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THE LOCK ON PANDORA'S BOX

BBC Watch Politics Show West: Tranquillisers

A Critique

Colin Downes-Grainger,
June 24, 2008

After opening the box and releasing terrible things on the world, Pandora slammed the lid down and locked it again. Only the spirit of hope was left inside it.

** WATCH VIDEO **

"Where once journalists were active gatherers of news, now they have generally become mere passive processors of unchecked, second-hand material, much of it contrived by PR to serve some political or commercial interest. Not journalists, but churnalists. An industry whose primary task is to filter out falsehood has become so vulnerable to manipulation that it is now involved in the mass production of falsehood, distortion and propaganda." Nick Davies, The Guardian, February 4, 2008

The present meaning of Weltschmerz (a word created by German author Jean Paul) is the psychological pain caused by the sadness of realizing that your own physical weaknesses and social circumstances were caused by the inappropriateness and cruelty of the world. Weltschmerz defines supremely well the situation of severely affected, prescribed benzodiazepine dependent addicts whose negative lives are not of their own making - people who can never be said to hold any responsibility for their situation beyond the decision they made to take their concern to a doctor in the first place. Such people had their circumstances created for them by drug companies who followed the analyses of Edward Bernays and seized their chance in a world of amateur drug regulation to make huge company fortunes through the manipulation of the medical mindset and the consequent suffering of the end-users of that project - the patients.

Between 1961 and 1988, when UK regulators finally left the world of make-believe and issued guidance on benzodiazepine prescribing, GPs and psychiatrists in the UK were completely free to prescribe as much and as often as they liked and the scale of injury reached epidemic proportions. A glossy advert from Roche during the earlier part of this period headed "Whatever the Diagnosis" pushed the message to prescribers that all illness produced anxiety and was therefore a candidate for Librium, the first benzodiazepine. Yet today the Department of Health follows a line that doctors routinely prescribed appropriately for clinical anxiety and the psychological and physical effects of this inappropriate and profligate prescribing lie properly within the domain of psychiatry.

Benzodiazepine prescribing peaked in 1978 and 1979 at about 31 million prescriptions for each year. In the next ten years (two of these years were after the 1988 guidance) there were a further 267 million prescriptions. At that time the internet hardly existed in the UK and it was not until 1995 that Microsoft issued Windows 95.

On 15 June 2008 the BBC Politics show in the West of England examined the topic of benzodiazepine addiction (see video above), presumably because someone from their area was travelling to London to give evidence to the All Party Parliamentary Group on Drug Misuse at the House of Commons. It started well with two contributors describing their decades on the drugs and the effect on their lives of iatrogenic addiction. The programme then completely lost the plot, diverting into the world of online drug sales which is a question that medicine, regulators and government have avidly seized on as a means of avoiding an examination and responsibility for what is the real scandal - the near fifty year over-prescription of highly addictive drugs to patients by doctors employed in the NHS.

Throughout years of denial the DoH has benefited from the fact that programme makers know little of the subject and have no idea of the questions that should be asked. I have worked out, on the estimates of from 1 million to 1.5 million addicts in the UK that those numbers would fill:

11 Wembley stadiums to capacity for a figure of 1 million
16.6 Wembley stadiums to capacity for 1.5 million

OR

1,904 A380 aircraft at 1 million
2,857 A380 aircraft at 1.5 million

OR

6 Highgate cemeteries for 1 million
9 Highgate cemeteries for 1.5 million

There are about 167,000 people buried in the cemetery.

This was a disgraceful programme and a long step backwards. Anyone who knew nothing of the benzodiazepine question would have learnt little of the truth, but a lot about taking the wrong route to discovery. What a local MP interviewed on the programme was saying about increased funding from government in her area was meaningless. She believed it would be necessary for a part of the funding to be allocated to prescription drug addiction. She was quite right but the long history of campaigning to achieve this has so far resulted in almost nothing being produced beyond a limited service in Oldham in the North of England. Strangely, though invited to visit the service and examine its successes and needs, health minister Dawn Primarolo has been unable to find the time or inclination to attend.

