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BENZODIAZEPINE AWARENESS NETWORK INTERNATIONAL
Joan E. Gadsby
Joan E. Gadsby's Main Page
Time for Action
(Tranquillizers and Sleeping pills)
An Integrated Approach to Positive Partnership Solutions
to a Long Standing Serious Worldwide Health Epidemic
PRESENTATION TO "BEAT THE BENZOS" CONFERENCE
Croydon, England · November 1 - 2, 2000
© Copyright Joan E. Gadsby
October 27, 2000
Abstract · Common Benzos · Adverse Side Effects · Some Facts · Cognitive Impairment
· Call To Action · Benzo Milestones · Resolution to Canadian Govt
· Where do we go from here? · Women's Mental Health · Biography
This Presentation will include an overview on the use, misuse and over prescribing of benzodiazepines; history of the benzodiazepine problem with pertinent research studies dating back to the late 1960s and current - North Shore, British Columbia, Canada, United States and Worldwide:
The 4 elements of the benzodiazepine problem include: (1) unnecessary prescribing beyond a short term if at all (2 to 4 weeks is stipulated in guidelines dating back to the early 70s and 80s and 7 - 10 days more recently by Health Canada) (2) serious and often dangerous side effects including paradoxical agitation, increased behavioural disinhibition, impaired new learning, decreased short and long-term memory, impaired psycho-motor functioning (many times leading to accidents and/or falls), rage, the appearance of worsening of depressive symptoms and chemical dependency. (3) severity and extended duration of withdrawal effects both acute and protracted; and (4) the potential for organic brain damage and potentially permanent cognitive impairment.
A discussion on the role of the key stakeholders - consumers, doctors, pharmaceutical companies, pharmacists, other healthcare practitioners, government, researchers and social services agencies will be followed by the costs and effects of benzodiazepines on individuals and society i.e. lost productivity to employers, work place safety, the loss of individual earning power, loss of property, falls, car accidents, related crime, police and legal costs, lost years, personal and family dysfunction, loss of life and quality of life and millions of dollars in costs to the health care system.
The presentation will identify obstacles to addressing the issue with solutions and conclude with a concrete focus on action in an integrated approach linking policy, practice and research to strategic partnership solutions amongst the key stakeholders.
Joan Gadsby · October 27, 2000
Generic Name Brand Name Alprazolam Xanax Chlordiazepoxide Librium Clorazepate Tranxene Clonazepam Klonopin, Rivotril Diazepam Valium Estazolam ProSom Flunitrazepam Rohypnol Halazepam Paxipam Flurazepam Dalmane Lorazepam Ativan Nitrazepam Mogadon Oxazepam Serax Quazepam Doral Temazepam Restoril Triazolam Halcion
Author's Note: CAUTION Under no circumstances attempt to withdraw from any of the above drugs without proper, ongoing medical supervision such as a well informed addiction or chemical dependency doctor.
There are several excellent websites dedicated to the
problems associated with benzodiazepines:
To join the benzodiazepine withdrawal email support group go to:
The Benzo Group
ADVERSE SIDE EFFECTS OF TRANQUILLIZERS AND
SLEEPING PILLS (Short and Long term)
Decreased mental alertness Confusion Impaired Judgment Disorientation Slurred speech Impaired learning (new verbal and visual information) Decreased short and long term memory Lack of concentration Impairment of decision making disorganization of thought induced amnesia impaired recall Fogged state of mind Dementia Delirium Drowsiness Lethargy Sedation
Note: Cognitive impairment can occur when (1) taking the drugs (2) during withdrawal and (3) for many years after withdrawal and may not be reversible. This can occur taking therapeutic doses long term - i.e. over many years.
Paradoxical reactions and agitation Increased behavioral disinhibition induced rage aggression hyper excited states release of hostility anti social behaviour (affecting family and others).
Sedation Ataxia (total or partial inability to coordinate voluntary bodily movements especially muscular movements) Impaired visual - spatial ability blurred vision staggering (i.e. "dry gin" effect) dizziness, leading to falls Impaired operation of a motor vehicle associated with increased accidents i.e. visual and motor coordination.
