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The Tranquilliser Trap
Panorama, BBC1, Sunday 13 May, 2001

Transcript of the Transmission

SHELLEY JOFRE: Over a million Britons rely on tranquillisers like diazepam and temazepam to calm them down and help them sleep. But long-term, the side effects and withdrawal symptoms can be horrendous.

SUSAN HYATT: It can feel a bit fearful, you know, what am I going to do without the drugs?

JOFRE: Doctors have known the risks for years, yet still they prescribe benzodiazepine tranquillisers.

ESTHER RANTZEN: How can a serious problem like this, which was revealed to millions of people and the professionals 20 years ago, how can it still be going on?

JOFRE: An exclusive Panorama poll reveals the alarming scale of the problem.

PROFESSOR LOUIS APPLEBY: It is difficult to defend that we have such a huge problem of benzodiazepine prescription and long-term use and therefore dependence.

JOFRE: We investigate how so many are caught up in the Tranquilliser Trap.

The outskirts of Newcastle. From the outside, one warehouse looks much like all the others on this industrial estate. But hidden inside one is evidence of an addiction problem much more widespread – and receiving much less attention – than heroin addiction. Millions of old prescriptions, carefully filed and stacked from floor to ceiling. They're stored here so the government can keep an eye on how much the NHS is spending on drugs.

SHELLEY JOFRE: But if anyone cared to look a little closer at all the information that's stored here, they'd find an almost unbelievable story. We've discovered that doctors are routinely prescribing drugs they know can cause addiction and all sorts of serious side effects. GPs were told years ago that they shouldn't fill out one of these little green slips for more than a four week supply of benzodiazepine tranquillisers. But research for Panorama suggests over one and a half million people have been prescribed the drugs for much longer than that, and many of them across the country have become addicted, like 21-year old Suzanne Tovey from Oldham. It's 8.30 and she's busy getting her kids ready for the day ahead. This is still something of a novelty for her. It's only in the past year she's been able to dress herself in the morning, never mind her kids, Sam and Chloe. As a teenager, Suzanne became addicted to two benzodiazepines – the sleeping tablet nitrazepam and the tranquilliser diazepam.

SUZANNE TOVEY (Prescribed Nitrazepam and Diazepam): I didn't used to get up in the morning. I used to wake up about half past one in the afternoon. My mum used to come for say half an hour with Chloe and I had absolutely no interest. I know that sounds really bad by I had absolutely no interest in any of them, and I just used to sit in my dressing gown all day long, and I had no feelings for anybody or anything, just absolutely no feelings whatsoever.

JOFRE: Throughout her 4-year addiction it was mum, Pauline, who had to pick up the pieces and look after Suzanne's children. Things got worse when Suzanne tried to come off the drugs. The withdrawal symptoms were similar to those you might expect from illegal drugs.

SUZANNE: You're shaking and you're getting headaches and you're panicking, you're really, really panicking, but the worst thing about it is the shaking and it's horrible.

PAULINE WHITTAM (Mother of Suzanne Tovey): She would know what time the next one was due and she would ask me before it was due could she have it early, and I had to refuse, I had to be the big baddie.

SUZANNE: As soon as you take the tablet you're alright again after that. You know... but it's the worst feeling that you could imagine.

PAULINE: She would be aggressive quite often and suicidal. She would have rages. She would be very abusive to me, verbally abusive, which wasn't Suzanne at all. That is not Suzanne. That is not her character.

JOFRE: Two hundred miles away in Watford, another woman is still fighting her addiction. Susan Hyatt was prescribed the tranquilliser lorazepam for anxiety three years ago. Over the last 12 months, she's been slowly coming off the drug. But every time she cuts back, her symptoms are worse than the original anxiety.

SUSAN HYATT (Prescribed Lorazepam): I have physical symptoms which are the palpitations, hot and cold sweats, shaking, trembling, to the psychological symptoms which is I think I'm going to lose it, I think I'm going crazy, I'm going mad – terrible pressure in my head. So they come back 10-fold. They're a lot worse. It's very painful and very difficult but you've got to force yourself through the threshold. Sometimes you can feel a bit fearful... you know 'what am I going to do without the drugs?'

