Campral and GP prescriptions

General health and lifestyle
1

Well, in about a week's time I should have the definitive answer on this one.

I've sent an email to the GMC asking if a GP is allowed to prescribe acamprosate or is it against GMC rules.

I didn't name names, I only signed the email off with my last name, which is the most common surname in Britain.

I gave them a bit of history, about me, about Adddaction and the state my liver is in and how my GP has said they can't prescribe, go back to Addaction. They can't say I didn't give it ago first time around as I spoke to their clinical direct at head office.

So, we will know once and for all, whether we have to go private, or we can shove a bit of paper infront of the GP's nose and see what he has to say to that.

2

Hi

I admire your persistence, and will be following this with interest and the final outcome.

As you know I was prescribed camprol and took it for two years without any problems.

My GP prescribed it, but I had to have an LFT first, and then repeat LFTs every 3 months. The only reason I can think of as to why your GP won't prescribe it for you, is that at present your liver would struggle to cope with it.

However, if it's been suggested you take camprol and you're left playing ping pong, going from GP to addaction to GP, with no one prepared to prescribe, then that's a different scenario altogether and totally unacceptable.

My new GP won't prescribe diazapam for me, and has also stopped my NITRAZAPAM as he says I'm becoming an addict!

I know many people who take diazapam, lorazepam and various types of sleeping tablets and even camprol and have no problems with getting their prescriptions.

If all these controlled drugs turn people into addicts, how come they are still prescribed and not withdrawn. It seems to me that it's a GP lottery, some will and others won't. At the end of the day, GPs currently seem to be able to play God.

3

Well, two things. I've taken it all the way to the top with Addaction to their clinical director, so they can't accuse me of not trying.

Whatever the state of my liver, it is good enough to have eight prescription meds per day and also good enough to have diazepam.

Even if it is weak, which is better, Campral or start drinking again, I know which will probably take its toll on me. I don't mind LFTs, I've had more of them than most people have had hot dinners. Both my GP and hepatologist do them independently and when I was in hospital, they stuck a cannula in my arm, because they took blood every three days without fail.

Reading between the lines, a GP can prescribe it, they just prefer that someone else takes the responsibility. As for diazepam, that is just the generic name for Valium, not exaclty a hard core drug, especially as they never give you more than two weeks supply.

The whole system is madness, if I was a heroin user I would get all the support I needed.

4

You may have already done this, so apologies if you have, but have you looked at the RAG list for Campral in your local health authority area?

The RAG list stands for Red, Amber, Green and this refers to who is expected to initilise the treatment.

For example, if Capral is RED in area, the it is specialist to prescribe and monitor eg, Addaction ONLY, no GP involvement.

Amber is usually shared care, meaning Addaction to initiate prescription but care shared with GP.

Green means suitable for prescribing and monitoring by GP.

Each local health authority may have a slightly different instruction.  If you are not sure where to look, PM me the town and county where you live and I will look it up for you.

5

Good discussion and thanks for looking into this RHGB plus will look into RAG Joanna, which I'd never heard of!

Currently in bed feeling terrible on Day 2, I never learn!!

Did you think campral helped Vickilou ? Like you, my doctor won't prescribe Diazapan, Lorazapan or anything to make the withdrawal more bearable. Hey ho I'm sure I will be ok in a couple of days x

 

6

I have a full script of acomprasate sittin in my bathroom, and havent taken it.  Still drinking every day though.  Does that stuff really help with diverting your mind from alcohol, or is it a waste of time?

 

7

Yes, it is meant to, but it only works once you have been detoxed and given up.So right now, it wouldn't really help you. If you had a week on diazepam without drinking, i.e. became abstinent, then it would help you from the cravings of going straight back to alcohol.

8

Well, Joanna was kind enough to go through the info (for my area) and explain exactly how it works.

Just to recap, Red is for specialists only i.e. Addaction (snigger, a contradiction if ever I heard one) to prescribe, GP is out of the loop.

Amber, referred to specialist, shared care, specialist recommends drug, GP prescibes and both GP and specialist work together to come to a complete overall solution, i.e. GP does the medical side and the specialist does the counselling side.

Green, the GP can prescribe and handle it all if he so wishes with no involvement from an outside organisation.

I am in Warwickshire and it is Amber, so Shataction must be involved. However if I moved a few miles North to Leicestershire, it is Green, so no involvement from Shataction.

So my GP is telling the truth. But I await to hear what the GMC has to say on it and then I will ask them why they feel that doctors in a neighbouring county can handle it but the inferior ones in my county can't. I will then ask them who gives the contract to Addaction and what is my route of redress and complaint. No doubt they will say your first port of call should be to complain to Addaction and I'll say, bingo! Done that, both spoken with and emailed with their Head of Clinical and Social Governance, next.

One of the things I learnt in middle management, was that you have to take the emotion out of a complaint and just deal in logic and facts. You also have to know which routes they are going to try and fob you off down and close them off. Resilience, tenacity and obstinency also help.

