Times: NHS plan to help millions stop using antidepressants and painkillers

Echoes of the Israeli flower arranging class for FM. Highly effective, or so they wrote.

But if they offer teleporting me to the class which lasts no more than 20 minutes, add in a real hot springs soak, and a snack of a good French baguette and melted Swiss cheese, I still wouldn't omit one dose of muscle relaxant, because that pill works for at least an hour.
 
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NHS England seems to think that prescribing music or art classes could yield the same results as pain-relieving medicine

Earlier this week, NHS England launched what it called a “new framework for local health and care providers” which “aims to further reduce inappropriate prescribing of high-strength painkillers and other addiction-causing medicines, like opioids and benzodiazepines”.

The framework includes serving up art or music classes for those suffering from chronic pain as alternatives to medication. Yep, if we all just sit in a circle and sing “Kumbaya” the pain will magically vanish.


The announcement hailed an 8 per cent reduction in the number of opioid painkillers prescribed “which is estimated to have saved nearly 350 lives and prevented more than 2,100 incidents of patient harm”. The numbers of benzodiazepines and sleeping pills handed out in England have also fallen by 170,000 (13.9 per cent) and 95,000 (10.2 per cent) respectively since the implementation of recommendations outlined in a 2019 review by Public Health England.

And sure, if the drugs don’t work and lives can be saved through cutting them out, how could you not be on board with that?


Well here’s the thing: sometimes the drugs do work.
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Why new NHS guidelines could end up torturing those of us who experience chronic pain | The Independent
 
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When you look at what the BPS model of medicine has to offer: arts & crafts, sing-alongs, tea and snacks, meditation, light exercise, look at cuddly pet pictures, share your feelings in a circle, white (and not so white) lies to "comfort"...

and you have to wonder, is this scientific medicine? Or kindergarten? Where's the difference? Having responsible adults in the room?

There's jumping the shark. Then there's doing an entire season of jumping the shark. This is like the 13th season of nothing but shark-jumping episodes. The same episode, filmed over and over again. Except no one would choose to watch this, so they are forced to, threatened with pain, disability and poverty for compliance.

It's one thing to give up entirely. But when you are a complete legal monopoly it's choosing violence.
 
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I will not go back to the hell that was my life before I got semi adequate pain management, in the form of opiates.

If it is mandated that I no longer receive opiates, and worse that my pain management is to come from useless pointless energy sinks in hostile and draining environments, then there is only one rational response I could make.
 
Wonko said:
I will not go back to the hell that was my life before I got semi adequate pain management, in the form of opiates.

If it is mandated that I no longer receive opiates, and worse that my pain management is to come from useless pointless energy sinks in hostile and draining environments, then there is only one rational response I could make.
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I feel the same.
 
Wonko said:
If it is mandated that I no longer receive opiates, and worse that my pain management is to come from useless pointless energy sinks in hostile and draining environments, then there is only one rational response I could make.
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I think there is probably more than one rational response, the more legal of which includes political campaigning to change things.
 
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Sly Saint said:
Merged thread

Why new NHS guidelines could end up torturing those of us who experience chronic pain | The Independent
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"The framework includes serving up art or music classes for those suffering from chronic pain as alternatives to medication." That is a very poor characterisation of what the document actually says. What is proposed is that GPs would refer to pain clinics - the route any individual takes in terms of reducing or giving up a medication would be part of a process, not a decision made by a GP in quick face to face with the patient.
 
Yes, I don't mean to downplay the seriousness of such a scenario (which sounds to be a bit different from the situation that has been reported in this thread) but there may be family and friends and medical professionals to advocate, it may be possible to sign petitions, letters to MPs, provide a soundbite for media articles, there may still be things to be done. In my country for example, marijuana was illegally supplied to people in pain, which, together with advocacy, did result in some law changes.

It's just, if ever a medical system did want to deny effective pain relief to people, those who make such callous decisions probably are not bothered if people just quietly cease to be a problem.
 
Given how Canada often copies the UK in these matters, and how we have been going on full-speed with medically-assisted death, often easier to access than even minimal medical care. Ugh.

We really don't care for one another as a species. We truly are our worst enemy.
 
rvallee said:
Given how Canada often copies the UK in these matters, and how we have been going on full-speed with medically-assisted death, often easier to access than even minimal medical care. Ugh.

We really don't care for one another as a species. We truly are our worst enemy.
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Given the Canadian system of medically-assisted dying seems currently to allow the inclusion of people whose quality of life is severely circumscribed by medical conditions that do not allow access to appropriate benefits and social care, presumably this could also logically be extended to people in chronic pain because they are refused access to effective pain medication.

