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Responsible Prescribing & Informed Use

Joan Gadsby
October 9, 2001


Whereas the benzodiazepine family of pharmaceuticals include powerful tranquillizers and sleeping pills such as lorazepam (Ativan), chlordiazepoxide (Librium), alprazolam (Xanax), clonazepam (Rivotril), clorazepate (Tranxene), diazepam (Valium), flurazepam (Dalmane), oxazepam (Serax), temazepam (Restoril), and nitrazepam (Mogadon), 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 leading to falls, car accidents); creation or exacerbation of 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 and addiction:

Whereas benzodiazepines are recognized to be highly addictive and withdrawal symptoms can be protracted for months and years 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 two decades to an alarming 10% to 15% of the general population and up to 30% of seniors with an estimated 60% receiving concurrent prescriptions of anti depressants:

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 1970s and 1980s (Reference Health Canada publication: "The Effects of Tranquillization*: Benzodiazepine Use in Canada" 1982 which went to all Canadian doctors) 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 irresponsible prescription and uninformed use of benzodiazepines cause not only irreparable damage to the lives of hundreds of thousands of Canadians, (15.8 million prescriptions in 2000, a 12.8% increase over 1999 - IMS data) but also well documented harm to the health of the nation, loss to the economy and increasing 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 people's lives, lost lives, costs to the legal and justice system, workers' compensation board claims, social welfare costs, hospital costs including emergency admissions, physicians' fees, pharmacists' fees, increasing drug costs and detox facilities:

Whereas neither Health Canada (whose mandate is the health and safety of Canadians) nor the medical profession nor the pharmaceutical industry at large have taken adequate steps to stem the continued misprescribing and use of benzodiazepines or to properly inform Canadians of the perils of these drugs:

Be it resolved that the Canadian Government and the Minister of Health specifically:

  1. Hold a National Public Inquiry and a series of nationwide hearings into the prescribing and use of benzodiazepines to assess the damage caused by these drugs;

  2. Develop a national multi stakeholder strategic action plan to address this serious health issue;

  3. Create an awareness program to educate the public and medical profession about their side effects and dangers; and

  4. Establish accountability when they are prescribed without due care and contrary to established short term guidelines.

Be it further resolved that the Canadian Government and the Department of Health in particular investigate:

  1. The provision of financial compensation for the extensive costs of personal injury to affected Canadians caused by benzo addiction.

  2. Provide financial support for treatment programs and the development and dissemination of patient withdrawal protocols for doctors/patients.

  3. Provide independent funding for research into long term damage (particularly cognitive impairment and floppy baby syndrome - similar to fetal alcohol syndrome) caused by benzodiazepines.

  4. Investigate financial contribution from the medical community, its organizations/regulators, and from the Research Based Pharmaceutical Companies and Generic Drug Companies who have marketed and distributed benzodiazepines and who continue to do so, to address this significant health issue.

Joan Gadsby · Revised October 9, 2001

* Note: "The Effects of Tranquillization: Benzodiazepine Use in Canada". Health Canada Publication: 1982. This booklet is in jpeg (image) format and may take quite a while to download.

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