BENZODIAZEPINES
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The Prime Minister on Benzodiazepine Addiction: "First, I pay tribute to the hon. Gentleman (Jim Dobbin, MP), who has campaigned strongly on this issue over many years. I join him in paying tribute to Professor Ashton, whom I know has considerable expertise in this area. He is right to say that this is a terrible affliction; these people are not drug addicts but they have become hooked on repeat prescriptions of tranquillisers. The Minister for Public Health is very happy to discuss this issue with him and, as he says, make sure that the relevant guidance can be issued." - Rt. Hon. David Cameron MP, Prime Minister, October 23, 2013.
Dalmane [flurazepam] and other similar benzodiazepine tranquillisers can make people much more suggestible and vulnerable to be being taken advantage of while taking the drug. There are cases in which people have shoplifted, crashed cars and behaved violently while under the influence of benzodiazepines which are comparable to the effects of alcohol. Dalmane [like Valium / diazepam] is a long-acting drug which has a cumulative effect and so while there may be fluctuations in the level of confusion, there would be no lucid moments...A person's judgement, insight, memory, ability to plan and perceptions are all impaired. Dalmane should be taken off the market...The prescribing guidelines [published in 1988] have had no effect whatsoever on prescribing and GPs are now being sued...they are being picked off one by one and the size of damages being paid will force the medical defence unions to issue further warnings. This is an ongoing problem which has not been addressed by the medical profession, but is at last being addressed by the legal profession." - Professor Malcolm H Lader, Emeritus Professor of Clinical Psychopharmacology, King's College London, January 2012.
I've met people who've been addicted to benzodiazepines for 20 or 30 years - wrecked their lives, wrecked their jobs, wrecked their families. It's a silent addiction. We all know about illegal drugs, we all know about alcohol, we don't know about this group... I think there has been some denial of the problem and I think that when you're talking about drugs that are legally, albeit unwisely, prescribed causing a problem - you know it's never really fitted anywhere, nobody wanted to grab hold of it - certainly not in denial now. We are going to get a grip of this and it needs to be dealt with on a number of different fronts, there's no doubt about that... I'm taking this very seriously. It's an issue that's fallen through the cracks. We want to make sure that training and awareness is raised so that GPs know how to prescribe well and then we need to make sure that we've got the right services in place to give them the help and support they need to get off these drugs and get back and enjoy lives as they should be able to. - Anne Milton MP, Public Health Minister on BBC Radio 4 Face the Facts, July 27, 2011.
I estimate about 20-30% of people who are on a benzodiazepine like diazepam have trouble coming off and of those about a third have very distressing symptoms. The anxiety or the sleeplessness comes back, they feel as if they're physically ill - we talk about a flu-like illness - then they start to get some very bizarre symptoms which we technically call hypersensitivity but essentially what it is is the brain is starting to wake up and it overwakes - sounds appear loud and lights appear bright, so they're wearing sunglasses indoors and they also have a symptom whereby they feel very unsteady and they will walk round the room holding on to the walls - and they really are then in a bad withdrawal state. It's very difficult to come off these drugs and the facilities are just not available and the great scandal is that the NHS claims to be dealing with these people by referring them to addiction centres, where essentially they'll sit next to a street user who's injecting heroine and of course a housewife who's been put on tranquillisers by her doctor is very upset by this ... There is a change taking place which is that if a general practitioner prescribes for longer than the agreed time - two weeks or four weeks - they can be sued by the patient for substandard clinical care and I suspect in the longer term the prescribing of these drugs will be as much dependent on lawyers' attitudes as it will be on doctors' attitudes. - Professor Malcolm H Lader, Professor of Clinical Psychopharmacology, Institute of Psychiatry, University of London on BBC Radio 4 Face the Facts, July 27, 2011.
"Dear Ray, I would like to state that I am extremely grateful for everything you have done for benzo users all over the world, including making my contributions - the 'Manual', my publications, and the Supplement available to all. You have done a great service to people with benzo problems worldwide. I could not have done anything like that without your expertise. You have also been a great source of information and advice to me and I thank you for your wise advice over the years. Yours sincerely, Heather Ashton".