[That's Life, Archive, 1984]

JOFRE: Remember this curious hybrid of talking animals and campaigning journalism? Well if you were one of the 15 million people who used to watch That's Life, these tales of tranquilliser addiction may sound strangely familiar. Back in 1984, the programme was flooded with letters from viewers who'd been prescribed benzodiazepines by their doctors.

That's Life archive: When I tried to cut down my pills I felt as if the floor was moving, walls seemed to give beneath my touch, I had a feeling that my skull was being crushed, I couldn't cope without taking tranquillisers.

ESTHER RANTZEN: We were absolutely astonished after we mentioned that problem in one programme that we were deluged with response from our audience, and we suddenly thought this is happening to thousands of people, and this was with harmless prescribed drugs, things that had become household names, Valium, Mogadon.

JOFRE: Today the drugs go by chemical names like lorazepam and diazepam. But like Valium and Mogadon, they're benzodiazepines and they can all cause the same problems. Prescribed properly, for short periods, they calm you down or help you sleep. But after just a few months use, they can cause dependence and side effects. For years doctors have known this, but they still prescribe them. At the last count, in 1999, GPs wrote seventeen and a half million prescriptions for benzodiazepines, these are just a few of them. It's hard to believe that after all doctors have been told about the dangers of these drugs that the total number of prescriptions has hardly fallen over the past few years. In fact, since 1995 prescriptions of benzodiazepines for anxiety have actually been on the increase. To understand the medical profession's unshakeable faith in these drugs you need to turn the clock back 40 years. It all began here in Switzerland at the headquarters of pharmaceutical giant Hoffman La Roche.

[The Money Programme, Archive 1974]

This is where they make the active chemical of Valium and Librium, the great tranquillisers of our time. In this small plant they make all the benzodiazepines which, as well as Librium and Valium, include the sleeping pills Mogadon and Rohypnol and the tranquilliser Nobrium.

JOFRE: When these drugs were launched on the market, they were promoted as safer and more effective than the older barbiturate tranquillisers.

[Money Programme Continued]

Thanks to Librium and Valium the company's turnover is now between five hundred and a thousand million pounds a year, nobody knows because Roche won't tell. But Hoffman La Roche has certainly become the biggest pharmaceutical company in the world.

PROFESSOR GRAHAM DUKES (Medical Adviser, World Health Organisation): Once one company had developed a few of these drugs and had taken out patents and had shown that they could develop a tremendous market, other companies tried to get into the act. They all began to produce their own versions of the benzodiazepines.

JOFRE: The drug companies knew they'd created a money-spinner and embarked on a hard-sell to GPs. Their adverts in medical journals offered a cure for everything from sleeplessness to guilt, ideal for propping up an increasingly stressed-out nation.

DUKES: The entire impression was given to doctors deliberately that a real revolution had occurred and it was time to change their prescribing habits and use these drugs for the benefit, as you might say, of mankind.

JOFRE: But that benefit was short-lived. In Newcastle, in the early eighties, Professor Heather Ashton was one of the first to encounter problems with tranquillisers at her drugs clinic. She helped set up classes like this one. Patients were slowly weaned off the drugs and instead taught relaxation techniques to help them cope with anxiety.

Brass Tacks, Archive, 1987

PROFESSOR HEATHER ASHTON (University of Newcastle): There was a trickle and finally a river and eventually a flood of patients with similar complaints who'd been prescribed tranquillisers or sleeping pills for all sorts of different conditions like not being able to sleep because you had a hyperactive baby, and they all said they did not feel well while they were on their drugs and could I help them get off. So it was really patient led, and very soon there were so many that I had to set up a separate clinic which started one day week and then ended up as two day a week.

JOFRE: Meanwhile, Esther Rantzen and her team commissioned a survey to find out the true extent of the addiction problem. More than two thousand people filled in their questionnaire and the results were a revelation.

THAT'S LIFE: 81% by now had side effects, tiredness, panic attacks, confusion and so on, and half of our survey told us these side effects were even worse than the original problem that had sent them to the doctor in the first place.

RANTZEN: And they were problems like intense depression, panic attacks, agoraphobia, dizzy spells, things that actually stopped them going out and leading a normal life. So this wasn't just 'it makes me feel slightly nauseous', this was... 'these symptoms are wrecking my life, making me feel as if I'm going out of my mind, making my family think that I'm going out of my mind.' And yet none of it was traced back – until we suggested it – none of it was traced back to the long-term taking of medication which should never have been prescribed for months and years.

