCT) stands tall. It’s the gold standard in methodology to reassure us that an intervention is causing an effect. Addiction treatment is founded on the rock of the RCT. Our clinical guidance (The Orange Book) is choc-a-block with RCT evidence and there’s now a search […]

Deaths from prescription opioids ‘epidemic’

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The White House is holding a summit on opiate addiction. Why? MNT reports alarming statistics around deaths involving prescribed painkillers. In the first ever review of existing research into the topic, researchers have uncovered exactly how much deaths due to such drugs – which outnumber deaths from heroin and cocaine combined – have increased. According to the […]

Antidepressants – not always happy pills

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The Fix has an article on antidepressants which, amongst other things, tackles the problems a significant number of people have when trying to stop them. Officially called ‘discontinuation syndrome’ these are arguably withdrawals by any other name. When you consider that there is little evidence of effectiveness of antidepressants for mild to moderate depression and they are […]

Faith in pharmacology

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Holy grails are few and far between. Pharmaceutical holy grails are no different. They are as rare as a moderate position in the Scottish independence debate. We have a few prescription drugs licensed to treat addiction and some make things significantly better, some have modest impacts, and some appear to have little impact. Regardless of […]

Recovery in Primary Care – best practice

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Most opioid replacement prescribing takes place in primary care settings and the GP is powerfully placed to be a catalyst in the recovery journey. What if we placed prescribing at the heart of a fully recovery-oriented system of care? SMMGP highlights the Public Health England guidance, a supplement to previous guidance, which calls on all treatment providers to […]

Gabapentin abuse

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Gabapentin can be addictive. Search for gabapentin abuse or pregabalin abuse on Google Scholar and you’ll turn up 18,000 entries in less than a second. Pubmed is a little more specific finding 249 papers related to the subject. Vaults of Erowid has over 100 gabapentin and pregabalin ‘experiences’ detailed by users. I wrote a while back […]