The Iatrogenic Tranquilliser Scandal

Author: Barry Haslam

Barry Haslam, who has himself suffered the negative effects of tranquilliser dependency here outlines the shocking scandal of the over prescription of Benzodiazepine and other similar tranquillisers. Despite the dangers of over-prescription, which have been known for many years, there has been no admission of the need for a significant change in usage or a strategy to help people overcome tranquilliser dependency.

Benzodiazepines where discovered by the chemist Leo Sternbach in the 1950s and little did he know of the enormous impact his research would have on health issues and future dependency of this over-prescribed world product. The only real winners are the drug manufacturer's who have banked super profits over the last half a century at the direct cost to human health.  In 1960 we had Librium. In 1962 Valium and in 1972 Ativan. Described as Mother's Little Helpers they have proved anything but, and the passing of time has shown up the true dangers of these highly dependence forming drugs. These drugs that where only ever given short-term trials by the manufacturers, because their faults would have become self evident, so it is we human beings who have become the long-term human guinea pigs.

Benzodiazepine prescribed drugs have been linked to an increased risk of Alzheimer's disease, brain damage, lung cancer and seizure. These drugs have been described as "worse to withdraw from than heroin" by Professor Malcolm Lader and a "medical disaster akin to Thalidomide " by Professor C. Heather Ashton. Yet despite all the serious and life changing hazards connected to these drugs we have no national withdrawal plans or dedicated withdrawal services to cope with this human tragedy, no NHS recognition of the problem. Instead government has swept the issue under the carpet for decades - terrified of its accountability.

More than 60 years later, we still have nearly 1 million long-term prescribed benzodiazepine drug dependent patients in England alone.

What follows are extracts from the British Medical Journal (29 March 1980 Pages 910-912) demonstrate:

Systematic review of the benzodiazepines... guidelines for data sheets

Committee on the Review of Medicines

The Committee on the Review of Medicines (CRM ) has completed a review of the benzodiazepines and has issued guidelines for use in anxiety, insomnia, and certain other conditions.

Efficacy

The committee took particular note of the lack of firm evidence of efficacy which might support the long term use of benzodiazepines in insomnia and anxiety. It noted and concurred with the findings of the Institute of Medicine (USA) and the conclusions of a study carried out by the White House Office of Drug Policy and the National Institute on Drug Abuse (USA) that there is little evidence that sedative hypnotics, including benzodiazepines, continue to be effective when used nightly in patients over long periods. This report further observed that sleep laboratory studies show most hypnotics tend to lose their sleep promoting properties within 3 to 14 days of continuous use. The committee further noted that there was little convincing evidence that benzodiazepines were efficacious in the treatment of anxiety after four (4 months) continuous treatment. It considered that an appropriate warning regarding long-term efficacy be included in the recommendations, particularly in view of the high proportion of patients receiving repeated prescriptions for extended periods of time.

Safety

The committee gave considerable attention to one of the main areas of current concern - that of the development of possible benzodiazepine dependence. It noted that both the medical and lay press and media had recently drawn attention to the high rate of prescribing of diazepam and similar benzodiazepines, particularly with respect to their extended and habitual long term use.

However, following an extensive review of all available data, the committee concluded that, on the present available evidence, the true addiction potential of benzodiazepines was low. The number dependent on on the benzodiazepines in the UK from 1960 to 1977 has been estimated to be 28 persons.

It has recommended that all benzodiazepine therapy - unless given on an occasional basis only - be withdrawn gradually and that doses within the therapeutic range are used wherever possible. It further suggested that patients receiving benzodiazepine therapy be carefully selected and monitored and that prescriptions be limited to short term use.

Elderly

The committee noted the increase in the occurrence of adverse reactions of all kinds in the elderly. Such effects, often accompanied by confusion, occur particularly during drug treatment with the long acting benzodiazepines, where impaired liver and renal functions delay the elimination of drug and metabolites even further. The committee has suggested that the use of benzodiazepine therapy in the elderly, especially the use of the long-acting benzodiazepines for insomnia, be undertaken for short periods of time, and only after careful consideration. Patients should also be closely monitored.