JOFRE: During the 1970s and 80s, Iain Caldwell never traced back his problems to benzodiazepines. He was a successful businessman and perfectly healthy when first prescribed the sleeping tablet Mogadon. All he wanted was an extra half hour's sleep in the morning. But like the thousands who wrote into That's Life, over time Iain became anxious, depressed and withdrawn. He never imagined it was Mogadon that was causing until he started doing his own research.

IAIN CALDWELL (Prescribed Mogadon): The whole situation was a complete mystery. There seemed to be no proper explanation for anything and I was determined to set out and to discover what had been known about the drugs, how the drugs operated, what the drug company knew.

JOFRE: In 1993, at his own expense, Iain embarked on a David and Goliath battle with Roche, the company that used to make Mogadon. His quest soon became a full-time job. He decided to examine in detail Roche's own research on the drug. To do that, though, he needed access to scientific papers and journals. Not easy from the rural hills of Blairgowrie. But, from the busy streets of west London, help soon came from another former tranquilliser addict. Michael Behan says his life, too, was ruined by benzodiazepines. He and Iain first met at a conference four years ago, where Iain explained he was suing Roche for negligence.

MICHAEL BEHAN (Prescribed Ativan): Iain was looking for medical papers that he had to produce by a certain day for his legal action so he was very keen to find them. So I offered to try and find them in the London libraries.

JOFRE: A chance encounter soon developed into a long-distance partnership. For the last 4 years, Michael's been a regular visitor to all of London's scientific and medical libraries. He's also hoping to sue the makers of the drug he was prescribed. Between them, this unlikely alliance have made some remarkable discoveries. They found that Roche put warnings about dependence and side effects on their Scandinavian data sheets years before these were ever mentioned on the British versions. Companies produce these sheets every year to keep doctors up to date on side effects and dosage.

Were you surprised to learn that they could be saying one thing in one country and another in another part of the world?

CALDWELL: Absolutely astonished. Absolutely astonished because human beings are human beings and the drug will have the same effect regardless of which country you live in.

JOFRE: Can you see any good reason why those warnings shouldn't have been made clearly in the United Kingdom data sheets?

PROFESSOR GRAHAM DUKES (Medical Adviser, World Health Organisation): No, the companies knew perfectly well what was required of them in other countries where there was a regulatory mechanism where there were laws and regulations to be adhered to, and should have kept those same standards in Britain.

JOFRE: But Iain and Michael uncovered an even more staggering revelation about Mogadon and its side effects.

BEHAN: While I was looking through one of the journals I noticed a Mogadon article which came from Roche's headquarters in Switzerland. That night I phoned Iain and told him about it, and in the article they indicated that they've made a mistake.

CALDWELL: I'd just got a very powerful inkling that this was what we were looking for, this was the key document. Here is a clear explanation as to why people have problems with what they thought was a simple sleeping tablet.

JOFRE: To avoid drowsiness the next day, a sleeping tablet should have a short half-life. But the Roche document, written in 1973, revealed Mogadon had a much longer half-life than originally thought.

DUKES: What they've found with their later research was that this drug was going to remain at half life levels, as we call them, in the body for something like 25 hours, perhaps more, and a drug that's there active in the body for 25 hours is not suitable as a sleeping remedy.

JOFRE: So after 1973 should they have marketed it as a sleeping tablet?

DUKES: No, I believe they were quite capable of producing drugs with a shorter half life than this which would have been more appropriate for that purpose.

JOFRE: Mogadon wouldn't just put patients to sleep, it could sedate them during the day too. This information was in Danish data sheets in the 70s but not in British ones until 1984.

JOFRE: That suggests that Roche sat on the results of its own research for at least 10 years.

DUKES: It certainly suggests that. Yes. Yes.

JOFRE: Is that a responsible way for a drug company to behave?

DUKES: No, a drug company should constantly adapt its information to doctors and to patients to what it knows about the drug.

JOFRE: You were prescribed Mogadon two years after this research was carried out. How do you feel about that?