Creation of depression worsening of depressive symptoms altered moods creation or appearance of psychiatric symptoms such as psychotic reactions, manic depression, hypomania Ego-alien suicidal ideation (i.e. patients felt "driven" as if by some outside force to commit suicide without the concomitant wish to die).
Note: Psychiatric disorders can't be diagnosed when there is usage of these drugs - source: DSM IV Psychiatric Manual.
Dependency on drugs cross addiction to alcohol and other drugs (to withstand anxiety caused by mini withdrawals between pills Build up of tolerance to drugs so that more are needed in higher doses over time.
Emotional anesthesia gastro intestinal disturbances sleep disturbances risk of congenital malformations in pregnancy floppy baby syndrome potentiation of the effects when taken with other central nervous system depressant drugs such as sleeping pills and anti depressants overdoses toxicity.
Mini withdrawals between pills Discontinuance of all drugs creates withdrawal symptoms. Acute, (weeks to months) and protracted, (up to several years). Rule of thumb is 1 month of withdrawal for every year of usage. Withdrawal symptoms can include insomnia, panic attacks, agitation, hallucinations, paranoia, depersonalization, derealization, depression, pressure in head, rebound anxiety, loss of appetite, weight loss, visual distortions, flashbacks, lack of concentration, agoraphobia, dizziness, sweating, nausea, nightmares, palpitations, creeping sensation in the skin, increased sensitivity to light, touch and smell, pins and needles, numbness and seizures and sometimes death.
SOME FACTS ON DRUGS AND BENZODIAZEPINES
Canadians swallow more than $6 billion in prescription drugs each year.
Estimated health care costs of inappropriate prescriptions exceed $ 2.56 billion a year in Canada.
Prescription Drugs are the fastest growing sector of health care costs and health care costs are the largest component of federal and provincial budgets.
Prescription Drugs now exceed the cost of physician services in Canada.
Worldwide sales of benzodiazepines (tranquillizers and sleeping pills) are estimated at in excess of $21 billion. In the United States, sales are an estimated $1.2 billion and in Canada $104 million.
Benzodiazepines have often been called the most widely prescribed group of drugs in the world and the biggest selling drugs in the history of medicine.
Approximately 10% - 15% of the population use tranquillizers and sleeping pills with up to 30% of people over the age of 60 years using these drugs (often over many years having been prescribed them at a much earlier age) and who have become "accidental addicts".
The World Health Organization (WHO) estimates that 33% of diseases today are caused by medical treatment i.e. iatrogenic or doctor induced illness.
An estimated 60% of users of tranquillizers and sleeping pills become addicted and suffer adverse reactions to the drugs.
Pharmaceutical companies spend more on marketing and promoting of drugs than on research and development - an estimated $15,000 - $20,000 on every doctor.
40% of impaired or dead drivers of motor vehicles show prescription drugs in their systems - predominantly tranquillizers and sleeping pills.
The adverse effects of benzodiazepines have been known for over 2 decades but little has been done to address the problem or to change doctors prescribing habits.
Guidelines for acceptable duration of benzo use in Canada date back over 2 decades. In 1982 with 1 - 2 weeks use recommended. Other sources stated a maximum of 2 - 4 weeks or for intermittent use only. Most recently, Health Canada states 7 - 10 days.
The infrastructure available and doctors knowledgeable to help people withdraw from these drugs is minimal.
Misdiagnosis, misprescribing and mistreatments of patients who trust their doctors to "do no harm" continues today in the area of tranquillizers and sleeping pills.
The high cost to our socio-economic system with the continued indiscriminate prescribing and usage of these drugs includes not only health and safety in the work place, but career devastation, family dysfunction, productivity losses, car accidents, falls, lost years of peoples lives, lost lives, costs to the legal and justice system, workers' compensation board claims, insurance claims, social welfare costs, emergency admissions, physicians' fees, pharmacists' fees, detox facilities and increased overall costs for healthcare and other public/private sector services.
The elderly receive more than twice the number of prescriptions for psychotropic drugs as do younger people.