Questions we should be asking

1. Why did we have to wait a further 38 years before a government health agency (Public Health England) awoke from its slumber and sloth to conduct another Review? How many more patients during these 38 years have slipped through the safety net to become dependent victims or committed suicide due to a drug that is said to be worse that heroin to withdraw from by Professor Malcolm Lader?
2. There was little convincing evidence that benzodiazepines are efficious in the treatment of anxiety after 4 months continuous treatment. So why have we currently nearly 1 million long term patients being prescribed benzodiazepines in England alone and a huge number of them have been on them for decades, as prescribed by their doctor? I can take you to a guy in Oldham who has been GP prescribed benzodiazepines without a break for 50 years. So much for efficacy guidelines!
3. The cover up the sheer scale of the problem can be seen in the totally absurd statement that "The number dependent on the benzodiazepines in the UK from 1960 to 1977 has been estimated to be 28 persons." Total utter nonsense, because during that period in England and Wales more than 300 million scripts were issued for benzodiazepines and we are led to believe that only 28 persons had become addicted in the whole of the UK!
4. Benzodiazepines have seen studies linked to an increased risk of Alzheimer's disease and brain damage and should be certainly not given to the elderly, especially with increased risk of falls and broken bones caused by these drugs. Benzodiazepines have also been linked to an increased risk of lung cancer and seizure.
5. Without dedicated withdrawal centres and after care facilities, not to mention the requisite number of trained staff, how do we gradually withdraw benzodiazepine patients receiving therapy as recommended by this 1980 review? Certainly substance misuse units have not the required expertise to tackle the logistics of iatrogenic dependency. Existing small charities who deal with prescribed drug dependent patients have had their funding withdrawn and some have gone to the wall such as CITA in Liverpool. It is total economic madness to destroy charities that are successful and cost effective. Why has this been allowed and who is responsible?
6. Going back to the current nearly 1 million long term benzodiazepine drug dependent patients in England - this drives a coach and horses through the 1980 recommendation that patients be carefully selected and monitored and prescriptions be limited to short term use. Cock up or cover up? A total farce - but lives have been lost and destroyed and still are put at risk, by long-term prescribing to a set of drugs only ever trialed by the manufacturer's for short-term use (i.e. weeks).
7. Research is urgently needed into the dangerous health implication of long-term prescribing of benzodiazepine and Z-drugs. We need to quantify the scale of those injured and those left disabled so that recognition, justice and compensation can be given to those patients, who only ever ingested these drugs as prescribed by their doctors and unfortunately trusted their clinical decision-making, especially repeat prescribing.
8. The above CRM 1980 Review highlights the massive difference in reality of this medical disaster that has been allowed to fester for decades due to weak guidelines and government apathy. These guidelines should have been made mandatory and enforceable on all health professionals from 1980 onwards, which would have saved untold misery to so many innocent victims of these dependency forming set of drugs.
9. A 24 hour national helpline for prescribed drug dependency is a non-starter because of the sheer logistics involved. Plus where are the availability of correct services to help withdraw patients from their prescribed dependency and the 'know how' to safely withdraw them? You cannot send them back to their doctors who caused the misery of dependence in the first place. So where are the dedicated withdrawal services going to come from and who funds them on a national basis?

It was known in the 1960 and 1970s that benzodiazepines where dependence forming for patients even on therapeutic dosages. It has been described as " a national scandal " in 1994 by the now Lord Blunkett and it still is. We the vast number of victims in this country fully deserve and are asking, for a public Inquiry into this "chemical man-made disaster" as a matter of urgency.

Barry Haslam is the ex Chair of Oldham Tranx and is permanently disabled due to prescribed iatrogenic BZ dependency.

The publisher is the Centre for Welfare Reform.

The Iatrogenic Tranquilliser Scandal © Barry Haslam 2018.

All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.