CALDWELL: Well I'm not very happy about it at all. This was the period when I was prescribed the drug and I'm quite certain that if the doctor had known the true implications of Roche's discovery she would not have prescribed it.

JOFRE: We invited Roche to answer these claims but they refused, citing the impending court case. A spokesman did, however, tell Panorama that the company rejects Iain Caldwell's allegations. Iain's case is that Mogadon cost him his livelihood as well as his health. He was a millionaire with a luxurious lifestyle when he first started taking it. But after nine years on the drug, depressed and exhausted, he'd lost everything he'd worked for. He's suing Roche for nearly 2 million pounds. Although the company won't speak to us, they have answered some of Iain's allegations in a legal document. In it, they claim Mogadon doesn't cause physical or psychological dependence. They say Iain must have been mentally ill.

CALDWELL: This is the first excuse that Roche always use. Anybody who takes the drugs and complains about them has some sort of underlying problem. All I can say is that I had no problems prior to taking the drug and I've had absolutely no problems since. They coincide with the ingestion of the drug and if they can't blame it on the patient, they blame it on the doctor. Everybody is to blame apart from Roche.

JOFRE: Roche still claims that Mogadon doesn't cause dependence. Is that true?

DUKES: It's not true and I think Roche is, at the present day, fairly isolated in that view. Years ago a wide discussion between experts concluded that these drugs all cause dependence.

JOFRE: But old habits die hard. Doctors should have known by the mid '80s that prescribing benzodiazepines like Mogadon for even a few months can cause dependence. Yet as That's Life's survey showed, GPs just carried on writing those prescriptions.

[That's Life Archive]

Esther Rantzen: When our people went back to their doctor after a month, 9 out of 10 of them were given a repeat prescription, and then another repeat prescription and still it didn't really help.

JOFRE: What did that tell you about the way doctors were dealing with patients ?

ESTHER RANTZEN: Doctors then, as now, were very pushed for time. It was quicker, and perhaps easier, just to repeat the prescription rather than have somebody back in the surgery describing this list of worrying symptoms for which there seemed to be no obvious cure. So I suppose those repeat prescriptions were what the patients felt they depended upon and the doctors didn't query.

JOFRE: In 1988 the Government's Committee on the Safety of Medicines finally tried to make doctors change their ways. Prescribing guidelines were sent to every GP in the country. They couldn't have been clearer:

  • Benzodiazepines should not be prescribed for longer than four weeks

  • They should be given in the lowest possible dose

  • They shouldn't be used to treat depression

The Committee pointed out that, in the treatment of anxiety, there was little evidence that the drugs actually worked after 4 months continuous use.

JOFRE: When the guidelines were issued, one of the government's main concerns was the number of patients on repeat prescriptions. Yet today, thirteen years on, the Department of Health has no idea how many of these are repeat prescriptions, nor can they tell us how many patients have been on the drugs for more than the recommended four weeks. They've got all the information stored here, they just haven't worked it out.

JOFRE: Do you know exactly how many people have been prescribed for longer than the recommended four weeks?

PROFESSOR LOUIS APPLEBY (National Director for Mental Health, Department of Health): We don't have exact figures on that. It's estimated that there are about between 1 million and 1 million people nationally taking these drugs, but we don't really know exactly how many people have been on them long-term.

JOFRE: Why not?

APPLEBY: Well it's to do with the way that national data are collected and I'm not going to defend that. I just think that what's been collected has been the number of prescriptions, and so the number of prescriptions tells its own story. It's several million prescriptions every year, but it doesn't tell us what we particularly need to know which is how many people take those drugs long-term and what measures are then taken to get them off.

JOFRE: Since the government don't know how many people are on these drugs long-term, we commissioned our own poll to find out. We asked almost two thousand people whether they'd been taking benzodiazepines on prescription for longer than 4 months. Over 3 percent said yes. That's over one and a half million people, if the same pattern is repeated across the adult population.

JOFRE: Because we couldn't get any figures from the Department of Health we carried out our own survey which shows that over 3% of the population have been on benzodiazepines for longer than four months. That shouldn't be happening should it?