"Tranquilliser addiction is an extreme problem in our country... I think that we must deal with the problem at source." - David Cameron, Prime Minister, PMQs, March 9, 2011.
"One possible reason why the MRC sat on this [benzodiazepine brain damage] story for thirty years? The regulatory agency in Britain that oversees the safety of medicines, the Medicines and Healthcare Products Regulatory Agency, is funded entirely by the drug companies it is meant to oversee." – Dr Christopher Lane, Psychology Today, November 12, 2010.
"The real tragedy about the benzodiazepines is that it was known in the 1980s that these drugs cause brain damage. I reported on the link in detail in my book Life Without Tranquillisers which was published in 1985. Sadly, millions more patients were given the drugs after this information was known. It's common for people to sue for trivial problems these days. I don't understand why a million or so people who were prescribed benzodiazepines after 1985 aren't suing. Those individuals were severely damaged by the prescribing of these drugs. And doctors knew of the dangers." – Dr Vernon Coleman, Email to the Editor, Independent on Sunday, November 9, 2010 in response to Drugs linked to brain damage 30 years ago, Independent on Sunday, November 7, 2010.
"Many tranquillisers victims have lasting physical, cognitive and psychological problems even after they have withdrawn. We are seeking legal advice because we believe these documents are the bombshell they have been waiting for. The MRC must justify why there was no proper follow-up to Professor Lader's research, no safety committee, no study, nothing to further explore the results. We are talking about a huge scandal here." – Jim Dobbin MP, chairman of the All Party Parliamentary Group for Involuntary Tranquilliser Addiction, Independent on Sunday, November 7, 2010.
On benzodiazepine brain damage reported to the Medical Research Council in January 1982: "The results didn't surprise us because we already knew long-term alcohol use could cause permanent brain changes. There should have been a really good, large-scale study but I was never given the facilities or resources to do it. I asked to set up a unit to research benzos but they turned me down... they could have set-up a special safety committee, but they didn't even do that. I am not going to speculate why; I was grateful for the support they did give me. There were always competing interests for the same resources, so maybe it wasn't regarded as important enough. I was getting on with other research and didn't want to be labelled as the person who just pushed benzos... I should have been more proactive... I assumed the prescribing would peter out, but GPs are still swinging them around like Smarties." – Professor Malcolm Lader, Emeritus Professor of Clinical Psychopharmacology, Institute of Psychiatry, University of London, Independent on Sunday, November 7, 2010.
"Klonopin - more deadly than coke" – Stevie Nicks, 2009 (video clip).
“We now try to prescribe (benzodiazepines) only for a few days because we know that it's very difficult to get people off these drugs, but there are still a lot of people on benzodiazepines and tranquillisers that have been on for many years...the patient doesn't want to come off the drug because they've tried before and they get all of these horrible withdrawal side effects which are very similar to coming off heroin or cocaine and indeed in my experience it can be more difficult to get people off benzodiazepines. What we've got to try to do is work with the patient to bring them off very slowly and very gradually, but the best thing to do is to not prescribe them in the first place… in some people, it can be three or four days of the drug before they get hooked. And what you find is that they can't have a day without them. They start to get very anxious, very sweaty, very panicky. In others it's even worse - it's not just that they can't do a day without them they need two or three or more, to actually keep them calm. So each patient is very different. Bringing people off the drug is very different and you have to do it slowly and really tailor it to the patient." – Professor Steven Field, Chair of the Royal College of General Practitioners, ITV West interview, March 2009.
"Benzos are responsible for more pain, unhappiness and damage than anything else in our society." – Phil Woolas MP, Deputy Leader of the House of Commons, Oldham Chronicle, February 12, 2004.
"Some people have been on benzodiazepines for many years, and it is very difficult to get them off because they are very addictive." – Dr Peter Fellows, Chairman of the British Medical Association's prescribing committee, BBC News February 11, 2004.
"Withdrawal symptoms can last months or years in 15% of long-term users. In some people, chronic use has resulted in long-term, possibly permanent disability." – Professor C Heather Ashton DM, FRCP, Good Housekeeping, August 2003.
