medication

Social prescribing comes of age

Social prescribing represents a steep learning curve for many doctors says Craig Sams, but it’s rocketing up the agenda

The setting: a GP surgery. Receptionist: “The doctor will see you now.” Doctor: “Hi, how are you getting on with your low-carb diet? Are you getting the regular exercise we agreed? Can we de-prescribe the Metformin? Let’s do a few tests to see whether you’re ready to come off the drugs. By the way, how are you getting on with your cookery classes? Let’s see if we can finally wave type 2 diabetes goodbye.”

Bad news for the pharmaceutical industry but ‘social prescribing’ is on a roll and there will be a lot more of it in the future. Professor Tony Avery, the NHS National Clinical Prescribing director has said the aim is to bring about a ‘culture change’. He sees social prescribing as transforming modern healthcare, saving money and improving people’s lives. Not only that, but adverse reactions to medication are estimated to cost NHS England over £2 billion a year (not to mention the impact on people’s lives and health). The number of disability claimants doubled from 2021 to 2022. 8.3 million Britons are now on antidepressants.

The College of Medicine’s Beyond Pills Campaign is pushing hard to stop the overprescribing of medicines. The college says that 1.1 billion medicines are prescribed unnecessarily. Its chair Michael Dixon (medical advisor to King Charles), has said ‘Medicine…is no longer affordable or sustainable. A new medical mindset is needed which goes to the heart of true healthcare.”

Back in the 1930s an experiment in social prescribing called the Peckham Experiment engaged with 950 local families to get them on the track to health. They had a gym, a swimming pool, cookery classes, a vegetable garden and workshops about health. Members would have a medical health check once a year and were monitored on a regular basis. The kids did better at school, marriages were more stable and women were empowered (knitting groups helped with this). Social and community activities were organised by the members and helped reduce isolation, loneliness and alienation, illness levels fell dramatically. William Beveridge who drafted the plan for the NHS, was impressed and envisaged similar health centres up and down the country. When the Government put his plan to the British Medical Association in 1948 they were not impressed and the Government was forced to back down and agree that all ‘health services’ would solely be via the GP’s surgery. The Peckham Experiment closed down two years later.

But social prescribing is finally rocketing up the agenda. There are now 15 Pain Cafes in Cornwall helping people manage pain without painkillers, relying instead on exercise and psychological support. Dependency on antidepressants has been shown to cause more harm than good (as anyone who watches Happy Valley already knows). Time to kick the diazepam.

Increasing awareness of the benefits of phytonutrients (the kind of stuff the health food industry has been emphasising for decades) is filtering through to the medical industry and impacting on social prescribing. It was the Dutch philosopher Desiderius Erasmus who famously said 500 years ago: “Prevention is better than cure.” With life expectancy rates going backwards, increasing rates of alcohol and drug-related deaths and hospitalisations, along with record levels of obesity, social prescribing is happening just in time. Will people be taking their prescriptions into the health food store? Or will the pharmacies try to capture this newly lucrative business?

The Bromley by Bow Centre in East London is pioneering the ‘new’ approach to health and wellbeing, and it is a model that is being emulated in more and more places.

Yes, the first reaction is ‘I told you so’ - but the fact is that these people are serious. At least so far.

How long will it be before doctors prescribe yoga and pilates classes or give out free prescriptions for herbal medicines and supplements? Will you get free cookery classes on the NHS?

There’s still a long way to go, but at least the direction of travel has finally changed. The Government has just allocated £50 million to support 42 Integrated Care Boards across the country to help doctors to ‘de-prescribe’ their patients and get them on the path to wellness without drugs. There will need to be proper support for the medical profession - they know it makes sense but it’s a steep learning curve for many doctors. They didn’t teach this kind of stuff at medical school.

Time to break the prescription drug addiction cycle

Craig Sams offers an alternative perspective on the culture of prescription drug addiction, saying a natural solution could be more effective in treating depression

A conversation took place three years ago between a good friend of mine and her doctor. Her husband had left her and she was extremely depressed. She went to see her doctor.

The doctor gave her a prescription for a very addictive 30mg pill that she would have to take every day for the rest of her life. She would sometimes be more prone to suicidal thoughts and less inhibited about acting on them. If she ever tried to stop taking them because she couldn’t stand the side effects, the doctor would not be able or willing to help. She eventually went cold turkey and now experiences periodic electric shocks in her head; which other people who have given up call ‘the zapps.’ Some people reduce the level of addiction by gradually reducing the dose level from 30mg to 26mg to 24mg to 22mg, right down to 6mg or 4mg, at which point it is much easier to get off. But no drug company provides that means of escape. If you go on the internet, there are some people in Holland who will provide you with reduced dose pills that make it a lot easier and safer to give up, but neither the NHS nor any drug company or doctor will help you with that.

What the doctor could have said: “Go out to a field and select half a dozen psilocybe cubensis mushrooms and eat them. Sit down in a comfortable spot and let them take effect and enjoy the journey. If that doesn’t do the trick completely, repeat after five weeks and you should be fine.”

Of people who take psilocybe just once, 94% experience a dramatic remission of anxiety and depression. The New Scientist recently called on the government to allow mental health researchers to study psilocybin. They do now, but the subjects have to buy it on the black market which invalidates the clinical results. If everybody who was depressed just took a few mushrooms the drug companies would be out of business.

Patrick Holford, the nutritionist, therapist and columnist in NPN, has just released a compelling rap called ‘Big Pharma Man: it’s a grand scam – he don’t give a damn’. It describes the criminality, fines, fraudulent research and cover-ups that have led to millions of lives being ruined by drugs that don’t work and are addictive. Just Google ‘Drug rap Patrick Holford’ and enjoy.

President Trump didn’t get any money from Big Pharma to get elected and so he has dared to say he’ll take action to deal with America’s opioid epidemic, where four out of five heroin addicts started on prescription opiods; drugs that are more addictive, expensive and dangerous than heroin. Meanwhile, Americans will continue to die at a rate of more than 1,000 a week from opioid overdoses. The makers of the drugs keep a database of doctors. Special attention goes to the ones who run ‘pill mills’, dispensing drugs at huge profit for themselves. These are doctors who swore the Hippocratic Oath: first do no harm. Hah! When Purdue, manufacturers of the opiod medication, ended up in court it paid $600 million in fines, and the executives who were found guilty of the criminal charge of selling OxyContin ‘with the intent to defraud or mislead’ paid $35 million. If someone sold $50 worth of heroin they would go to jail for a few years. These pharma guys get off light; the fines are insignificant compared to the billions of dollars they continue to make.

In my view it’s time to legalize all drugs, make them all available on the NHS, then let informed people choose how they want to get well instead of spending lives of misery hooked on drugs that have terrible side effects, which are treated with more drugs that also have terrible side effects. The alternatives are safer and cheaper.

Is it any wonder that I haven’t been to a doctor since 1965? I just say no to prescription drugs.