Advertisement
If you have a new account but are having problems posting or verifying your account, please email us on hello@boards.ie for help. Thanks :)
Hello all! Please ensure that you are posting a new thread or question in the appropriate forum. The Feedback forum is overwhelmed with questions that are having to be moved elsewhere. If you need help to verify your account contact hello@boards.ie

GPs prescirbing drugs inappropriately

Options
13

Comments

  • Options
    #62
    Macavity.
    Closed Accounts Posts: 2,745 ✭✭✭Macavity.


    It's very difficult to get a prescription for Ritalin, Adderall or "smart drugs" as you put it in this country. Likewise, getting a benzo legally is not easy. I can't help but feel you are basing a lot of your views from what the current situation is in the USA. Where these drugs are indeed prescribed excessively and much more readily than over here, and even taken as a combo from what I've heard on Reddit - Xanax + Adderall, affectionately known as the student speedball! :P

    Theoretically, benzos can easily be sourced illegally. Likewise, the availability of amphetamine substitutes and methylphenidate (Ritalin) analogues are widespread and they can be easily obtained through illegal sources - there is essentially no way of stopping this. I would say in relation to performance enhancing it does sometimes happen, but, in my experience, is extremely uncommon in Ireland. I don't for a second believe it's a serious issue over here, both from experience and also the lack of any source that would suggest it is. I think your GP is really in the minority, tbh. Stimulant abuse for increased academic performance is undoubtedly very common in North American colleges however, and probably a testament to the failed war on drugs over there IMO.

    The above aside. Another question, for me, is - where is the line drawn? All stimulants that enhance performance? Or just the stronger ones? How do you even calculate something like that? What about caffeine/theanine combo which are both legal and harmless substances, yet people report profound benefits to their concentration? What about the various nootropics available - all legal, and relatively harmless? What about people who have different levels of ADHD? I would argue that the average ADHD sufferer with an Adderall script, even with their condition, has a huge advantage over most people. Is it really unethical for someone to take a benzo/beta blocker before a presentation to calm their nerves? What about an insomniac who uses a benzo to aid sleep before an exam? Are they using it to enhance their performance - without it they may be tired or fatigued? I'm not trying to be difficult, but there are just so many variables relating to this subject that it is impossible to say what exactly is ethical or not IMO.

    Someone earlier mentioned that their doctor was pushy with wanting them to take an antidepressant. That is very common here, and the preferred method of treatment for anything depression/anxiety related. But it is in no way representative of GP's attitudes to prescribing drugs like Ritalin or benzos here. I really feel the doctor you are referring to is very much in the minority OP.


  • Options
    #63
    steddyeddy
    Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    The gp I was referring to was prescribing beta blockers for presentation nerves not smart drugs. As to it's appropriateness? Some of the students consider her to be cheating because some of them can't afford to go to a GP and shell out on drugs. Another girl said she suffers from panic attacks and her gp didn't prescribe them. From an academic point of view I can see the problem. I don't mind people taking them if it helps them feel better though.

    Benzodiazepines are not different to obtain. They are actually ridiculously easy to synthesise.


  • Options
    #64
    Kurtosis
    Moderators, Science, Health & Environment Moderators Posts: 2,881 Mod ✭✭✭✭Kurtosis


    steddyeddy wrote: »
    The gp I was referring to was prescribing beta blockers for presentation nerves not smart drugs. As to it's appropriateness? Some of the students consider her to be cheating because some of them can't afford to go to a GP and shell out on drugs. Another girl said she suffers from panic attacks and her gp didn't prescribe them. From an academic point of view I can see the problem. I don't mind people taking them if it helps them feel better though.

    Benzodiazepines are not different to obtain. They are actually ridiculously easy to synthesise.

    That's a bit of a moot point considering the poster above said it was difficult to get benzodiazepines legally. They are controlled drugs, so diy synthesised benzos are just as illegal as those bought on the black market.


  • Options
    #65
    echo beach
    Registered Users Posts: 1,252 ✭✭✭echo beach


    steddyeddy wrote: »
    Some of the students consider her to be cheating
    It is not cheating to take a legally prescribed drug for an indicated medical condition.
    because some of them can't afford to go to a GP and shell out on drugs.
    That is like saying those who can afford to pay for grinds are cheating. They may be getting an unfair advantage but those with money have an advantage from birth, in education, health and many other areas.
    Another girl said she suffers from panic attacks and her gp didn't prescribe them.
    Without wishing to second-guess her GP that sounds like a reasonable approach. Panic attacks are different to performance anxiety and unlikely to respond to beta-blockers


  • Options
    #66
    _Tombstone_
    Closed Accounts Posts: 3,006 ✭✭✭_Tombstone_


    steddyeddy wrote: »
    Right another big pharma are out to get us rhetoric is it?