"We actually knew from some experiments back in the 1960s that you could have dependence... addiction to benzodiazepines but only on high dose. Later it became apparent that some people were having problems trying to stop and that they weren't on high doses; and then the whole question arose: can you actually get dependent - can you actually become addicted - to normal therapeutic doses? And then the alarm bells started to ring, quietly at first and then louder and louder. [...] Doctors were not well equipped to deal with this. This was something new in their experience. They don't like dealing with chronic drug use or addiction anyway and here they were being confronted by hundreds in their practices - who they had put on the tranquillisers - and were now coming for help to come off. And I think they were bewildered by the numbers and severity of some of the reactions. [...] The main characteristic of these dependent people was that when they tried to stop they didn't just get their old symptoms back, they didn't just get their old symptoms back in an exaggerated form, they developed new symptoms which they had not experienced before. [...] Some people are put on to these tranquillisers not because they are anxious or have insomnia, they can't sleep, it's because they have muscle spasms - they've been injured in some way - they've had a skiing accident, or they've got a bad back. And they're put on and they've had no psychiatric history, they've had no anxiety, no insomnia, and yet they're just as likely to show dependence and withdrawal when they stop as those with a previous psychiatric history." – Professor Malcolm H Lader, Professor of Clinical Psychopharmacology, Institute of Psychiatry, University of London. In Pills We Trust, Discovery Channel, December 4-18, 2002.
"We regard dependence on benzodiazepines a very important issue and the Department of Health has taken a number of measures to tackle the problem. The main focus of the Department's action in this area has been to try and prevent addiction from occurring in the first place by warning GPs (and other prescribers) of the potential side-effects of the prescribed medicines and the dangers of involuntary addiction to benzodiazepines." – Caroline Adams, Political Office, 10 Downing Street, London SW1A 2AA, March 19, 2002.
"I am passing your letter to Paul Boateng who, as legal affairs spokesman, has specific responsibility for the litigation side of what is a national scandal." – David Blunkett MP, 1994.
"Clearly, the aim of all involved in this sorry affair is the provision of justice for the victims of these drugs [tranquillisers]." – Paul Boeteng MP, 1994.
"Doctors who prescribe benzodiazepines continuously are courting disaster. What we need to realize is that benzodiazepines are addictive... The drugs should not generally be prescribed for longer than a few weeks. You use them clinically when it is indicated for short periods of time. Short-term use is certainly less than three months. In general practice I wouldn't be using them for more than two to three weeks... It is a drug that takes a much longer detox procedure than almost anything else" - Drug-addictions expert Dr. Garth McIver, The Vancouver Province, December 31, 2001.
"Episodic anxiety is best treated with an entirely different class of drugs known as benzodiazepines, including Valium, Xanax, Ativan and Klonopin. These work within minutes, not weeks - but they're potentially addictive, so they shouldn't be used for more than two weeks or so." – Richard Friedman, psychiatrist and director of the Psychopharmacology Clinic at New York Weill Cornell Medical Center in Manhattan, Time Magazine, October 21, 2001.
"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. ... 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." – Dr Jim Kennedy, Royal College of General Practitioners, The Tranquilliser Trap, BBC Panorama, May 13, 2001.
"It is difficult to defend that we have such a huge problem of benzodiazepine prescription and long-term use and therefore dependence. – Professor Louis Appleby, National Director for Mental Health, The Tranquilliser Trap, BBC Panorama, May 13, 2001.
"The writing is on the wall for benzodiazepine use." – Dr Andrew Byrne, Benzodiazepine Dependence, 1997.
"Ray, You are right in EVERYTHING you say and as a third generation doctor I apologise unreservedly to you and those like you who may have been prescribed Valium and similar drugs where simple alternatives may have existed. Yes, by 1988 it was abundantly clear that these drugs had many, many dangers and very limited benefits for insomnia or anxiety patients. You are welcome to quote anything I have written to you on your web page, especially my small apology which is VERY real and heartfelt (and, I hope, meaningful)." – Dr Andrew Byrne, General Practitioner, Drug and Alcohol, 75 Redfern Street, Redfern, New South Wales, 2016, Australia, Email: ajbyrne@ozemail.com.au – March 25, 2001. See: Benzodiazepine Dependence, 1997 · Benzodiazepines: the end of a dream, 1994.
