3.1 Reduction History

3.1.1

As outlined in my letter dated 10th September 2004, Wayne was referred to the Alcohol & Drug Service on 19th April 2001 and first presented initially to our Detox Nurse and subsequently the following day to me. He was referred for assessment for his Benzodiazepine dependence with a view to subsequent reduction.

NB: As part of the evaluation process Wayne was also assessed by a Senior Clinical Psychologist, Dr. Alan Guy, who I understand has also provided reports for Wayne’s case.

3.1.2

Breakdown of Dosages During Reduction

3.1.3

At presentation it was clear to us that Wayne did not understand about the nature of the drugs he had been prescribed, including what they are normally used for.

3.1.4

Wayne on presentation, had comprehensive documentation regarding his history and presented it to both myself and the Detox Nurse. Points of note in this history include that Wayne reported the following symptoms:

1. Palpitations
2. Tightness in the chest
3. Flushes
4. Stomach pains
5. Paresthesia
6. Visual disturbances
7. Anorexia
8. Episodes of emotional instability

3.1.5

On presentation to us Wayne was being prescribed Clonazepam 0.5mg tablets one twice daily. Wayne had self reduced this in the previous week to 0.5mg tablets, half a tablet, twice a day. He had reported that he was feeling lousy at that stage and was encouraged to stay on this dose until he could readjust to this level.

3.1.6

Throughout the reduction program we endeavoured to give Wayne all of the advice and support he needed to help him cope with his withdrawal. This included; the provision of information on Benzodiazepines, practical advice on reduction, dietary and nutritional advice, lifestyle advice, etc.

NB: This was the first time Wayne realized that, not only are Benzodiazepines addictive, they also have numerous untoward side-effects. Subsequently, Wayne expressed strong feelings of injustice towards Dr. X and he demonstrated a strong determination to distance himself permanently from the use of Benzodiazepines.

3.1.7

I reviewed Wayne on 30th April 2001 and at that stage he had reduced his Clonazepam to one half of a 0.5mg tablet taken in the morning. Wayne had noticed the worsening of some of the symptoms that the Clonazepam was initially prescribed for, namely:

1. Dizziness
2. Pulsating temporal arteries.

3.1.8

On 21st May 2001 Wayne had been Benzodiazepine free for 16 days. He had reported at this stage that his sleep had generally been good except for the day before. He also reported the following symptoms:

1. Some tightening in his muscles
2. Tingling sensation over his face
3. Increase in emotional instability

Accordingly, the nature of withdrawal symptoms was generally discussed with him again at this point.

3.1.9

Wayne was additionally worried about his visual symptoms, which had worsened, and it was suggested to him that he see his GP for a check up in case of any other underlying pathology causing the visual symptoms he reported.

3.1.10

Wayne was subsequently discharged from our Service and referred back to his GP, Dr. Whitwell, as he had successfully become Benzodiazepine free.

3.1.11

In general, Wayne made excellent progress in his withdrawal from Benzodiazepines, although a little quicker than I would have recommended, but well within a safe level of reduction.