    You know, this is a stupid ould rehashed line.

    How many news articles/incidents/evidence would have to be put under your nose before you'd open your eyes.

    Money comes first.

    Here's another story of a drug company accuses of blocking trials of cheaper drugs.....you'll pay up or go blind.

    http://www.bbc.com/news/health-32151801


    Its endless this sorta stuff and there you are with "uhhh big pharma"


  • Advertisement
  • Options
    #67
    steddyeddy
    Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    echo beach wrote: »
    It is not cheating to take a legally prescribed drug for an indicated medical condition.

    That is like saying those who can afford to pay for grinds are cheating. They may be getting an unfair advantage but those with money have an advantage from birth, in education, health and many other areas.

    Without wishing to second-guess her GP that sounds like a reasonable approach. Panic attacks are different to performance anxiety and unlikely to respond to beta-blockers

    First of all I the first girl said she gets panic attacks and got them. Second of all I don't believe getting nervous when standing in front of a room full of people grading you is pathology. Thirdly people definitely use beta blockers for panic attacks.

    Just because people have an advantage from birth doesn't mean I'm OK with them getting all sorts of other advantages. My purpose in this capacity as an academic is to decide who was the best.

    I am looking for the best scientist (it was a thesis presentation for undergraduates). If someone uses a performance enhancer to trick me into thinking she's the best then I have a problem with that. The grading system is about you and not any little advantages life might have conferred on you.


  • Options
    #68
    Dingle_berry
    Registered Users Posts: 885 ✭✭✭Dingle_berry


    steddyeddy wrote: »
    ... Second of all I don't believe getting nervous when standing in front of a room full of people grading you is pathology...

    Yes it is quite 'normal' to be nervous in that situation. But when those nerves escalate towards and beyond a phobia it would definitely be described as a pathology. Nerves aren't a binary experience, it's an emotion with an entire range of intensity and associated physiological responses.
    If you ban pharmaceutical help for anxiety you should ban all pharmaceutical help (those with depression may be getting motivation from anti-depressants, those with ADD/ADHD... )


  • Options
    #69
    steddyeddy
    Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    penguin88 wrote: »
    That's a bit of a moot point considering the poster above said it was difficult to get benzodiazepines legally. They are controlled drugs, so diy synthesised benzos are just as illegal as those bought on the black market.

    Oh yes it's difficult to get them legally depending on the GP


  • Options
    #70
    Kurtosis
    Moderators, Science, Health & Environment Moderators Posts: 2,881 Mod ✭✭✭✭Kurtosis


    steddyeddy wrote: »
    First of all I the first girl said she gets panic attacks and got them. Second of all I don't believe getting nervous when standing in front of a room full of people grading you is pathology. Thirdly people definitely use beta blockers for panic attacks.

    Just because people have an advantage from birth doesn't mean I'm OK with them getting all sorts of other advantages. My purpose in this capacity as an academic is to decide who was the best.

    I am looking for the best scientist (it was a thesis presentation for undergraduates). If someone uses a performance enhancer to trick me into thinking she's the best then I have a problem with that. The grading system is about you and not any little advantages life might have conferred on you.

    I'd have thought the best scientist may not necessarily be the best presenter/public speaker. A student may be at a considerable disadvantage if they have anxiety to the extent that it significantly affects their ability to present their project. If they have been prescribed something deemed appropriate by their doctor which will help to reduce the impact of this, it's hardly fair to call that a "trick".


  • Options
    #71
    steddyeddy
    Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    penguin88 wrote: »
    I'd have thought the best scientist may not necessarily be the best presenter/public speaker. A student may be at a considerable disadvantage if they have anxiety to the extent that it significantly affects their ability to present their project. If they have been prescribed something deemed appropriate by their doctor which will help to reduce the impact of this, it's hardly fair to call that a "trick".

    No the best scientist isn't the best speaker but he/she needs to be able to communicate their ideas in a simple way.

    Of the eight students presenting most would experience some extent of anxiety that effects their ability to present. One student has to be led by the hand to the microphone.

    I've seen this girl present many times without the drugs and she was grand. She heard one guy was getting them and she went to the GP and said I have panic attacks. I'm not 100% certain people aren't using them for performance enhancement rather than genuine pathology.

    They are actually considered performance enhancers in sport and athletes get them by telling their GPs they have panic attacks.