9

fep

i can only speak for myself and a close friend. I found it excellent and would recommend it.

I was very scathing about campral and couldn't see how it would work. You take two tablets three times a day.

I expected instant effect, but didn't feel any different. However after 4/5 days, I went for long parts of the day without thinking about alcohol. It was like switching off a light. The idea of never drinking again horrified me, so I admit I stop started with it. I.e I would stop a week before a holiday, party etc, and then start taking them. They do work so why not have a go

10

Thanks Vickylou. Maybe I'll give it a go.  Drinking a qt of Vodka a day is killing me slowly...

11

Translated into English, that is about a litre a day.

12

Hi paper fairy

yes it helped me a lot. As well as a deterrent it greatly reduces cravings and after a couple of weeks, I found I wasn't craving alcohol at all.

I couldn't envisage my holidays without alcohol, so if that makes me an alcoholic, or alcohol dependant then that's what I am.

We have a villa in Spain where we just chill by the pool, either with a few beers or wine. I no longer drink spirits. If I found I was slipping and my drinking was getting worse, I'd take campral again.

I must be in a green area, as my GP prescribed my campral. I'd read up on it online and asked my GP about it. He'd never prescribed it before, previously prescribed Antabuse for patients, but said he'd give it a go.

Hope you are feeling better, is it day 3 today?

13

RHGB

I took fep's daily alcohol intake to be a quarter bottle of vodka, not a litre. If it is a litre then I would imagine he would need a complete detox like you said, before starting campral

14

Hi Vickylou. Just catching up on posts. Thanks for explaining about campral. When I'm capable of getting out of bed and visiting a doctor I am definately going to try it. As you know where I live do you think I'm classed as the same area as you to be able to get it from my doctor and not have to go through addaction( who we all know are useless ). ? 

No im still drinking, haven't the courage to stop yet xx

15

And the house is in chaos, fallen out with an auntie and mum and dad, sister are all very disappointed. At least my kids aren't involved! Blumin eck feeling gutted and ashamed of myself sad

16

If you are in the same county, the answer is probably yes. But if you PM Joanna, she will confirm for you.

17

Well, I had my reply from the GMC, which didn't tell me much.

"Thank you for your email regarding your recent experience and issues obtaining a prescription.

I can appreciate that this must be a difficult time for you. However, I am afraid I cannot help you, as the matter you raise falls outside our jurisdiction.

It might help if I explain that the GMC is the statutory regulatory body for medical doctors in the UK. Our responsibilities include setting standards for medical education, granting registration with a licence to practise to suitably qualified people, promoting good medical practice, and taking appropriate action where doubts arise about a doctor's fitness to practise.

You may wish to contact PALS, the Patient Advice and Liaison Service, or NICE for further assistance.

I am sorry that we cannot help at this time."

So I sent one back, saying I didn't want to bounce around departments, who did she suggest would be the best person to speak to. And I got this reply from a senior contact advisor.

"Dear Sir / Madam

Thank you for your email.

You may wish to contact NICE who will be able to assist you further.

If you would like to discuss this further, please reply to my email or call me on the number below."

I'm going to call him later today, as I think a phonecall will get to the root of the problem and who to speak to the quickest. Meanwhile I have sent an email to the Coventry and Warwickshire (my county) Area Prescribing Committee:

'Dear Sir or Madam,

Is the CWAPC responsible for deciding which drugs/medications GPs can prescribe directly to a patient without referral to an outside partnership such as Addaction?

If so, can you give me an email address of someone (not a general address, a specific person that I may communicate with) directly responsible for setting these guidelines, as there are some serious shortcomings.

Yours faithfully'

Somewhere, somehow, I'm going to find out who is responsible for this and give them a good shake. I have all the reasons documented, and the help that I was not offered. I am going to give Addaction (different branch) another go, this time it is for the Campral not diazepam, half expecting them to fail, but that will just be another nail in the coffin, as I will document it all. Of course that is why I have bought my own Campril, should I need a back up plan.

I will update the thread as and when I have new information.

18

RHGB

i hope you've not been using naughty words again!!

Seriously though, I hope you get the answers to the questions you've asked. You must get ten out of ten for your persistence and determination.

Look forward to reading how things develop.

19

There were no profanities, no links, and nothing in the second one that could in anyway be misconstrued as in need of moderation, hence my test message to see if all my messages were being sent to moderation.

20

I don't expect NICE will be able to help you with this one, as they make their decisions on what medications should be provided on the NHS.

The NHS have a legal responsibility to assess you for any medications that NICE approve, but how that is done is a matter for each individual area prescribing committee.

So, yes I believe getting a contact at the CWAPC is the next step for you.

In addition, all the pathways (procedures) that are set in place by the CWAPC are supposed to be used as guidelines - in the sense that doctors who have experience in alcohol addictions could, if they wish, prescribe any NICE approved medication if they are willing to take on the responsibility for doing so, which obviously includes any providing any additional proceedures that NICE recommends.