An interesting view of Community Drug Services.

[bobbin]

Interesting......I once called a GP who had prescribed chlordiazepoxide to a guy I had just seen downing pints in the local pub! He still got his next script though.....

My experience with contacting GPs is that they frequent ignore any useful advice or information which I have provided.

[bobbin]

£1000 sounds highly unrealistic, especially when you consider 'shrinkage' of stock from the shop.

[Fleegle]

I am a specialist nurse in substance misuse and hepatology rather than a pharmacist but in my experience to give chlordiazepoxide to someone who was still drinking would not be considered good practice and would be against clinical guidelines in normal circumstances. It would generally only be prescribed in cases where someone had made a decision to stop completely. If they wanted to cut down they could more safely be given advice on a regimen to reduce it with minimal withdrawal. The only common exception to that would be if someone with alcohol dependence was admitted to hospital for a short stay when they would be given chlordiazepoxide for the duration of their stay so that they did not withdraw, although this would be stopped on discharge unless the hospital had an alcohol in-reach service able to continue it.

Great in theory. I frequently see guys on a Monday morning just after discharge from their lost hospital weekend brandishing a script for Librium. Dosage as follows..

Librium 10mg 2 tds 3days
10mg 2 bd 3 days
10mg 2 od 3 days
5mg tds 2 days
5mg bd 2 days
5mg od 5 days

The guy can't walk, speak or read...did the prescribing doctor not realise there may be a slight problem with compliance?..where's the sense in that?

Fleeg.

[kathrynrothwell]

That is certainly very risky as, without support, there is a strong likelyhood that they will just go back to drinking as they were before admission as welll as taking the librium. In the area where I work they would not be handed a script but assessed by a specialist nurse, given only enough meds to get them to Monday morning and an appointment for the alcohol service detox clinic where they would be seen and dispensed to on a daily basis until detoxed. This generally works well as those who don't want to stop just dont bother turning up for their appointment, and at least they only then have limited supplies of meds. If they do seriously want to stop, then they can access a proper support package.