  • Advertisement
  • Options
    #72
    steddyeddy
    Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    Dingle_berry wrote: »
    Yes it is quite 'normal' to be nervous in that situation. But when those nerves escalate towards and beyond a phobia it would definitely be described as a pathology. Nerves aren't a binary experience, it's an emotion with an entire range of intensity and associated physiological responses.
    If you ban pharmaceutical help for anxiety you should ban all pharmaceutical help (those with depression may be getting motivation from anti-depressants, those with ADD/ADHD... )

    Banning drugs for anxiety is not the same as saying some levels of anxiety are normal for a particular situation.


  • Options
    #73
    steddyeddy
    Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    In either case the drugs (propranolol) backfired. She got a dry mouth and got a bit lippy when someone asked her a question.


  • Options
    #74
    skallywag
    Registered Users Posts: 2,992 ✭✭✭skallywag


    I've been prescribed beta-blockers in the past for high blood pressure, and I still have quite a large stockpile of them at home. I don't take them regularly these days as my BP is under control, and in any case beta-blockers are no longer the front line in controlling hypertension, calcium channel blockers tend to be first line defence these days.

    Would I think that taking beta-blockers is going to help someone when giving a presentation, or performing live, etc? Most definitely. That said, one would be crazy to take a beta-blocker for the first time before a presentation due to potential side effects. This is a personal thing, I've never had any side-effects myself whatsoever, but some people certainly do.

    As to the ethics argument, I do not see any issue with a doctor prescribing beta-blockers for such use (as far as I am aware many concert musicians use them before a performance?). Beta-blockers are generally very well tolerated and non-addictive, so don't come with the same issues such as Valium, etc. Adrenal levels will be lowered but without any type of 'highness' side effects associated with other drugs.


  • Options
    #75
    partyatmygaff
    Registered Users Posts: 10,992 ✭✭✭✭partyatmygaff


    India is probably the second biggest manufacturer of counterfeit medicines after China. Couple that with the fact that most online pharmacies that don't require a prescription are illegitimate, I can guarantee you that whatever you receive (if anything at all) will be counterfeit or substandard.

    Don't take any medicine, especially anything psychoactive, unless you absolutely have to. Ritalin isn't really that addictive (unless it's insufflated/snorted like cocaine) because it doesn't lead to as rapid a release of dopamine as other stimulants like cocaine and the amphetamines.


  • Options
    #76
    steddyeddy
    Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    From an academic point of view smart drugs most definitely are cheating. The way around this is to design a test that doesn't revolve around memory.


  • Options
    #77
    skallywag
    Registered Users Posts: 2,992 ✭✭✭skallywag


    katie232 wrote: »
    ...But I just can't get my head around something that is so misleading and potentially dangerous being legal...

    It is indeed illegal to import prescription drugs without having a valid prescription for the same.


  • Options
    #78
    skallywag
    Registered Users Posts: 2,992 ✭✭✭skallywag


    katie232 wrote: »
    Why are the websites up and running then?

    It's often the case that these websites are hosted and / or the drugs supplied from another country which is outside of the jurisdiction of the importing state. It is also the case of course that in some countries it may be legal to sell these drugs openly. In any case you yourself will be breaking the law of this country if you import them without a valid prescription.


  • Options
    #79
    echo beach
    Registered Users Posts: 1,252 ✭✭✭echo beach


    katie232 wrote: »
    I have ten 2nd year pharmacy exams starting in two weeks and I am strongly considering dropping into my GP to see what he says. At this point I'll try anything...

    I take it none of those exams are in law or ethics.
    Don't waste your GP's time. They have sick people to look after.
    I'll suggest something you could try. Get off the internet, put your head down and do the studying.


  • Options
    #80
    Simon2015
    Banned (with Prison Access) Posts: 702 ✭✭✭Simon2015


    skallywag wrote: »
    It's often the case that these websites are hosted and / or the drugs supplied from another country which is outside of the jurisdiction of the importing state. It is also the case of course that in some countries it may be legal to sell these drugs openly. In any case you yourself will be breaking the law of this country if you import them without a valid prescription.


    The Belgravia Hair Loss clinic in the UK are posting Propecia over to Ireland which isn't even legal here. You think the government would step in and do something ? Its not like the Belgravia clinic are an underground drug distributor.


  • Options
    #81
    skallywag
    Registered Users Posts: 2,992 ✭✭✭skallywag


    Simon2015 wrote: »
    You think the government would step in and do something ?

    Which government are you referring to? If the source is in the UK then the Irish Gov has no control here, and the UK Gov will not bat an eye as long as the laws of the UK are being adhered to.

    The law is been broken by the individual in Ireland who is doing the importing.