Non "psychiatric" conditions account for 70% of benzo users.
Cross addictions to other drugs and alcohol occur in 73% of benzo users - many of whom never used alcohol or other drugs previously.
43% of emergency room suicide attempts or overdoses involve tranquillizers and sleeping pills.
Prescription drug addiction to benzodiazepines is far more gripping and debilitating than addiction to heroin or cocaine and withdrawal is much worse.
In British Columbia a report released in May 1999 revealed that in 1997 benzo prescriptions surpassed all other Phamacare prescriptions for women exceeding cardiac drugs, antidepressants and estrogen. 67% of prescriptions were issued to women.
A booming market also exists for anti depressants such as Prozac, Paxil, Zoloft and Luvox with worldwide sales in the billions of dollars and Prozac sales of more that $2 billion with more than 24 million users worldwide in 1997. Many benzo users are also prescribed antidepressants with 70% being prescribed for women. Concurrent prescribing of benzos and anti depressants is estimated to be for 60% of patients.
The drugging of children with Ritalin, a highly addictive central nervous system stimulant, continues with increasing regularity and controversy with Ritalin use in Canada nearing a world record having increased 50% last year alone. In the United States usage of Ritalin is up an estimated 70% between 1990 and 1998. Is it a question of hook them young and they are customers for life?
Statistics from 39 studies done in US hospitals spanning 4 decades found that 2.2 million serious injuries and more than 100,000 deaths were attributed to prescription drugs taken as instructed. Further, the ingestion of prescription drugs was found to be one of the leading causes of death, along with heart disease, cancer and stroke.
68% of people prescribed benzos receive their prescriptions from only one doctor.
New "diseases" are being created by drug manufacturers including the latest - "social anxiety disorder" for which the anti depressant, Paxil is being promoted heavily on television currently. Paxil prescriptions in Canada increased 23.9% in the past year reaching just under 3 million prescriptions.
Joan Gadsby · October 27, 2000
COGNITIVE IMPAIRMENT RESEARCH:
(TRANQUILLIZERS & SLEEPING PILLS)
"Sedative Hypnotic Dependence: Neuropsychological Changes and Clinical Course"; Stefan Borg, Karolinska Institute, Sweden.
Results: Neuropsychological impairment has been observed not only in connection with abuse or dependence, but also in long-term users showing no signs of abuse or dependence. Impairment seems to be present even after a period of abstinence.
"Psychophysiology and Anxiety - Current Issues and Trends"; S. Levander; Pharmacological Treatment of Anxiety, National Board of Health and Welfare, Drug Information Committee, Sweden, 1; 43-51.
Results: Treatment with benzodiazepines may have negative therapeutic longtime effects, and may induce neuropsychological impairment, which in the worst case may be permanent.
"Cognitive Impairment in Long Term Benzodiazepine Users"; Susan Golombok et al; Psychological Medicine, 18, 365-374, United Kingdom.
Results: Patients taking high doses of benzodiazepines for long periods of time perform poorly on tasks involving visual-spatial ability and sustained attention. This is consistent with deficits in posterior cortical cognitive function. This implies that these patients are not functioning well in every day life and that they are not aware of their reduced ability. Further only after withdrawal do they realize that they have been functioning below par.
"Dependence on Sedative-Hypnotics: Neuropsychological Impairment, Field Dependence and Clinical Course in a 5-Year Follow-Up Study." H. Bergman, S. Borg et al; British Journal of Addiction 1989; 84: 547-553.
Results: Despite some neuropsychological improvement, cerebral disorder diagnosed in a group of3O patients who had been hospitalized 4-6 years earlier is often permanent through the years with neuropsychological status linked to long term prognosis.
"Protracted Withdrawal Syndromes from Benzodiazepines." H. Ashton; Journal of Substance Abuse Treatment; 8:19-28.
Results: Benzodiazepines may occasionally cause permanent or only slowly reversible brain damage.
"Learning and Memory Impairment in Older, Detoxified, Benzodiazepine-Dependent Patients"; Mayo Clinic Proceedings 68:731-737.