"It is more difficult to withdraw people from benzodiazepines than it is from heroin. It just seems that the dependency is so ingrained and the withdrawal symptoms you get are so intolerable that people have a great deal of problem coming off. The other aspect is that with heroin, usually the withdrawal is over within a week or so. With benzodiazepines, a proportion of patients go on to long term withdrawal and they have very unpleasant symptoms for month after month, and I get letters from people saying you can go on for two years or more. Some of the tranquilliser groups can document people who still have symptoms ten years after stopping." – Professor Malcolm H Lader, Royal Maudesley Hospital, BBC Radio 4, Face The Facts, March 16, 1999.
"The Medical profession, I think, is fairly ashamed of what has happened. It's allowed this very untrammelled prescribing to go on. My estimate is that there's something between a quarter and half a million people in this country, at this moment, who would have problems trying to stop their tranquillisers. They would need help to do so and there's been a sense that they're difficult to treat, difficult to deal with and a lot of these patients are just kept on their medication indefinitely. No real attempt is made to help them come off ... The Government should tackle this problem face on. There are thousands of people out there who are not receiving treatment, hundreds of GPs who don't know really how to treat these patients. There are self-help groups who are crying out for funding just to keep going at a very low level. I think the Government should now acknowledge the problem and set funds aside, because if the Government doesn't do that, these people will go to their graves with their tranquilliser bottles beside them." – Professor Malcolm H Lader, Royal Maudesley Hospital, BBC Radio 4, The Facts, 1991.
"We knew from the start that patients taking markedly increased doses could get dependent, but thought only addictive personalities could become dependent and that true addiction was unusual. We got that wrong. What we didn't know, but know now, is that even people taking therapeutic doses can become dependent." – Professor Malcolm H Lader.
"There's certainly a problem, the NHS are concerned. The NHS spend about £40 million per annum on these drugs. There are a substantial number of people who do suffer from this problem long-term. I know that the withdrawal symptoms can be agonising for some people and can be very difficult indeed." – John Patten, Health Minister, 1984.
"I would like to congratulate the members of this [benzo] group who contributed to a thorough and remarkably helpful document on benzodiazepines and benzo withdrawal. A 'must read' for anybody considering coming off benzos. More important, a must read for my colleagues who keep putting more on benzos! Well done!" – Dr Ray Baker, Assistant Clinical Professor in the Faculty of Medicine at the University of British Columbia, Canada.
"If the popular press and more recently the legal profession had not taken up arms against the over prescription of tranquillisers, the issue of benzodiazepine dependence would still remain a medical curio only for the pages of medical journals. The media and lawyers have undoubtedly altered prescribing practices mostly for the better." – Dr Cosmo Hallström, Journal of Forensic Psychiatry, 1991, 2 pp5-7.
"The wide human exposure to this group of drugs throughout the world is of great concern for human health." – Giri AK, Banerjee S, 1996.
When they first came out they were seen as some sort of panacea – or universal remedy. But with constant use it was found they turned people into zombies in the end." – Dr Ian Telfer, Consultant Psychiatrist, West Pennine Health Authority, UK.
"If benzodiazepines are prescribed it should be only for a very short term – for two to four weeks. These drugs are highly addictive and people just can't stop taking them overnight." – Dr Rakesh Kohli, Oldham, UK.
"Benzodiazepine dependence would be of minor clinical significance if it occurred only in those few individuals taking high doses of drugs; but it would be very important indeed if it supervened even to a minor degree in patients on usual clinical doses. Our clinical impression is that many patients experience symptoms on reduction or withdrawal of their benzodiazepine medication, and that whilst these symptoms somewhat resemble those of anxiety they differ qualitatively and are often more severe than those for which the medication was originally given." – C. Hallström, M. Lader, Benzodiazepine withdrawal phenomena, Int. Pharmacopsychiat, 1981, 16, 235-244).
