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Troubles behind the calm – Growing awareness
of the scale of tranquilliser addiction
August 17, 1988
by Joy Melville
Anyone who went to their doctor in the 1950s complaining of stress, tension and anxiety would probably have been given barbiturates, the only effective drugs then known to calm the nerves, barbiturates were not only rapidly addictive but also highly toxic - a small overdose killed. Trained to diagnose physical problems and having no time to respond to emotional problems, doctors were quick to welcome the first non-toxic tranquilliser. Librium was launched in 1960, after research on the chemicals benzodiazepines showed they had a calming effect on the brain. Valium appeared two years later and then Ativan. Tranquillisers were swiftly dubbed 'happiness pills'.
Nearly 30 years on, it has become clear that tranquillisers brought many users only unhappiness. At least 300 people in Britain have instructed their solicitors to claim compensation for the addiction they have experienced from long-term use of tranquillisers. There are believed to be over 2 million addicts. (The benzodiazepines are all minor tranquillisers. The major tranquillisers, including Largactil and Modecate, are given in cases of psychosis, such as schizophrenia.) The number of claimants is growing and seven firms of solicitors now form a steering committee to co-ordinate the claims, though legal proceedings are still at an early stage. Paul Balen, a Nottingham solicitor whose firm set up the committee, considers the drug companies ought to have known, if they did not, about the addictive nature of these drugs. 'The issues involve the medical profession and the government licensing authorities, but it all starts with the drug companies'.
The question of responsibility is crucial. Take the new anxiety-lowering drug, Buspirone, marketed earlier this year, which the manufacturer, Bristol-Myers Pharmaceuticals, claims is non-addictive. Can we be absolutely sure of this, without tests lasting for years? Or will the public act as guinea pigs again? How can you not become dependent, at least psychologically, on a drug which relieves anxiety? Tranquillisers, taken for a few days to deal with a specific trauma, can be useful. The damage was done by repeat prescriptions. Patients placed orders with their GPs for 10, 15, 20 or more years and, without query, they were signed. There was no standard dosage - it depended on the GP's assessment of the patient and could range from the normal therapeutic dose in the case of Valium of 15-20 mg a day right up to 60 mg a day. Gradually, complaints from long-term users of feeling numb, unemotional and out of touch with reality began to emerge. But it was not until 1980 that the Committee on Review of Medicines warned doctors that tranquillisers lost their effectiveness after four months. The terms 'addiction' and 'withdrawal symptoms' were finally applied.
Addiction conjures up images of hypodermic syringes rather than small coloured pills. But if you rely on a drug in order to carry on normal existence, then you are dependent on it. One woman, challenged by her husband to stop taking tranquillisers, reported: 'Admittedly I'd taken them every day for years, but it was really more that I'd fallen into a habit than that I needed them. So I stopped taking them that night, just to show him, and I've never felt so terrible in all my life'. Some people can give up tranquillisers after lengthy use without any trouble. Others find they feel 'terrible' when they stop. For this reason the Committee on Safety of Medicines recommended in January that tranquilliser use be limited to two to four weeks, even for those suffering 'unacceptable distress'.
As a rough rule of thumb, withdrawal symptoms are thought to last a month for every year on tranquillisers. Symptoms include sickness, and feelings of unreality, panic attacks, confusion, visual disturbances, palpitations, hot and cold flushes and shakiness. Because withdrawal symptoms approximate symptoms of acute anxiety, doctors are quite likely to re-prescribe tranquillisers. And the merry-go-round begins again. One woman, who had taken tranquillisers for 18 years, says: 'Nobody understood, I didn't myself. My children were confused, hating to see me trembling and shaking. They'd say, 'Oh, Mummy, you need a tablet.' They didn't realise I had to get over this. And neither did the doctor. Every time I went to see her, trying to reduce the dose, I'd come out with more pills'.
On becoming aware of addiction some doctors take patients off tranquillisers immediately. But withdrawal symptoms can be seriously heightened if the drug is stopped abruptly, rather than gradually reduced in dosage. Sometimes a patient who has managed to come off tranquillisers gets them re-prescribed on going into hospital. There is no point in stopping tranquillisers but going on to sleeping pills (sedatives) since they are basically interchangeable. For example, 5 mg of a sedative such as Mogadon taken at night could well be taken in a dose of 2.5 mg twice during the day as a tranquilliser.
Twenty-five million tranquilliser prescriptions a year are still being handed out in Britain. The National Association for Mental Health (MIND) encounters people who have been on tranquillisers for many years. According to Joan Jerome of Tranx, a support group for people seeking help with tranquillisers, 'There are still a whole lot of doctors out there who think tranquilliser addiction is a heap of nonsense'. She believes that people should place minimal reliance on tranquillisers and she advises 'Find a counsellor. Find someone to listen to you.' She asserts that if you mask emotion with tranquillisers the emotion will resurface when you stop taking them. According to one widow, tranquillisers actually prolonged the process of bereavement.
We laugh now at 18th century credulity in the Famous Drops, which claimed to 'comfort the Brain and Nerves, compose the hurried Thoughts, and introduce bright lively Ideas and pleasant Briskness, instead of dismal Apprehension and dark Incumbrance of the Soul'. But aren't we still susceptible? Don't we all crave a panacea?
Many local MIND offices run tranquilliser support groups and Tranx (25a Masons Avenue, Wealdstone, Harrow, 10-863 9716) offers information and support in person and by telephone.
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