Results: A neurological study in which twenty deto4fied, benzodiazepine-dependent patients were matched with twenty detoxified, alcohol-dependent patients, along with twenty-two control subjects from a community sample showed that the benzodiazepine group had "significantly lower" scores on auditory-verbal learning tests. Most investigators believed that use of a combination of benzodiazepines had a "cumulative effect on memory" which "did not necessarily diminish with time".
"Drug-Induced Cognitive Impairment"; Drugs and Aging 3(4): 349-357.
Results: Drug-induced cognitive impairment is a common cause of delirium and is frequently a confounding factor in dementia... sedatives such as benzodiazepines have a particularly high risk of cognitive impairment...
"Lack of Cognitive Recovery Following Withdrawal from Long Term Benzodiazepine Use"; P.R. Tata, Psychological Medicine 24, 202-213.
Results: Twenty-one patients with significant long-term therapeutic benzodiazepine use were given psychometric tests of cognitive function, pre- and post-withdrawal and at 6 months follow-up. The results demonstrated significant impairment in patients in verbal learning and memory, psychomotor, visuo-motor and visuo-conceptual abilities, compared with controls, at all three time points. Despite practice effects, no evidence of immediate recovery of cognitive function following benzodiazepine withdrawal was found Modest recovery of certain deficits emerged at 6 months follow-up in the benzodiazepine group, but this remained significantly below the equivalent control performance.
"Neuropsychological Changes During Steady State Drug Use, Withdrawal and Abstinence in Primary Benzodiazepine Dependent Patients"; U. Tonne et al, Acta Psychiatry; Scandinavia, 91, 299-304; 1995.
Results: Impairment on neuropsychological tests during steady-state drug use and withdrawal, and after discontinuation of benzodiazepines, was studied in primary benzodiazepine-dependent patients. This study confirmed earlier observations of neuropsychological deficits in long-term benzodiazepine-using patients and demonstrated that these changes are "partly" reversible by discontinuing drug intake.
"Intellectual Impairment and Acquired Intellectual Deterioration in Sedative/Hypnotic Drug Dependent Patients"; Department of Psychology and Psychiatric Clinic at Stockholm University, Sweden.
Results: Every second patient dependent on sedative/hypnotic drugs showed signs of intellectual impairment... The general test profile indicated an acquired intellectual deterioration.
"CALL TO ACTION"
October 27, 2000
Obstacles to Getting the Benzodiazepine
Problem Reduced and Some Solutions
Obstacle 1:Lots of studies, little action.
Solution 1:Redirection of research funding toward action-oriented strategies, including professional help and supervision for chemically dependent persons, public awareness and education campaigns targeting doctors and consumers; i.e., through media, conferences, brochures, product inserts, pill hotline, etc.
Obstacle 2:Prescribing guidelines are not being followed; i.e., CPS, CMA, HPB, Drug Formulary, Therapeutics Initiative.
Solution 2:Recognition and acknowledgment of established guidelines by doctors, their regulatory bodies, the Health Protection Branch (HPB). Enforcement of guidelines through mandatory monitoring of doctors prescribing practices by the Colleges of Physicians and Surgeons. Disciplinary measures and mandatory education for doctors who do not follow guidelines. Use of independent, objective health watchdog organizations (i.e., Therapeutics Initiative). Maximum utilization of PharmaNet program and warning letters from the HPB to doctors.
Obstacle 3:Doctors' lack of ongoing education.
Solution 3:Compulsory educational upgrading of doctors (including testing) based on research findings replacing outdated drug treatments. Better education strategies from the College of Physicians and Surgeons, the CMA, and Pharmacare to encourage awareness and compliance, i.e. academic detailing.
Obstacle 4:Lack of legal accountability.
Solution 4:The development of government policy to assist those seeking restitution for medical malpractice associated with inappropriate prescribing; i.e., specific legal action fund with mandatory contributions by pharmaceutical companies and doctors - also utilizing fines levied against offending doctors. Legislation to ensure that health care practitioners are held accountable for improper prescribing.
Obstacle 5:Lack of objective information provided the consumer.