"Dependence on the benzodiazepines does occur. Patients taking these drugs, even at therapeutic doses, for two or more months, may develop a physical withdrawal syndrome. The cardinal feature of the syndrome is anxiety, which may be mistakenly interpreted as a recrudescence of the original anxiety for which the drug was prescribed." – N. Hockings, B.R. Ballinger, Hypnotics and anxiolytics, in New Drugs, London: British Medical Association, 1983, 149-155.
"It is generally agreed that, lacking evidence that the anti-anxiety properties of these drugs exceed two to four weeks, and since anxiety is typically episodic, courses of one to two weeks are recommended." [Appropriate Uses of Benzodiazepines, Duration of Use and Dosage, p21] "Efficacy as an antianxiety agent has not been demonstrated for longer than a few weeks and, because of the risk of dependency as well as with individual variation in dose response, continuous use should not exceed two weeks." [Summary And Conclusion, p49] – The Effects of Tranquillization: Benzodiazepine Use in Canada, Health and Welfare Canada, 1983.
"These (pills) relax people and put them to sleep, but they also cause physical dependence. It's not as dramatic a story as heroin or cocaine, but if you totalled all the damage, benzos would be comparable. Tranquillizers, the group of drugs formally called benzodiazepines, are too easily prescribed by well-meaning physicians who don't know enough about the drugs' addictive qualities." – Dr Doug Coleman, British Columbia, Canada.
"The benzodiazepines are probably the most addictive drugs ever created and the vast army of enthusiastic doctors who prescribed these drugs by the tonne have created the world's largest drug addiction problem. – Dr Vernon Coleman, The Drugs Myth, 1992.
"Increasing numbers of people have been turned into drug addicts through legal prescriptions which perhaps suits the politicians and multi-national bureaucrats as well as the drug companies for it ensures an uncomplaining and docile community which is easy to administer, manage and manipulate...tranquillisers are more addictive than heroin." – Dr Vernon Coleman, Life Without Tranquillisers, 1985.
"I don't think anyone really knows what long-term effects the benzodiazepines are likely to have on the brain tissue ... [they] may damage your brain cells and produce real physical damage to your thinking processes and there is also the risk that the benzodiazepines will cause psychological damage." – Dr Vernon Coleman, Life Without Tranquillisers, 1985, p55.
"For well over twenty years now I have repeatedly warned that drugs in the benzodiazepine group are being wildly overprescribed and can cause tremendous problems. (For most of that time I was abused and attacked by many members of the medical establishment who maintained that there were no problems). And I have on many occasions warned that drug abuse experts have told me that getting patients off these drugs is frequently more difficult than getting patients off heroin. Sadly, it seems that although some doctors now accept that these drugs can cause problems there are still doctors in practise who do not understand the problems the benzodiazepines can produce. If you see a doctor who tells you that the benzodiazepines never cause problems, don't cause addiction and can be stopped suddenly without danger my advice is simple: change doctors fast." – Dr Vernon Coleman, Benzodiazepine tranquillisers - facts every patient should know.
1975: "The world's biggest addiction problem is not teenagers taking hash but middle-agers taking sedatives. The tranquilliser is replacing tobacco. It will, perhaps, give us an even bigger problem. It may prove even more dangerous. Already Valium is said to be taken by 14% of the population of Britain. The habit usually starts insidiously. The patient may have a good excuse for taking a few tablets. A close friend or relative has died or there is a rush on at work. And the doctor finds it difficult to refuse the request for a little help. The drugs which people take to help relieve their pressures vary. If he is young the addict may take drugs from a pusher. If he is older he may take drugs from a medical adviser." – Dr Vernon Coleman, 'The Medicine Men' 1975.
"Doctors prescribe by nature. I had a patient who told me that her doctor had warned her that if she came off her medication she might die. I just saw another patient who was on 70 tablets a day. There are doctors out there who are absolutely committed to prescribing, and if the patient doesn't get better, they just up the dose." – Dr Lefever, director of the Promis recovery centre in Kent.
"The medical profession took nearly 20 years from the introduction of benzodiazepines to recognise officially that these minor tranquillisers and hypnotics were potentially addictive. The 'happiness pills', which had been propping up a fair proportion of the adult population since the early 1960s, were found to have an unexpectedly bitter aftertaste: doctors and patients alike were unprepared for the problems of dependence and withdrawal that are now known to be common even with normal therapeutic doses." – Editorial (Anon), The benzodiazepine bind, The Lancet, 22 September 1984, 706.
