The Effects of Tranquillization:
Benzodiazepine Use in Canada
Health Canada Publication: 1982
TABLE OF CONTENTS
UNDESIRABLE PHYSIOLOGICAL AND PSYCHOSOCIAL CONSEQUENCES OF USE
APPENDIX A: BENZODIAZEPINES SOLD IN CANADA, 1981
APPENDIX B: GLOSSARY OF MEDICAL AND DRUG-RELATED TERMS
General Canadian Data
High Risk Groups:
The Elderly
The Chronically Ill
The Institutionalized
Use as Anti-Anxiety Agents and Hypnotics
Use in Non-Psychiatric Conditions
Psychiatric Contraindications
Duration of Use and Dosage
Appropriateness in Pregnancy, Pediatric Medicine, the Elderly
Physical Effects:
Motor and Cognitive Impairment
Polydrug Use and Cross-Addiction
Overdose and Poisoning
Biomedical Model of Illness
Physician-Patient Relationships
Organization of Medical Care
Drug Promotion and Advertising
ACKNOWLEDGMENTS
The authors wish to thank Professor E. Vayda, Associate Dean, Division of Community Health, Faculty of Medicine, University of Toronto, who contributed extensively to an earlier version of this document and has provided a continuing supply of information and support. Dr. Usanda Busto, Research Fellow, Clinical Pharmacology Program, Addiction Research Foundation, gave freely of her time and expertise. Dr. H.L. Lennard was an active participant in preliminary discussions which resulted in this paper. Particular thanks go to Jennifer Evans for her editorial and typing skills and her intelligent role as 'every-woman'. We also wish to thank our seven reviewers for their thorough and constructive comments.
1. INTRODUCTION
During the past two decades, there has been a proliferation of psychotropic* chemical agents developed by the pharmaceutical industry, prescribed by physicians and used by consumers. Among the most widely used psychotropic drugs are the benzodiazepines. One of the most popular drugs in this class in Canada for many years has been diazepam (most common trade name, Valium). This is only one of 10 benzodiazepines marketed in Canada and while they are advertised for a variety of purposes they all share common sedating properties.
Concern with benzodiazepine use in Canada has been expressed by consumers of health services, professionals and government agencies. The purpose of this document is to bring together information on these drugs, including extent of use, appropriate indications, contraindications, and some of the problems associated with their use. These include dependence, polydrug use, overdose, and the risk to some segments of the population who receive large quantities of these drugs.
In addition, factors impinging on drug use such as the structure of the health care system, its philosophical view of illness, and physician-patient relationships are discussed. Finally, some of the social consequences and meanings of extensive benzodiazepine use are explored.
Health and Welfare Canada has chosen to publish this document as an indication of their concern with the issues posed, and in order to provide an informed basis for further discussion by those responsible for the provision of health services to the Canadian population.
*For a glossary of the medical and drug-related terms used in this document the reader is referred to Appendix B.
TITLE PAGE · TABLE OF CONTENTS
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