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Talk Radio UK Interview
with Mike Dicken and Susan Bibby
December 5, 1998

MIKE DICKEN: Another problem I've always felt it was worthwhile bringing to your attention but never really had the facts at my disposal, concerns the prescribing of what are called tranquillisers, sleeping pills. It's long been of concern in this country that doctors are overprescribing, but by how much, I don't think anybody knows.

But you will know from your own experience that if you go to the doctor, talking about feeling a bit depressed, not being able to sleep he'll probably come up with Valium or Librium or Ativan or something very much like it – fine – they work. On a short-term basis – no problem – but on a long-term basis – big problem.

Joining me on the line is Susan Bibby who is the founder of Benzact, which is a group dedicated to action for people damaged by tranquillisers and sleeping pills. Susan good morning.

SUSAN BIBBY: Good morning Mike.

MIKE: I know it's easy to blame doctors for this, but I wonder if we're blaming the wrong person, because it's the patient that becomes addicted, they say: "I like that – I want some more."

SUSAN: Well you could say that, but in fact, most people are told to take these drugs by their doctors and they're also encouraged to take them, quite often for far too long.

MIKE: And how long is too long?

SUSAN: More than four weeks.

MIKE: So four weeks is the recommended period by whom?

SUSAN: By the Committee on Safety of Medicines and the Committee on Regulation of Medicines, the British National Formulary, and also the drug companies themselves now since 1988.

MIKE: So what are the doctors doing prescribing them for longer periods?

SUSAN: I really don't know. I think they should be asked that question.

MIKE: Well how long a period have you become aware of – what sort of timescale are we looking at here?

SUSAN: Oh people have been prescribed them for 32, 33 years – non stop. They've become very ill. Sometimes their physical health has fallen to bits as well as their actual mental health. Whatever problem they had in the first place is really irrelevant compared with the effects that they've then experienced during the long-term use of these drugs – and doctors are still prescribing them for far more than four weeks.

MIKE: So they cure (in most cases), the original problem, sleeplessness, depression, whatever [yes, very effectively], but they bring on things – I've read about these, long and short-term memory deficit, disturbances to the immune system, personality changes – to name but a few – what else happens?

SUSAN: Well, apart from people's physical health going down (although luckily, some people seem to be able to stand up to that), they are described by their families as being "Jekyll and Hyde". Agoraphobia (not being able to go out) is a very, very common symptom which very few people actually have before they're given the drugs – sometimes they might have it, but mostly they don't have it until they've been put on the drugs. This of course makes them [the patients] incapable of doing anything much. They can't go out to the local shops, they can't look after their children properly, they are very distressed by this and feel it's their own fault. Usually they go back to the GP and the GP will say: "Oh you're an anxious personality and that's what's wrong with you," and they usually give them more benzodiazepines, or other antidepressant drugs as well.

MIKE: Do GPs' partners and managers, those that look after the practices for them, those that have pharmacists within their practice, not have records of this and does it not become apparent to them that they're doing something very stupid?

SUSAN: Well they do have audits, but the results of the audits, of the practice knowledge is not made available to the general public. Doctors have a thing called their "clinical judgment" and they don't divulge any information about their patients as far as I know. So far there isn't any 'body' that is regulating what they do. Hippocrates, the well known oath that Doctors [used to] have to swear. Included in that is the phrase: "first do no harm", well the doctors are depending on clinical judgement, but they actually don't know what the drugs do, they don't know how they work so they can't really do that.

MIKE: It seem quite extraordinary to me, because doctors are amongst those who have had to be very careful about budgeting. They didn't used to have to, but in the past few years they've certainly had to be very careful about budgeting and every time they write a prescription that comes off their budget. Consequently if they're writing unnecessary prescriptions, they're spending their own money unwisely and I don't think doctors would do that.

SUSAN: Also, what I don't understand, and I would like to ask the profession this, is that after long-term use of a drug which causes this sort of damage, people end up having to have a lot of investigations and they are actually disabled and often they can't work, so it's costing the country a lot more by giving these prescriptions. Benzodiazepines, (that's this group of tranquillisers and sleeping pills) – which most tranquillisers and sleeping pill in the last 30 years have been – are very cheap. They've become much cheaper in recent years, so I don't know why they do it.

MIKE: Really, it does depend upon someone like you coming up with a reason to challenge the doctors with because it seems that they're doing something not only to harm their patients, but to harm their practice and to harm the long-term effect of health care.

SUSAN: Oh yes, yes, and of course it doesn't stop there because in fact, there's a lot of very strong and compelling research in animals and humans showing that children who are exposed to this group of drugs before birth, can go on to have long-term problems and certainly if their parents are ill with the drugs, then their parenting skills are going to be compromised as well. So it's really got to the second generation.

A lot of the children whose parents take therapeutic doses of benzodiazepines during pregnancy are born with what is termed "floppy infant syndrome" and this includes their being unable to feed. They can't actually get rid of the drug from their system – nobody knows how long it actually stays stored in the system. They are compromised from birth onwards. They also suffer from withdrawal effects from the drug. This has been little known, nobody has taken much notice of this. People make a fuss about things like alcohol and opiates and other 'street drugs', but they aren't looking at this very, very commonly prescribed group of drugs. We now have a second and, in fact, third generation of people who will have been affected one way or another by benzodiazepines.

MIKE: Can we quantify this at all? You say it's over-prescribed, you've given me the astonishing figure of over 30 years, whereas it should never be more than a month or 6 weeks at the outside. Those figures in themselves are quite disturbing to put it mildly, but how many people are involved? How many people are taking these pills and potions who don't actually need them and shouldn't be taking them?

SUSAN: Well, an estimate around the country for people who have been on the drug for more than 10 years, so that's chronic use, at this present time is just below or around 1 million. That doesn't include people who've been given it recently nor people who've been long-term damaged by the drug, but who've luckily managed to get off [the drug].

Also there are a lot of deaths attributable to benzodiazepines – due to overdose and/or accidents and other reasons. They also account for a lot more deaths, Home Office statistics in, I think, 1989 are in thousands – more than all other 'street drugs' put together. Obviously there are more people given these drugs so that explains some of it. Nobody has taken any notice of it because they [the benzodiazepines] are a prescribed drug and we are told they are safe, and they are supposed to be safe.

MIKE: I don't want to sensationalise this Susan but, in the last couple of minutes, you've actually accused doctors of murder.

SUSAN: Well I think that they do have a case to answer – it would be very nice if one or two of them would actually stand up and speak.

MIKE: I will invite them so to do. Susan Bibby, thank you very much for joining us.

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