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It's time to look the facts in the face

Gurli Bagnall, Patients' Rights Campaigner
22 April 2001

Reply to an article by Gavin Yamey in the BMJ
(British Medical Journal), March 24, 2001.
Read the article and more replies here.

Re: It's time to look the facts in the face

It is surprising how a group of drugs which has destroyed so many lives, is rarely mentioned in the medical journals. I refer, of course, to the benzodiazepines. As a patients' rights campaigner and a victim of these drugs, I learnt the facts the hard way.

Up till very recently, whenever an article about the dangers of BZDs appeared in the printed media or as a documentary on TV, there was no shortage of doctors to deny that addiction and other adverse affects occurred. Such allegations had not been proved, they said, but by the same reasoning, they had not been disproved either, so why were they being prescribed at all?

Proof of the danger or safety of any drug is not a matter for test tubes and Bunsen burners. Where BZDs are concerned, the proof was and is all around us in the form of an army of people who suffer the ill effects associated with them.

All that was required of those who declared the innocence of the drugs, was to observe the changes in their patients' personalities, listen to what they had to say, and equally important, how they said it. Did they speak in a flat, dull monotone? Was their speech hesitant and did they experience difficulty in finding the words they needed? Was there a blankness to their eyes and were they unable to maintain eye contact? That clear signs such as these were, and still are, routinely ignored, spells negligence. Outside of the medical profession, inflicting brain damage upon others is a criminal offence.

Gavin Yamey is the author of the article to which I am responding. Unfortunately, he did not specify his area of expertise. Nevertheless, what he describes as a "lively" history of the rise and fall of Valium, others would describe as scandalous. I take issue too, with his comment that "...the much hyped concerns about benzodiazepines are not, it would seem, always justified".

Where, in Yamey's opinion, should the line be drawn? The evidence suggests that considerably more than 50% of users suffer ill effects to these drugs, but for the sake of argument, let's assume that half are affected. How can widespread use of BZDs be justified under these circumstances? Pressure is placed upon the health system, social services and to some extent, the police. It is the tax payer who bears the financial burden, while the victim struggles as best he or she can to survive with a devastating illness on insufficient funds.

There was a time when the drug companies denied that BZDs are addictive. When that was no longer credible, they maintained that less than 10% became addicted if excessive doses were taken, but even then, only if the patients had "addictive personalities". I believe it was Beatrice Faust who said in her book "Benzo Junkie", that there is no such thing as an addictive personality – only addictive drugs. Yamey's reference to hip fractures in the elderly has already been dealt with by others, so I move on to his quoted list of BZD usefulness – epilepsy, movement disorders and temporomandibular joint dysfunction. Taking the last two first, I confess to being somewhat surprised. My drug manual does not list these conditions under BZDs. It is, however, fortuitous that the author mentioned them, for they are common withdrawal symptoms.

BZDs are well known for their potential to cause the very conditions for which they are recommended. I have personal knowledge of one epileptic whose seizures became increasingly frequent and of longer duration while taking a BZD which had been prescribed to control them. To add to her problems, she was plagued with symptoms associated with tolerance, and now, several years after stopping the drug, she is still suffering the effects of the post withdrawal syndrome.

Whether or not the original condition was one for which BZDs are recommended, for the 50%+ who suffer adverse reactions, that condition typically pales to insignificance after the anxiety, the insomnia, the sensitivity to light and noise, the out of kilter co-ordination, the inability to function mentally, the constipation, the jaw pain etc. set in.

It is of concern that the lessons of history have not been leant. Alcohol, opium, cocaine and heroin have all, at one time, been popular with the medical profession. Freud is recorded as having made a comment to the effect that it was not the noxious drugs that caused inebriation and anti-social behaviour. That, he said, was caused by some peculiarity within the patient. The same blame-the-patient arguments are still used today and it is this attitude that has seen withdrawal symptoms misdiagnosed, resulting, not infrequently, in patients being admitted to psychiatric facilities where shock treatment was administered to some. This is not a fairy story. It is a horror story.

We now know that people are adversely affected at therapeutic levels and sometimes in less than two weeks. We know that some birth defects are associated with BZDs, and that newborn babies suffer the agonies of the withdrawal syndrome. We know that some people take years to recover from the post withdrawal syndrome while others never recover at all. Some in the latter category, have been diagnosed with ME/CFS, the symptoms of which, are identical to the post withdrawal syndrome.

Given the treatment of patients at the hands of their physicians, it was inevitable that the media would become involved, but still the complaints were denied or ignored. For every article written by a concerned health professional, several followed to deny his or her "allegations". The question that begs an answer is: why?

During the past year, the BMJ and others have, at some time, featured medical error and the alarming figures relating to it. The BZD experience has contributed hugely to the call for medical accountability and the resultant proposed periodic revalidation of practitioner competence.

Gurli Bagnall
New Zealand
April 22, 2001

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