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Croydon, UK, November 2000
Benzodiazepines and Babies
Dr James Robertson
Arrowe Park Hospital, UK
I am a paediatrician. I look after babies and for the last six years I also look after drug addicts. I think I am the only paediatrician who looks after them when they are pregnant and I look after them before they're born, to stop the problems after they are born. We decided to prioritise what we thought were the most dangerous drugs:
Top of the list, which has been mentioned very briefly today is actually alcohol and yet it is the only one that's actually socially acceptable [of the list].
Cigarettes - we just - everyone's on them, very dangerous unfortunately.
Benzodiazepines come third on the list above heroin and above methadone and five years ago we were having 50% of our babies withdrawing at birth. They were withdrawing - I think our maximum was 77 days which is two and a half months but I'm pretty sure it goes on for months longer than that and I think it used to be described as colic. You are all from an era when colic drops worked because they were 20% alcohol, but they've taken out the alcohol so they don't work any more. [transcript missing].
Alcohol is top of the list because we know it does cause permanent damage. It is not known if [BDZS] do cause permanent damage. It hasn't been proved yet in terms of proof that benzodiazepines do but there's enough evidence to say that they should not be used in pregnancy.
Two areas which will eventually become very difficult to separate in terms of benzodiazepines are:
The effect during pregnancy.
The effect after pregnancy.
The only way you can prove it was during pregnancy is either, the mum stops as soon as the baby is born and is totally back to normal, but, as is so obvious here you are not back to normal just like that or the baby is adopted.
Our experience tells us that people on benzodiazepines cannot be good mothers - because they're not in control - that is not a criticism of them as an individual but a criticism of them plus benzodiazepines.
There is also very good evidence that your first 2 years of life are incredibly important, so if you haven't got good parenting, to what extent does that effect the rest of your life? What's going to happen at different stages? I don't know the answer but I do worry about it... That's why we have benzodiazepines very high up on our list.
To the people who say it's all the doctor's responsibility, (I have to admit I have a colossal 6 months experience of General Practice), and I couldn't stand it because 90% of the patients I could do nothing for. As a doctor I felt very helpless because a lot of them had violent partners, had lost their jobs, they had money stresses, the house was awful etc. and unfortunately under the constraints of this country and every other country doctors do have (I think ours is 7 and a half minutes, which makes it one minute and a half more than America, but I did feel there was not a lot we could do and I don't know the answer. I also agree with the statement that a prescription is used at the end of the consultation, which if the antibiotics are anything to go by, if you don't prescribe antibiotics to somebody and explain that they're not necessary, they're less likely to see you next time. Now I don't know if that's good or bad - you have to think about that.
The last thing I will say is that recently there's been evidence to suggest that the role of the 90s and the 80s seems to be that nobody is allowed to experience 'normal' on their own and if there's ever a major tragedy in this country the first thing that happens is that 3,456 professionals and counsellors flood in followed by about 1,800 press people and it has come out in the last 6 to 9 months that that does more harm than good and if you could speak to people who've survived the war they would probably agree and they would have said, "Well we could have told you that 20 years ago". People are better at getting over things in their own way than some interfering professional. However it isn't the interfering professional who has created this, it is society, so it is a much bigger issue.
So I am going to sneak to the back and run! Benzodiazepines should not be given in pregnancy. Thank you.