PIP and informing DWP of taking black market medication

Hi there,

I was wondering if anyone had any experience of a disability benefit claimant taking medication that is not prescribed to them, i order to carry out an activity and if there would be any repercussions/issues if someone were to put this in their PIP form.

Basically, my client says he takes street diazepam in order to make familiar journeys and speak to people. I tried to get it out of him why he can’t get this from his GP but he evaded the question again and again.

Obviously I think it’s very relevant when answering the questions. If I don’t include this they will say he doesn’t take any medical to manage his anxiety. If I say it’s street drugs, other issues may arise.

I’ve had similar instances where I’ve said a client has self-medicated with alcohol and/or class A/B drugs to help them manage the activities.

I reckon the key to this answer be to get it out of him why his GP won’t prescribe. But I thought I’d ask you guys to see if anyone else has put this.

Thank you for any help/advice in advance

Fairly sure no GPs now prescribe, because used for a couple of days or more and it makes you worse apparently. And of course is very addictive. Diazepam in my opinion is probably no worse than cannabis, secured on the street, as far as the law is concerned. And is of course very popular at the moment.

I’ve had a similar case which went to an appeal as the DWP completely disregarded this as its not prescribed.

The appeal tribunal was a little bit more receptive (despite a bizarre and hilariously confused doctor who had no concept of getting street-drugs) but again the problem was that it wasn’t prescribed - lots of questions re. why didn’t you get it prescribed etc

Unfortunately, it does take a lot of convincing but isn’t impossible!

Bcfu - 19 April 2023 10:27 AM

I’ve had a similar case which went to an appeal as the DWP completely disregarded this as its not prescribed.

The appeal tribunal was a little bit more receptive (despite a bizarre and hilariously confused doctor who had no concept of getting street-drugs) but again the problem was that it wasn’t prescribed - lots of questions re. why didn’t you get it prescribed etc

Unfortunately, it does take a lot of convincing but isn’t impossible!

Thank you for this, it gives me a little confidence that I can at least try and argue and I might not be laughed at lol!

davidsmithp1000 - 18 April 2023 04:01 PM

Fairly sure no GPs now prescribe, because used for a couple of days or more and it makes you worse apparently. And of course is very addictive. Diazepam in my opinion is probably no worse than cannabis, secured on the street, as far as the law is concerned. And is of course very popular at the moment.

I thought I’d ask my friend who is a GP and she says that yes, she is moving away from prescribing Diazepam! I’ll get some more information from her but thanks for the prompt. I think it may be a mixed bag with GPs and whether or not they will prescribe or not, but at least I could mention it and therefore preempt arguments they could potentially make when making a decision. Thanks!

I don’t see that there is much to be concerned about. Making reference to illicit drug use isn’t itself going to land you in any trouble and there are claims made on the basis of substance misuse of itself. Plenty more people self-medicate with various illicit drugs.

I wouldn’t treat self-medication in the same way as prescription drugs, in that it shouldn’t be included in the medication part of the form but you can make reference to it in the relevant parts.

The point is that if you can only engage with other people having zonked yourself out on street benzos then you aren’t managing the activity to a reasonable standard.

What he said…

Some GPs still do prescribe Diazepam, sometimes in surprisingly large doses. The NHS website states that most prescriptions will be for no more than 4 weeks, or if longer the dosage will likely be reduced.

However, GPs will be more reluctant to prescribe benzos where there are known drug misuse or addiction issues, which may or may not be the case with your client.

For appeals where appellants are self-medicating drugs or alcohol to combat anxiety you will likely focus on the reliability criteria. How is someone doing tasks safely/to a reasonable standard if they are dependent on illegally taking addictive street drugs in order to perform the activity? Side effects of benzos can include aggression, confusion and paranoia.

The British National Formulary precribing notes re benzodiazepines say

Important: benzodiazepine indications

1. Benzodiazepines are indicated for the short-term relief (two to four weeks only) of anxiety that is severe, disabling, or causing the patient unacceptable distress, occurring alone or in association with insomnia or short-term psychosomatic, organic, or psychotic illness.
2. The use of benzodiazepines to treat short-term “mild” anxiety is inappropriate.
3. Benzodiazepines should be used to treat insomnia only when it is severe, disabling, or causing the patient extreme distress.

DIAZEPAM
Indications short-term use in anxiety or insomnia (see p. 222); life-threatening acute drug-induced dystonic reactions (see also section 4.9.2); adjunct in acute alcohol withdrawal; status epilepticus (section 4.8.2); febrile convulsions (section 4.8.3); muscle spasm (section 10.2.2); peri-operative use (section 15.1.4.1)

Dose
By mouth, anxiety, 2mg 3 times daily increased if necessary to 15–30 mg daily in divided doses; ELDERLY (or debilitated) half adult dose Insomnia associated with anxiety, 5–15mg at bedtime

Needless to say many if not most GP’s are reluctant to prescribe diazepam for anxiety and those who do will only prescribe it short term

Having said that I have represented a few clients who have used someone else’s medication or have used street drugs to deal with pain or anxiety

I find that its best if the client is completely up front with the Tribunal and to be ready with my own questions if any panel member seems sceptical.

I would not bother to try to argue the point with the DWP at the MR stage as its a waste of time from my experience

Details about why he doesn’t get it from his GP will likely be in his records.
Often there will be addiction concerns - and one of the hurdles you might have to overcome at tribunal is whether his use is more on the recreational side. If he is reluctant to speak about it that might cause some issues.

Also be cautious that the effects of Diazepam can sometimes be overstated - especially if there are addiction issues he might have developed tolerance to it - at which point he couldn’t rely on it to resolve his anxiety issues - in turn indicating he might manage the activities without the use of illicit drugs. Again, GP records would be useful to see what treatments have been considered and why/not they were considered ill-advised or ineffective.

Whether a GP will prescribe it varies wildly between practices and even between individual doctors. Many of my clients get Diazepam ‘for emergency use’ on an incommensurately regular basis - usually a good argument at tribunal where DWP have tried to argue that ‘their anxiety is well managed with medication’.

Late to respond but….
Agree that can only be documented in the claim as self medication. Could i guess add to the list of medications with an asterisk and make this clear !

A print out of GP records will probably state if there is an addiction concern or indeed any overdose concerns.  Like others said NICE guidance tells GPs to only prescribe short term if new prescriptions but…..many with severe enduring mental health conditions are still prescribed where sedation is considered a therapeutic approach. So for eg in mania and/or psychosis.
IMHO is oft used because there is very little MH support out there as an alternative to pharmaceutical sedation.

Also certain physical conditions where severe muscle spasm occurs may have diazepam prescribed. Not relevant for your client from initial take but something to bear in mind when we look at the guidance available to us.

Some overthinking here for me.

The only issue is whether he can perform the issue reliably. Being unable to perform it without a drug, regardless of source, scores the points.

As regards where you list this I don’t see it as an issue. Do we separate out non-prescribed paracetamol? Are we suggesting three sections now?

- Prescribed
- Stuff I take as needed
- Stuff I take illegally

I don’t see the difference and have never met a tribunal who give a stuff either.