The end of the programme was taken up by an interview with a Bristol GP - also a spokesman for the British Medical Association, the most effective trade union in the country. Professor Malcolm H Lader, Professor of Clinical Psychopharmacology at the Institute of Psychiatry, University of London had told the BBC in 1991:

"The Medical profession, I think, is fairly ashamed of what has happened. It's allowed this very untrammelled prescribing to go on."

I do not believe this to be the prevailing view among doctors at all. The BMA spokesman from Bristol preferred the more usual view, of the problem belonging to patients. Classic tactics were employed in the responses:

The internet is of course a major red herring. The majority of today's long-term addicted patients were addicted by doctors long before internet sales of prescription benzodiazepines boomed. The question was not examined, but it is perfectly possible that the majority of those who use the internet to feed an addiction to benzodiazepines, had that addiction created by NHS doctors. Such people, introduced to the drugs by their prescribers, then developed drug seeking behaviour. Most people, not addicted, will have no motivation for ordering internet drugs. I have had it said to me (and it has a certain ring of truth) that the UK regulator the MHRA is mainly concerned about the internet because it is a threat to its control of access to drugs. So it is like a turf war between drug dealers. In the BBC programme the debate glossed over what happens to people addicted by doctors over decades when the internet did not exist (many of whom are still addicted), to making an assertion of internet and individual patient responsibility.

In 2001 a spokesman for the Royal College of GPs was saying:

"There's still a significant continuing problem with benzodiazepines in this country. We would have liked if it was solved 20 years ago, but it still exists. We continue to work as a College with prescribing groups around the country to try and continue to raise awareness of this issue and reduce the prescribing of these drugs to appropriate use, but it is a very long struggle...I think it should be a significant priority for this country. It's potentially a million people who are on drugs which only maybe a tiny percentage of them need to be on, and that is not good for this country. It's also a waste of resource. We are ploughing money into these drugs and into support services for patients for a situation that we may have created ourselves." Dr Jim Kennedy, Royal College of General Practitioners, 'The Tranquilliser Trap', BBC, May 2001.

Very true, except for the 'maybe' and the non-existent support services. And in the same year and on the same programme, the government Mental Health chief, Louis Appleby, said:

"It is difficult to defend that we have such a huge problem of benzodiazepine prescription and long-term use and therefore dependence." Professor Louis Appleby, National Director for Mental Health, 'The Tranquilliser Trap', BBC, May 2001.

But in June 2008 a spokesman for the doctors' trade union is saying:

"The problem is people want to go on and on and therein lies the problem."

"I think the government should come out so that the public at large know it's not their right [...to ask for and become addicted to benzodiazepines]. It's not in their interests. We come back to smoking, alcohol and various other things which doctors speak out against."

So the whole problem of benzodiazepine addiction was emphatically NOT created by doctors, it was due to the fact that the government failed to educate the public out of their insane desires for tranquillisers, that a foolish element purchase drugs from the internet, and doctors have been helpless, confronted as they are by waves of patients with addictive personalities - the equivalent of alcoholics.

Where were the voices of UK doctors speaking about the dangers of benzodiazepines in the long years from 1961 to 1988 (and subsequently)? Apart from Professor C.H. Ashton, Professor Malcolm Lader and a few other enlightened souls, there were none. Why are there a significant number of doctors not speaking out but still addicting patients today? Why doesn't a spokesman for the BMA understand that 'wanting' and driven by addiction are two different things? As a fellow campaigner commented:

"Jesus wept, I despair."

If only the Pandora's box that is benzodiazepines had not been re-closed, and hope had been allowed to escape into the world. But the box has remained firmly locked, kept shut by politicians, drug company lobbyists and executives, key advisers to government and the state of UK law. The legally addicted see no hope. If only medicine, its regulators and government would just for a moment listen to what campaigners and patients tell them and act on it. If they would only remember the words of Oliver Cromwell:

'I beseech you, in the bowels of Christ, think it possible you may be mistaken.'

Colin Downes-Grainger
24 June 2008

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