APPLEBY: No, no it shouldn't. There's no way of defending that except to say that in order to get people off benzodiazepines you need to have a fairly comprehensive approach to the problem with the provision of alternative treatments so there's no temptation in the first place for people to go on them for anxiety, with treatments for withdrawal, with proper monitoring which I think we haven't had in detail previously. We need to do more than simply tell doctors what to do.

JOFRE: Undoubtedly. According to our survey, the warnings have been falling on deaf ears. We asked those taking benzodiazepines how long they'd been on them, and remember the guidelines say it should be no more than 4 weeks. 28 percent said they'd been on them for more than ten years, and it's clear the guidelines continue to be ignored by many doctors. 72 percent of people said they were prescribed the drugs within the last ten years. Over half were prescribed within the last five years.

The guidelines that were introduced in 1988 were very clear. They said benzodiazepines shouldn't be prescribed for more than four weeks at a time. Which part do you think doctors didn't understand?

APPLEBY: I think the guidelines are completely clear. I don't think there's any problem in understanding them. I think what the problem has been that changing individual prescribing practice requires more than guidelines. It's also necessary for doctors to have a clear idea of what alternative treatments there are, meaning different drug treatments but also in particular meaning psychological therapies for anxiety.

JOFRE: Isn't that their job to know what sort of treatments are available?

APPLEBY Yes, yes it is, but prescribing practice changes slowly and I suppose that's one of the lessons of this whole disaster.

It's a disaster alright, and Suzanne Tovey is just one of a new generation who've suffered as a result. As a teenager, Suzanne took diazepam without a prescription and became addicted. With help from her GP, though, she was slowly coming off it. But when she had a baby three years ago, she moved house and switched doctors.

SUZANNE TOVEY (Prescribed Nitrazepam and Diazepam): I went to the doctor and I said, look, you know... I think I've got postnatal depression. I didn't have postnatal depression, it was withdrawal from the tablets. But because I didn't know that, I just put it down to being postnatal depression and then he gave me nitrazepam and said there you go, them'll be alright, them'll sort your postnatal depression out for you."

JOFRE: Not only did he give her nitrazepam, he also continued her prescription for diazepam – the drug she'd been trying to come off. So she was on two benzodiazepines – a potent combination.

SUZANNE: The scariest thing is when you feel that you're going mad. I used to think I should be in a mental home, I honestly did and I was really scared, and I was thinking God, why am I like this?

PAULINE WHITTAM (Mother of Suzanne Tovey): I knew it was the drugs that was causing it, and I actually phoned the doctor up and asked him to stop prescribing them. As soon as I found out that he prescribed Nitrazepam I rang him up and said please don't give my daughter any more of these. She's just come off them. We don't want to get back on them.

JOFRE: What was his response?

PAULINE: He didn't take any notice whatsoever. He did not take any notice. So I went into the surgery and I pleaded with him not to give her anymore.

JOFRE: But for nearly a year he issued repeat prescriptions for nitrazepam and diazepam.

JOFRE: Would it be acceptable to prescribe more than one benzodiazepine at a time in your opinion?

DR JIM KENNEDY (Royal College of General Practitioners): Good practice would say that if you have to prescribe, prescribe for short periods, prescribe a short-acting benzodiazepine and try to keep to just one benzodiazepine rather than a mixture.

JOFRE: So it's not good practice to do that?

KENNEDY: That's certainly not recommended practice.

JOFRE: What happened when you tried to raise the subject with your doctor that these pills might actually be harming you?

SUZANNE: Oh he just went mad. He just... he was pointing his finger at me and sort of like holding me and pointing his finger at me and telling me that he knew and I didn't know anything about anything and he just got really, really angry. And I took a book in with me to say that I'd read it here and everything and he said "Put your stupid book away" and everything.

JOFRE: Rewind 17 years.

[That's Life Archive]

So if we look at the people who have tried to give them up, it has not been thanks to medical advice. Only a quarter of them have been advised to try and cut down by their doctor.

JOFRE: People might be forgiven for thinking this is a problem that ought to have been sorted out. The guidelines were introduced 13 years ago. Why is it still a continuing problem?

DR JIM KENNEDY (Royal College of General Practitioners): 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.