Solution 5:Mandatory product labeling and package inserts for prescription drugs with full disclosure of all potential side effects, dangers of long-term use, the intense withdrawal reactions associated and cognitive impairment with benzos; i.e., European system. Awareness building and educational initiatives; i.e., use of media, brochures. Government regulations on pharmaceutical advertising targeting doctors and consumers. Expansion of drug store role re: warnings with prescriptions; i.e., Shoppers Drug Mart model.
Obstacle 6:Incentive for pharmacists to follow up questionable prescriptions.
Solution 6:Incentive-oriented government initiatives which reward the implementation of flagging systems in pharmacies; i.e., B.C. Pharmacare program doubling pharmacists' dispensing fee for successful prescription intervention (after contacting the prescribing doctor).
Obstacle 7:High demand for the drugs due to doctor-induced chemical dependency; lack of alternatives for patients.
Solution 7:Provide health care coverage for psychologists (not just drug-oriented psychiatrists). Multifaceted educational process encouraging doctors to counsel re: whole health factors - lifestyle/diet/exercise; provide information, support and referrals to addiction specialists, detox facilities, naturopathic physicians, and community support and activity programs.
Obstacle 8:Lack of infrastructure, skill and knowledge surrounding safe withdrawal.
Solution 8:Education drives targeting doctors geared to better identification and recognition of benzodiazepine dependency, short- and long-term withdrawal syndrome, the dangers of sudden withdrawal. Need for well-trained doctors to provide medical supervision Explore UK model: doctors sending letters and information to patients at risk. Create accessible infrastructure for safe, supervised withdrawal; i.e., insured detox centres, (percentage of pharmaceutical sales/profits to be allocated to set up infrastructure); systemic acknowledgment.
Obstacle 9:Minimization and denial of the problem by government, drug companies, doctors.
Solution 9:Create awareness of socio-economic costs of drug dependent patients to the health care system, justice system, productivity and safety in the workplace, and road safety; i.e., car accidents. Encourage transition toward redirection of monies supporting current chemical dependency and its complications to strategies addressing and alleviating the problem.
Obstacle 10:Industry education is often led by those who will profit from excessive prescribing; i.e., drug manufacturers.
Solution 10:Provide and require issue of continually updated, objective prescribing guidelines from impartial regulatory bodies not profiting from the promotion of prescription drugs; i.e., CMA, Health Protection Branch, Therapeutics Initiative. Strict controls and independent approval of advertising, product literature. Expand BC's "academic detailing" program nationally.
Obstacle 11:Conflicting relationship between profit-motivated drug companies and research and development funding.
Solution 11:People before profit. Guidelines, conflict of interest regulations and code of ethics set for allocating drug manufacturers' contributions to research at Universities and for clinical trials to protect the public's health. Independent body directing research dollars. Well publicized and audited clinical trials fully accessible to the public.
Obstacle 12:Government's reliance on drug profits encourages drug-based health care - resulting in lack of insured alternatives not producing profit.
Solution 12:Acknowledge falsely economical "quick-fix" of drug treatments for normal emotional responses. Progressive systemic change encouraging human approach to wellness with long-term benefits. Provide insured alternatives: i.e., psychologists - allowing patients to avoid unnecessary, damaging drug therapies promoted by drug companies and doctors. Investigation of alternatives offered by naturopathic doctors and other holistic practitioners.
Obstacle 13:Lack of financial resources to rectify the problem.
Solution 13:Expose the waste of money linked to long-term benzo dependency; i.e., doctor's office visits, emergency services etc versus the short-term cost of assisting in recovery. Initiate the redirection of money by reducing consumption. Prevention equals savings.
Obstacle 14:Lack of coordinated, integrated effort by key stakeholders: doctors, pharmacists, pharmaceutical companies, academia, consumers. Lack of leadership and commitment.
Solution 14:Legislative, regulatory acknowledgment encouraging open communication between stakeholder groups focusing on prevention education and consumer protection. A central information/advocacy centre with an integrated approach to positive solutions Leadership and commitment.