  • Advertisement
  • Options
    #82
    Simon2015
    Banned (with Prison Access) Posts: 702 ✭✭✭Simon2015


    skallywag wrote: »
    Which government are you referring to? If the source is in the UK then the Irish Gov has no control here, and the UK Gov will not bat an eye as long as the laws of the UK are being adhered to.

    The law is been broken by the individual in Ireland who is doing the importing.

    Most people who buy meds from somewhere like the Belgravia clinic would not even be aware they are breaking the law.


  • Options
    #83
    _Tombstone_
    Closed Accounts Posts: 3,006 ✭✭✭_Tombstone_


    echo beach wrote: »
    I take it none of those exams are in law or ethics.
    Don't waste your GP's time. They have sick people to look after.
    I'll suggest something you could try. Get off the internet, put your head down and do the studying.
    Nice guys finish last.


  • Options
    #84
    partyatmygaff
    Registered Users Posts: 10,992 ✭✭✭✭partyatmygaff


    katie232 wrote: »
    See thats what I thought. But I just can't get my head around something that is so misleading and potentially dangerous being legal.
    I wasn't intending on buying them online, just thought I'd see what would come up out of interest!
    It's not legal. Though the chances of the drugs being seized are very slim.
    skallywag wrote: »
    It is indeed illegal to import prescription drugs without having a valid prescription for the same.
    It's illegal to buy any prescription drug online, with or without a prescription and with or without the EU Common logo for online pharmacies.


  • Options
    #85
    skallywag
    Registered Users Posts: 2,992 ✭✭✭skallywag


    partyatmygaff wrote: »
    It's illegal to buy any prescription drug online, with or without a prescription and with or without the EU Common logo for online pharmacies.

    I stand corrected. I had incorrectly assumed the Irish legislation was similar to that in the UK.


  • Options
    #86
    steddyeddy
    Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    echo beach wrote: »
    I take it none of those exams are in law or ethics.
    Don't waste your GP's time. They have sick people to look after.
    I'll suggest something you could try. Get off the internet, put your head down and do the studying.

    Yet you don't have a problem with people going to the GP because they get nervous when giving presentations?


  • Options
    #87
    Kurtosis
    Moderators, Science, Health & Environment Moderators Posts: 2,881 Mod ✭✭✭✭Kurtosis


    steddyeddy wrote: »
    Yet you don't have a problem with people going to the GP because they get nervous when giving presentations?

    Beta blockers are licensed to treat anxiety. Ritalin etc. are not licensed as study aids.


  • Options
    #88
    steddyeddy
    Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    penguin88 wrote: »
    Beta blockers are licensed to treat anxiety. Ritalin etc. are not licensed as study aids.

    Yea beta blockers are classified as a performance enhancer in sport and music competitions. If you don't see how they could be used as such you need to get researching.


  • Options
    #89
    exgp
    Registered Users Posts: 126 ✭✭exgp


    Xeyn wrote: »
    My cardiology professor suggested as long as there were no contraindications certain beta blockers should be considered for those with an anxiety about presenting. The Ritalin thing is very debatable. The risk profile would suggest it shouldn't be used for that purpose but I'm no expert an I would hope a proper consultation occurred with the prescribing doctor first.
    Totally agree.


  • Options
    #90
    Kurtosis
    Moderators, Science, Health & Environment Moderators Posts: 2,881 Mod ✭✭✭✭Kurtosis


    steddyeddy wrote: »
    Yea beta blockers are classified as a performance enhancer in sport and music competitions. If you don't see how they could be used as such you need to get researching.

    I fully appreciate that, but I'm not sure how that relates to what I posted.


  • Advertisement
  • Options
    #91
    echo beach
    Registered Users Posts: 1,252 ✭✭✭echo beach


    steddyeddy wrote: »
    Yet you don't have a problem with people going to the GP because they get nervous when giving presentations?
    I don't think everybody who gets nervous when giving a presentation should rush to their doctor.
    I do think that if the anxiety experienced is far greater than the normal nervousness almost everybody experiences, causing a person to shake, to have a racing or irregular heartbeat, to be physically sick or to faint then it is appropriate to seek medical help, which may or may not include being prescribed a licensed medicine.
    penguin88 wrote: »
    Beta blockers are licensed to treat anxiety. Ritalin etc. are not licensed as study aids.
    Exactly. There is a world of difference between a person using a prescribed licensed and proven treatment for a recognised condition and a person seeking to enhance their abilities.
    It is most unlikely that a doctor would prescribe these smart drugs. (You have said that the anecdotal reports of their use come from products purchased on the internet, not prescribed, so the title of this thread is misleading). That was why I advised the poster not to waste her doctor's time.


Advertisement