DR ELLIE CANNON: How do I get more sleeping pills now GP has cut mine?

I was first prescribed zopiclone, a sleeping pill, about 16 years ago and still take them to this day. I couldn’t cope without them.

However, my GP now says I can have only 14 per month, starting next month. I’m absolutely dreading this. 

One night without the tablets and I suffer terrible nightmares, sweats and panic attacks. 

I’ve been searching the internet to see if I can buy them, but it’s so expensive. I’m desperate.

Severe insomnia and addiction to sleeping tablets is sadly a very common problem that I see in clinic. Often it’s related to untreated significant mental health problems such as depression, anxiety or post-traumatic stress disorder.

Not being able to sleep in itself is traumatising and torturous. And it perpetuates a cycle of mental health symptoms which is hard to break. For this reason patients – and their doctors – often resort to sleeping tablets.

Zopiclone is one of the more modern sleeping tablets, but just like more old-fashioned types, it is known to be addictive – and it’s been a controlled drug in the UK since 2014. That means doctors can’t normally prescribe more than a certain amount in one go.

Patients who become dependent on sleeping medication often say they feel they cannot cope without it. But medical studies show that people who come off zopiclone feel vastly better in terms of mood, concentration and even sleeping.

That said, quitting the drug is not easy. Withdrawal symptoms are, unfortunately, likely. These can include anxiety, panic and even paranoia and anger. For this reason we advise patients to withdraw zopiclone very slowly as advised by NICE, reducing the amount taken each night over a period of four to six weeks.

A GP should be able to help and support this, but there are also many specialist support services nationwide for patients trying to come off sleeping tablets safely. As well as withdrawal advice, the services can offer access to psychology, support groups, counselling and insomnia clinics to aid recovery.

It’s vital not to buy medicines online, or in any other way. It’s illegal to sell controlled drugs to people in the UK, and so you’re buying them from criminals, no matter how legitimate their website might appear. There is a significant risk you’ll get tainted medicines, containing all sorts of harmful substances. This is shown time and again, when tablets bought online are tested.

For some years now I have been affected by a burning sensation in my upper back. It comes on after I have spent time standing or walking, and I have to sit or lie down in order to recover, which usually happens quite quickly. GP tests came back negative. I am 69-years-old and in good health otherwise.

This sounds like what we call neuropathic pain – pain that originates within a nerve, rather than a typical pain when the body is reacting to an injury, such as a cut or broken bone.

Our nerves are responsible for all the sensations we feel in our skin, such as pain, heat and touch. When they are functioning normally, they carry signals to the brain which we feel as those senses. If the nerves are damaged or not functioning properly, these senses become abnormal.

And so heat, pain, tingling or numbness can be felt even when, in fact, there’s no stimulation. This is neuropathic pain.

It happens for many reasons: for example, the nerve can become trapped if there’s a problem in a joint. It can also be triggered by diseases such as diabetes or even Vitamin B12 deficiency. Recurring infections like shingles or herpes may cause recurrent nerve pain, but these would be unlikely to pass just by changing position.

A pain that is fleeting is hard to treat: taking a painkiller at the time of pain is likely to be worthless if the pain passes before the analgesia works. But a regular painkiller that targets neuropathic pain and is taken every day pre-emptively may be worthwhile.

Discuss this with your doctor – it may only be worth it if the pain is distressing enough to warrant a regular tablet and potential side effects.

I read online that testing your own urine at home, using a dipstick kit, is a good idea as it helps monitor for health problems such as diabetes. I bought tests from an internet pharmacy and was worried to discover there were high levels of leukocytes in my sample. What does this mean?

This is a great example of why we don’t advise healthy people to test their urine at home. Doctors often carry out dipstick tests – mainly because it’s a quick and easy way to flag if something’s up. But results can be very variable, and they’re not considered a diagnostic test by any stretch. It’s also not a way to screen for diabetes, whatever certain websites might suggest. If a dipstick result was of concern, we might repeat the test, send a sample to a lab and maybe start other investigations.

Leukocytes are white blood cells. If a patient has pain in the pelvis or when urinating, and we find leukocytes, it might indicate an infection. But high levels of leukocytes can also be found in healthy people. I’d advise discussing any seemingly abnormal results with a GP – and also point out that urine-testing strips can become inaccurate if not stored correctly or if kept beyond their expiry date.

Dolly ‘vaccene’ song hits right note 

Forget the Queen talking about her Covid jab… the film of Dolly Parton having her vaccine last week, above, is absolute gold.

The purple mask that matches her sparkly top; the little cut-out shoulders so she can have her jab without rolling up a sleeve – and the fact she sings her hit Jolene, with the words: ‘Vaccine, vaccine, vaccine, vaccee-ee-een…!’

There are still millions of older Britons who’ve not had the jab, despite it being a lifesaver. To anyone who is feeling worried or nervous, just look at Dolly, 75, who’s confidently having hers with style and, of course, humour. She has also, I should point out, donated millions to help fund research into the jabs.

As she summarises in her song: ‘I’m begging of you please don’t hesitate, ’cos once you’re dead, then that’s a bit too late.’ I couldn’t have said it better myself.

Forget the Queen talking about her Covid jab… the film of Dolly Parton having her vaccine last week, above, is absolute gold

Jab side effects show it works 

More than 21 million people have now had their first dose of a Covid vaccine in the UK, and I am sure I’m not alone in feeling more optimistic as a result.

But I’ve had a few letters from readers asking about side effects. 

One in ten people on trials got a headache, or felt tired and even feverish for a day or maybe more. 

Anecdotally, I’ve heard of people who say they’ve had Covid and seem to suffer stronger ill effects from the jab. But none of this is anything to worry about. 

Most of us have had a jab at some point, causing similar transient symptoms. It’s just a sign the jab is working. 

Given that getting Covid can kill you, or leave you suffering months of crippling ill health, it seems a small price to pay for protection.