Does this represent a value judgement in relation to what deserves treatment and what does not?
 
The only problem I have with medically assisted dying is that the medical assistance looks a lot like gatekeeping, and in the jurisdictions where clinicians control access to euthanasia they are likely to refuse it to people with illnesses like ME. It’s an adjacent issue to criteria for access to pain relief, but I don’t see any relevance in the way it has been adduced here.
 
In the link given by @Sly Saint above there are now two comments :

https://www.independent.co.uk/voices/chronic-pain-nhs-opiods-sleeping-pills-b2293589.html

One commenter resorted to seeing a private doctor to get the pain relief he needed.

The other commenter refers to him being able to afford knee replacements.

In Victorian times in the UK the rich thought the poor were poor because they were lazy. This idea of removing pain medications seems to come from the same mindset. The rich will be able to afford private treatment because they deserve it, the poor will just have to suffer.

The bizarre thing about this is that there must be plenty of doctors and other medical staff, either currently working or retired, who suffer from chronic pain. They must know what they will be inflicting on patients. And yet I haven't seen any articles from them saying how sadistic this is, or any suggestion that they strike and hold demonstrations to make the government change its mind. And the government will say it isn't up to them anyway, its up to the doctors. I'm wondering how big the spike in suicides will be. But suicides save the rich money, so it probably won't even get reported on, or will be a one-day wonder in the media.
 
The discussion appears to be largely about painkillers; I think the issue of over prescribed anti-depressants should be approached separately
(although I am aware that some people are prescribed anti-depressants in lieu of painkillers; that issue also doesn't seem to have been covered in these articles).
 
Sly Saint said:
I am aware that some people are prescribed anti-depressants in lieu of painkillers
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I was prescribed anti-depressants repeatedly during my 20s, 30s, and 40s. I think women usually are treated for depression when they say they are in pain, rather than being treated for pain itself. Yes, I was depressed. But the main component of that depression was from having untreated severe pain that doctors didn't believe in. The anti-depressants were utterly useless for me for both pain and depression.
 
I don't live in the UK, but I find that the article highlights legitimate concern caused by this policy...

But what concerns me is that hard-pressed GPs will see this as gospel and decide to cut all their patients off, including those for whom medication is working.

I’ve spoken to pain consultants, pain sufferers, and even the occasional lawyer about this. They’ve told me this has already been happening, sometimes with deeply malign results. On occasion, consultants have written fierce letters to GPs. But what if you can’t get hold of your pain consultant? That isn’t easy in today’s NHS.

If you can’t, and the medication is appropriate, the result can be something like torture. And no, that’s not hyperbole.
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This is such a sensitive topic but one that needs to be addressed frankly, and can only be handled with professionalism and real empathy, compassion on the part of physicians. Because the truth is that living with chronic pain, moderate to severe, can become downright unbearable if it is not relieved or at least diminished, and those who live it testify to the crucial importance of medication for them in order to maintain a relatively acceptable quality of life. At such a level of pain, it's even a person's life that can be at stake (suicidal risk). Consequently, the search for adequate relief is paramount, vital. And as a pwme who has suffered from chronic pain for over a decade (pain becoming acute in PEM), I consider that those who best understand its severity, extent and true impact are most often those who experience it. Hence the absolute need to listen and believe the patient, it is he alone who experiences it, period.

Peter Trewhitt said:
presumably this could also logically be extended to people in chronic pain because they are refused access to effective pain medication.

Does this represent a value judgement in relation to what deserves treatment and what does not?
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This is exactly the perverse effect of this law here in Canada and which, in my opinion, must continually be denounced for things to change. It is often by alerting the general public to such inhuman aberrations that things can end up improving, although unfortunately this is often a long-term process.
 
Arnie Pye said:
Has that ever worked in medicine?
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Oh yeah. Plenty. It's probably the only thing that works, actually.

From the most basic disability rights to the AIDS crisis, without a lot of political activism, medicine would be even worse than it is today.

But you need a critical mass, lots of healthy allies. Or at least cognitively healthy.

But achieving progress for a discriminated population is almost always achieved through politics. Medicine is no different. Not even a bit, it turns out, as even in the cases where physicians did a lot of advocating, they were the healthy allies involved in political activism.

I think that's one reason medical activism is so disliked, it shows how the system is not nearly as benevolent and competent as the narratives say. It involves overruling professionals who explicitly struggle with admitting even small mistakes.

In a nutshell, it's no different than anything else. If you want a better life, you have to fight for it politically. No one else will. And certainly not the people who are engaged in doing the very harm we are trying to undo. They clearly can't process that.
 
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