JOFRE: It's certainly a long struggle for addicts like Susan Hyatt who are trying to come off the tranquillisers. Today, she's picking up her last ever prescription for lorazepam. She's been gradually cutting down her dosage over the past 12 months. The drug was first prescribed to her in 1998 by a psychiatrist, when she'd suffered a series of panic attacks. Yet, unbelievably, just a year earlier psychiatrists were reminded by their own professional body about the risks of prescribing benzodiazepines for more than 4 weeks.

What did your psychiatrist tell you about lorazepam at the time he prescribed it?

SUSAN HYATT (Prescribed Lorazepam): Nothing. I was given no information whatsoever.

JOFRE: No information that it might cause dependency?


JOFRE: No information that it might have some adverse side-effects?


JOFRE: Hang on. Isn't that the same story we heard back in the eighties?

THAT'S LIFE, 1984: Half of the people were not even told the pills were tranquillisers. Nine out of ten people say they were given little or no information about them, weren't told they only worked for a short time or warned about the side effects.

JOFRE: Almost two decades on Susan is weaning herself off the tablets, cutting them down into manageable doses.

HYATT: The tablets are one milligram, they're quite small, but they're scored, they've got a mark on them. So I just chop half way, and then chop again so I end up with four quarters, and then with one quarter I chop again, that gives me the eighth. Previously when I've been reducing, because I was stabilising on two milligrams and then reducing, I was able to reduce one eighth a week. I'm now down to five eighths and it's taking me longer. I'm actually struggling. I'm struggling on this level.

JOFRE: Is the government making enough of a priority out of this because things do not seem to be changing very quickly at all?

DR JIM KENNEDY (Royal College of General Practitioners): I think it should be a significant priority for this country. It's potentially a million people who are on drugs which only maybe is 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.

PROFESSOR LOUIS APPLEBY (National Director for Mental Health, Department of Health): It's obvious that the cost will be enormous of inappropriate prescribing. These drugs are not particularly expensive but if we have a million or a million and a half of people taking them regularly, then of course we're bound to be spending millions of pounds on drug treatments that aren't needed.

JOFRE: Can that be justified?

APPLEBY: No, it can't.

JOFRE: Yet cutting the cost can be fairly straightforward, as the local Health Trust in Newcastle has just found. In a study still to be published, they asked some local GPs to write to long-term users to see if it would prompt them to come off tranquillisers. Cheap and very simple – but it had a dramatic effect – more than forty percent of patients responded by reducing their dosage or stopping the pills altogether.

JOFRE: What's the longest you've gone without one?

MRS HAILEY: I would say about a week, yes.

JOFRE: Remember those guidelines that said not to prescribe for longer than 4 weeks? Well Mrs Hailey was first prescribed temazepam 30 years ago and she's been on it ever since.

JOFRE: What was your reaction when you got the letter from the surgery suggesting that you ought to cut back on the Temazepam?

WILHELMINA HAILEY (prescribed Temazepam): Well my reaction was well I'm too old now to bother about... you know... cutting down or anything. I mean there's... you've only got a short span of life and I've lived it.

JOFRE: Spurred on by the letter, though, Mrs Hailey did cut back her dose. Across the region, the study found that this sort of response could save the Health Authority up to seven million pounds a year. But Mrs Hailey, like many patients, is reluctant to cut out the tablets altogether.

JOFRE: You have managed to cut down from 20 milligrams to 5 milligrams a night. Are you planning to try and reduce any more?

MRS HAILEY: Well I'll leave it at the 5 just now and see what happens and then I might manage to break off altogether. But as I say – why at my time of life?

JOFRE: Are you apprehensive about stopping altogether?

MRS HAILEY: I am a bit worried about stopping altogether, yes. As long as I've got something to fall back on.

JOFRE: Do you think many of the older patients you see, who have been taking sleeping tablets for example for 20 years, would regard themselves as being dependent on those drugs?

DR LIZ HARRISON (Village Green GP Practice): I don't think they regard themselves as being dependent at all and would certainly not label themselves as drug addicts, and I think we need to take a very different approach to try to help people to stop this type of medication.

JOFRE: But across the country, counselling and support services are stretched to the limit.

PAM ARMSTRONG: [A help line call]: There a bit of disappointment in the fact that you don't feel any better. I know every day it's not going to be better but you'll find that some days and you'll be thinking gosh yes, I've had some good days.