October 27, 2000
Dr. Mark Berner in 1982 wrote a Canadian paper entitled "Benzodiazepines an Overview" stating "all benzos are equally effective in the short term treatment of anxiety but said "there is no evidence to support their long term use". He further stated that "not infrequently patients receive one benzo during the daytime and a second agent as a sleeping pill". He pointed out "this practice is irrational". He discussed " the abrogation of responsibility on the part of physicians and their prescribing of repeat prescriptions for years on end". The same Dr. Berner became chair of the CMA Guidelines Committee on Benzodiazepines in 1996 - some 14 years later.
The former Director of Health Program for the Canadian Medical Association in giving evidence to the Standing Committee on Health in March 1997 stated that "by law, when a physician prescribes for a patient, the physician is required to make sure the patient is fully informed about the risks and benefits of the therapy prescribed, and consents to that therapy with full informed knowledge".
The Pharmaceutical Manufacturers Association of Canada in April 1997 published a statement in the Globe and Mail newspaper acknowledging the problem stating "there is an urgent need to educate the medical profession" with - "some of the worst problems in inappropriate prescribing occurring with well established medications such as benzodiazepines - tranquillizers."
Effective September 1, 2000 Benzodiazepines were categorized as Class 1 Targeted Substances to the Controlled Drugs and Substances Act in Canada. Regulations call for the control of more than 30 benzos - decisions originally agreed upon at United Nations conventions in 1971 and 1988.
October 5, 2000 the problems of medication with benzodiazepines and their negative impact on Canadians was raised in the Senate of Canada by the Honourable Lucie Pépin who has referred the issue to the Senate Standing Committee currently undertaking a study of Canada's health system.
Joan Gadsby · October 27, 2000
Recommended Resolution to Canadian Government
October 27, 2000
See Revision: October 9, 2001
Whereas the benzodiazepine family of pharmaceuticals include powerful tranquillizers and sleeping pills which are meant to be carefully controlled by prescription:
Whereas the side effects of benzodiazepines include: potentially irreversible cognitive impairment (e.g. dementia, delirium, induced amnesia, memory loss, impaired concentration, judgment, and decision making); uncontrollable behaviour and paradoxical reactions (e.g. violence, paranoia, rage, disinhibition); psychomotor impairment (e.g. loss of ability to coordinate motor functions, dizziness, blurred vision, impaired spatial awareness); psychiatric symptoms (e.g. depression, psychosis, suicidal ideation and thoughts); and other symptoms (e.g. sensory, deprivation; emotional anaesthesia, unintentional overdoses, risk of congenital malformations in pregnancy and floppy baby syndrome:
Whereas benzodiazepines are highly addictive and withdrawal symptoms can be protracted for months and serious (e.g. panic attacks, paranoia, depersonalization, depression, agoraphobia, hallucinations, seizures and sometimes death):
Whereas benzodiazepines have become chronically overprescribed in Canada for the past 2 decades to an alarming 10% to 15% of the general population and up to 30% of seniors:
Whereas benzodiazepines are often not only (a) prescribed capriciously and inappropriately, but are also (b) prescribed long term for years despite their intended short term or intermittent use (e.g. 2-4 weeks is stipulated in guidelines dating back to the 1970's and 1980's and 7-10 days by Health Canada) and (c) without full disclosure to patients of their deleterious short and long term side effects:
Whereas the continued indiscriminate prescription and use of benzodiazepines cause not only irreparable damage to the lives of Canadians, but also well documented harm to the health of the nation, loss to the economy and costs to the health care system including health and safety in the work place, career devastation, family dysfunction, productivity losses, insurance claims, car accidents, falls, lost years of peoples lives, lost lives, costs to the legal and justice system, workers' compensation board claims, social welfare costs, emergency admissions, physicians' fees, pharmacists' fees, increasing drug costs and detox facilities:
Whereas neither Health Canada nor the medical profession nor the pharmaceutical industry at large have taken adequate steps to stem the misprescribing and use of benzodiazepines or to properly inform Canadians of the perils of these drugs:
Be it resolved that the BCWLC urge the federal government collectively and the Minister of Health specifically to call for a National Public Inquiry and series of nation wide hearings into the prescribing and use of benzodiazepines to assess the damage caused by these drugs; to develop a national strategic action plan to address their indiscriminate or inappropriate prescription; to create an awareness program to educate the public and medical profession about their side effects and dangers; and to establish accountability when they are prescribed without due care and contrary to established short term guidelines.