"The extent of pharmacological dependence with regular as opposed to intermittent dosage of benzodiazepines was not fully appreciated until recently. This was probably because prominent features of drug dependence, such as tolerance and escalation of dosage, are uncommon among patients starting on normal doses. The chief manifestation is a withdrawal syndrome on stopping the drug." – Anon (A. Herxheimer, ed.), Some problems with benzodiazepines, Drug & Ther Bull, March 25 1985, 23 (6), 21-23.
"In the UK, 11.2% of all adults take an anti-anxiety drug at some time during any one year. But over a quarter of these people (3.1% of all adults) are chronic users, taking such medication every day. Even at a conservative estimate, 20% of these will develop symptoms when they attempt to withdraw. That means a quarter of a million people in the UK. The sooner the medical profession faces up to its responsibilities towards these iatrogenic addicts, the sooner it will regain the confidence of the anxious members of our community." – M.H. Lader, A.C. Higgitt, Management of benzodiazepine dependence – Update 1986, Brit J Addiction, 1986, 81, 7-10.
"It has been estimated that one in three patients prescribed benzodiazepines in normal therapeutic doses for six weeks would experience withdrawal symptoms if treatment were withdrawn abruptly. Even with gradual withdrawal, patients would request further prescriptions. Thus, there is a considerable risk of dependence even in comparatively short-term use." – M.A. Cormack, R.G. Owens, M.E. Dewey, The effect of minimal interventions by general practitioners on long-term benzodiazepines use, J Roy Coll Gen Practitioners, October 1989, 39, 408-411.
"The presence of a predictable abstinence syndrome following abrupt discontinuance of benzodiazepines is evidence of the development of physiological dependence. Historically, long-term, high-dose, physiological dependence has been called addiction, a term that implies recreational use. In recent years, however, it has become apparent that physiological adaptation develops and discontinuance symptoms can appear after regular daily therapeutic dose administration ... in some cases after a few days or weeks of administration. Since therapeutic prescribing is clearly not recreational abuse, the term dependence is preferred to addiction, and the abstinence syndrome is called a discontinuance syndrome." – American Psychiatric Association Task Force on Benzodiazepine Dependency. Benzodiazepine Dependence, Toxicity, and Abuse. Washington DC: APA, 1990.
"The risks of these drugs [benzodiazepines] often outweigh therapeutic benefits." - Health Canada, 1996 Review of Benzodiazepine Use.
"1.5 million Xanax addicts are produced (in the U.S.) each year." - John Steinberg, Medical Director of the Chemical Dependency Program, Greater Baltimore Medical Center.
"I think there was a tremendous failure to perceive the potential danger of this drug [Xanax]. The worst thing about this drug was a failure to perceive how difficult it would be to stop, how intensely people would be attracted to it." - Dr John Steinberg, Medical Director of the Chemical Dependency Program, Greater Baltimore Medical Center.
"Patients need to be told that this [Xanax] is an addictive drug and they must be careful not to keep taking it and not to increase the dose." - Professor Solomon Snyder, Dept of Neuroscience, Johns Hopkins University.
"People were innocently put on this medication [Xanax] and in some instances it works out well. [But] there is a significant risk and we see it all of the time. Many people who have lost many years of their lives, who have lost jobs, been on the verge of suicide. I'm aware of cases where people have committed suicide. The drug can be dangerous, it can be fatal. During withdrawal the heart rate can go up, they may have a seizure, sometimes the body temperature can go up and in some instances its fatal." - Dr. Neil Capretto, Director of the Gateway Rehabilitation Center in Pennsylvania.