JOFRE: A cramped 2nd floor office in a rundown building near Liverpool docks is the headquarters of Britain's only national support group for tranquilliser addicts. Every day a handful of volunteers field dozens of calls from anxious, sometimes suicidal, people.

PAM ARMSTRONG (Council for Involuntary Tranquilliser Addiction): It's such an underestimated problem. I mean this lady has just said to me "How could my doctor have done this to me?" He only put her on tablets three years ago. How come he didn't know what he was getting her into?

JOFRE: With no government funding, they can only afford to operate their help line for a few hours each day.

ARMSTRONG: We could work all the hours we could stay open. The phone rings non-stop. There's no doubt there's a demand. But I don't know really, there just doesn't seem to be the recognition by the government that would fund us.

JOFRE: To try and get all of these people off of drugs now will require a lot of help and support and yet we've found that a lot of the withdrawal clinics and support services that existed at the end of the 80s and early 90s have now shut down.

PROFESSOR LOUIS APPLEBY (National Director for Mental Health, Department of Health): Well the treatment of benzodiazepine withdrawal in some ways is not all that complicated. You need somebody to be able to supervise the gradual reduction of the amount of the drug that you're taking, and you need support and treatment for the kind of symptoms that then recur, essentially anxiety and insomnia. These are not particularly complicated things to do. Most local services have got the capacity to do that.

JOFRE: Yet the help line is deluged with calls from people who can't find help locally.

ARMSTRONG: I think it's a deplorable situation. We used to run our help line all day. We now can only run it in the mornings which is source of great sadness because we know that people very often can't get through and are desperate.

JOFRE: And when Suzanne Tovey was desperate, it was her mum who had to help her off the drugs.

PAULINE WHITTAM (Mother of Suzanne Tovey): The last four years have been appalling, horrendous, hard work. I would never live through that again. I would never wish anybody to live through that. Yes, it's been awful. Really awful. I don't think she will recall much of the last four years actually, being on the tablets, because when I speak to her about it she says "I never did that" and "I never did this". I said well you do Suzanne, you've forgotten because you're on the tablets. Yes. So really she's lost those four years in her life and she'll never get them back. So sad when she's missed her teenage years.

JOFRE: Now 21, Suzanne's finally starting to pick up the pieces of her life. She's recovered enough to look after her two young children. Today she's moving out of her mother's house into a home of her own.

SUZANNE: It's brilliant yes, I'll get both my children together again and be able to be a proper family and everything now, rather than having to rely on other people to help me. I just couldn't have done it a few years ago. But it's a little bit scary but yes, it's very important to me because it's just, you know, better and like everything I can give my children what they need now as where before I couldn't.

JOFRE: Susan Hyatt took her last dose of lorazepam 6 weeks ago. It hasn't been easy, but she's hopeful she's now off them for good. Michael Behan, meanwhile, is back on his bike looking for more documents to help in his legal action. And Iain Caldwell is looking forward to his day in court later this year. If his case succeeds he hopes it will change not just his own life, but the lives of thousands of other people who are still caught in the tranquilliser trap.

IAIN CALDWELL: There are still people who are suffering and yet these drugs are still being prescribed and many doctors, I suppose, believe that they are still comparatively safe. The perception of the medical profession and the public as a whole must be changed. They must see these drugs for what they are and I hope my legal action will help towards that.

You can find more information about tranquillisers on the Panorama website at www.bbc.co.uk/panorama.


Reporter: Shelley Jofre

Film Camera: Alex Hansen

Sound Recordists: Paul Kennedy, Chris Watson

Dubbing Mixer: John Rogerson

VT Editor: Nick Kampa

Graphic Design: Julie Tritton, Kaye Huddy

Film Research: Eamonn Walsh

Production Team: Jessica Kenny, ABI McLoughlin, Rebecca Maidens, Amanda Vaughan-Barratt

Production Manager: Martha Estcourt

Unit Manager: Maria Ellis

Researcher: Nicola Behrman

Film Editors: Phil Clemo, Ian Corcoran

Web Producer: Ben Peachey

Assistant Producers: Tom Anstiss, Rob Cole

Producer: Murdoch Rogers

Deputy Editors: Andy Bell, Karen O'Connor

Editor: Mike Robinson

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