Note: To the above resolution can be added:
1. To obtain financial compensation for personal injury from benzo addiction.
To provide financial support for treatment programs and patient withdrawal groups.
To obtain funding for research into long term damage (particularly cognitive impairment) caused by benzos.
Joan Gadsby · October 27, 2000
"BEAT THE BENZOS" CONFERENCEBeat The Benzos Index Page
WHERE DO WE GO FROM HERE?
October 27, 2000
CLASS ACTION LAWSUITS.
USE OF POLITICAL SYSTEM.
IDENTIFY "CHAMPIONS" AMONGST BUREAUCRATS.
USE OF INTERNET AND WEBSITES.
FORMATION OF INTERNATIONAL BENZO AWARENESS NETWORK WITH LINKS TO OTHER BENZO GROUPS.
TAKE BENZO ISSUE TO THE WORLD HEALTH ORGANIZATION AND TO THE UNITED NATIONS.
SHARE KNOWLEDGE OF LEGAL SYSTEM - issues to overcome, i.e. what was known, when, lack of informed consent, standard of care (where 2 bodies of opinion exist such as Canada) errors in judgment, determination of negligence. Cataloguing of successful lawsuits where and how achieved throughout the world. Settlements out of court etc.
MULTI STAKEHOLDER FOCUSED STRATEGIC ACTION PLAN - private/public sector partnerships and non-profit organizations.
PRESENTATIONS, PUBLIC SPEAKING - Opportunities at conferences, to stakeholders, to governments.
STRONG LOBBYING OF MEDICAL GROUPS - Associations, Addiction Specialists, Disciplinary medical bodies, Colleges of Family Physicians etc.
FORMATION OF "EXPERTS" COMMITTEE GROUP on benzos from all related disciplines including survivors.
CONTACT WITH UNIVERSITIES, COLLEGES - Involved with medical education (new doctors and for continuing education).
RAISE FUNDS for ongoing activities - advocacy, treatment facilities, support groups, education and research.
Other books, television documentaries etc.
Joan Gadsby · October 27, 2000
WOMEN'S MENTAL HEALTH
PROBLEMS OF OVERMEDICATION
The Honourable Lucie Pépin
Thursday, October 5, 2000
Debates of Senate Document Cover (jpeg image)
Hon. Lucie Pépin: Honourable senators. I rise today to draw your attention to the problem of mental health, particularly that of women.
One of the areas of health in which the greatest differences between men and women are observed is that of mental health. This is not without repercussions on the quality of life of women and those around them. Levels of depression are higher among women than men, suggesting that women and men experience stress differently.
The rate of hospitalization for psychiatric treatment is higher among women than men. Women are more inclined than men to have low self-esteem and to experience problems such as anorexia and bulimia. Women are more likely to he overmedicated than men.
The case I am about to present is that of a woman who went through hell, but, who found - and is still finding - the courage to fight against the excessive prescription of drugs. This woman is Joan Gadsby, the author of Addiction by Prescription, a essay in which she relates her own story, of course, but one in which she offers a lucid analysis of the disastrous effects of overmedication. The drug with which Ms Gadsby had trouble was benzodiazepine, a tranquillizer and sedative.
While this drug may meet certain expectations in the short term, it has a number of undesirable side effects: learning problems, such as confusion; behavioural problems, such as aggressiveness; psychomotor problems affecting such things as eye-hand-foot coordination; psychiatric problems, such as depression or suicidal ideation: and finally, problems of addictiveness.
Honourable senators, drugs must be used with restraint. Naturally, for a variety of reasons, patients may depart from the recommended dose of a medication. However, such departures may also arise from a belief that the solution to problems lies in pills, and that the relict they provide is preferable to the symptoms a patient would experience without them.
I am not here to judge the Canadian medical profession, much less the pharmaceutical industry. Nevertheless, I want you to think about the problem behind overmedication. It is probably easier for society to individualize problems by applying individual solutions than to wonder about the source of these problems and propose global solutions. It is also probably easier for a doctor to prescribe medication than to consider longer-term alternatives. Of course, the medical profession constantly reviews its use of medication, so that doctors are more aware of the negative impact of overmedication. However, there are still cases - too many, unfortunately - where doctors prescribe too much medication, because they feel it is the best, the easiest or the quickest solution.
Honourable senators, I am asking you to join me in reflecting on the role of medication in our society. The Senate Standing Committee on Social Affairs, Science and Technology has undertaken a vast study on Canada's health System. I truly hope that, in the course of its proceedings, the committee will be receptive to the problem of overmedication and its negative impact on Canadians.
Tragedies such as the one experienced by Joan Gadsby must never he repeated. Thank you for your attention.
Sources: International research compiled over 9˝ years from various sources.
Joan E. Gadsby - Biographical Information
Born Kincardine Ontario, Canada; grew up in St. Catharines, Ontario
Bachelor of Arts, University of Western Ontario, London, in Psychology, English and Journalism
Moved to North Vancouver, British Columbia 1963 and resident since
Post Graduate Studies in MBA Program, University of British Columbia in Marketing and Industrial Relations
20 years of diversified senior level business experience in marketing, strategic planning, public affairs, government relations and issues management with 4 of Canada's largest companies. 8 years in senior management position with BC Provincial Government
President/Owner of Market Media International Corporation which provides with senior contract executive associates consulting services in strategic marketing and planning, business development, public affairs, government relations and issues management
Former elected poll topping Councillor, District of North Vancouver for 13 years
Consultant/Part time Faculty member "Leadership in Government" Program, Royal Roads University, Victoria, British Columbia
Author of book "Addiction By Prescription" - one woman's triumph and fight for change published by Key Porter Books, Toronto, Canada April 2000. Internationally endorsed by experts, chosen as non fiction choice for a Canadian writer and available internationally online at www.amazon.com and www.chapters.indigo.ca or through bookstores. Book was one of the biggest hits at the Frankfurt Germany Book Fair in October 2000 and will be available in other languages in the future. Also released in paperback spring 2001
Wellness and Health Promotion Consultant to corporations, governments, healthcare and other organizations and to individuals on the subject of prescription drug addiction
Co Executive Producer and Research Consultant of television documentary "Our Pill Epidemic" which has been broadcast nationally on CTV (available for international broadcast and in video.) Videos available in North America 1-800-471-5628 International formats email email@example.com
Project Leader/Consultant for development and implementation of national multi stakeholder strategic action plan and awareness campaign for benzodiazepines (currently in proposal stage seeking private/public sector funding)
Recognized international authority and public speaker on the responsible and informed use of benzodiazepines (tranquillizers and sleeping pills). Numerous guest appearances on national television, radio, other media and at trade, health and wellness shows
Co Executive Producer - International TV Documentary
Creative Developer and Executive Producer of film/movie of the week project based on my book "Addiction By Prescription"
Second Book - "Against the Wind" - the fight for and process of systemic change
Selected as one of Canada's notable women, Canadian University Women's Club - 1994
National and British Columbia Board Member, Women Entrepreneurs of Canada 1999 - 2001 and member of International Alliance of Professional and Executive Women
Member Vancouver Board of Trade
Vice President of International Benzodiazepine Awareness Network (BAN) committed to responsible and informed use of tranquillizers, sleeping pills and antidepressants
Many other professional/business affiliations and recognitions. Extensive volunteer and community work.
Personal Data - An active mother and a classic car and convertible enthusiast who enjoys daily running, fitness, sports, dancing, boating, nature photography, fashion designing, music, travel, and reading
November 19, 2001
Market-Media International Corp.
4507 Cedarcrest Ave., North Vancouver, BC, V7R 3R2, Canada
Phone: (604) 987-6064 Fax: (604) 987-6063
More articles, letters and information at
Joan E. Gadsby's Main Page
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