"The biggest drug-addiction problem in the world doesn't involve heroin, cocaine or marijuana. In fact, it doesn't involve an illegal drug at all. The world's biggest drug-addiction problem is posed by a group of drugs, the benzodiazepines, which are widely prescribed by doctors and taken by countless millions of perfectly ordinary people around the world... Drug-addiction experts claim that getting people off the benzodiazepines is more difficult than getting addicts off heroin... For several years now pressure-groups have been fighting to help addicted individuals break free from their pharmacological chains. But the fight has been a forlorn one. As fast as one individual breaks free from one of the benzodiazepines another patient somewhere else becomes addicted. I believe that the main reason for this is that doctors are addicted to prescribing benzodiazepines just as much as patients are hooked on taking them. I don't think that the problem can ever be solved by gentle persuasion or by trying to wean patients off these drugs. I think that the only genuine long-term solution is to be aware of these drugs and to avoid them like the plague. The uses of the benzodiazepines are modest and relatively insignificant. We can do without them. I don't think that the benzodiazepine problem will be solved until patients around the world unite and make it clear that they are not prepared to accept prescriptions for these dangerous products." – Dr Vernon Coleman, Life Without Tranquillisers, 1985.
The most common tranquillisers are the Valium-like drugs, the benzodiazepines (most sleeping tablets also belong to this class of drugs). They are very effective at relieving anxiety, but we now know that they can be addictive after only four weeks regular use. When people try to stop taking them they may experience unpleasant withdrawal symptoms which can go on for some time. These drugs should be only used for short periods, perhaps to help during a crisis. They should not be used for longer-term treatment of anxiety. - The Royal College of Psychiatrists, July 2001.
"There is inappropriate prescribing going on, not always consciously, but there are some doctors who know what they are doing and they are doing it for financial reasons. Most of the people being given benzodiazepines should not be on it and definitely shouldn't be on it longer than four weeks, but many are taking it for years." – Dr Ide Delargy, Irish College of General Practitioners, Irish Examiner, May 21, 2001.
"Benzodiazepines cause a more significant withdrawal for the newborn baby than either heroin or methadone. When a baby is withdrawing, they have a state of irritability, they are hyper-responsive, which means that they tremor at the slightest noise, even when quiet and they cry with a cry that is very distinctive – it's much higher pitched and it's much more of a distressed cry as if the baby is in discomfort. They basically are miserable, unsettled babies." – Dr James Robertson, Arrowe Park Hospital, Liverpool BBC Radio 4, Face The Facts, March 16, 1999.
"The developing foetus can be congenitally malformed; it can have heart attacks in the womb. We also know that the newborn baby born to somebody taking benzodiazepines will have difficulty breathing and they would have floppy muscles – what doctors call a 'floppy baby' and they may be unduly cold because the temperature regulation, which is so important to a baby, is disrupted ... Well I think if any doctor is prescribing benzodiazepines to a pregnant woman, he should check his indemnification status because it is in fact illegal prescribing." – Robert Kerwin, Professor of Psychopharmacology at the Maudesley Hospital in London, BBC Radio 4, Face The Facts, March 16, 1999.
"Well I think that you'll know that this is nothing short of a national scandal that many practitioners know about. There are very many patients in the UK, (I think it was about 70,000 at the last count), who are 'stuck' on Valium." – Professor Robert Kerwin, BBC Radio 4, 'You and Yours', October 27, 1999.
"When somebody comes into my office and says that they've been trying to stop their lorazepam, my heart sinks because I know I shall have twice as much of a problem as getting them off, say, Valium: the symptoms are more severe, they're more persistent, more bizarre, and people are much more distressed by them ... I feel that this compound should not now be prescribed because of the problems which may arise in some patients." – Professor Malcolm Lader, member of the Committee on the Review of Medicines, Brass Tacks, BBC2, October 20, 1987.
"Benzodiazepines are, of course, addictive. And coming off any addictive substance is difficult and unpleasant. For some it is particularly unpleasant." – Ed Walker, staff doctor in accident and emergency, Dewsbury, West Yorkshire, writing in the BMJ, 1997.
"Physical and psychological dependence on tranquillisers can happen in an alarmingly short space of time. You reach a stage where you can't cope without tranquillisers and are terrified of trying to stop taking them... Suffering withdrawal from tranquillisers is no joke, but it can be done. Those who have gone through it say that it must be harder than coming off heroin." - Dr Miriam Stoppard.
"Klonopin is a horrible, dangerous drug." - Stevie Nicks.
"Amnesia is frequently a real side effect of the use of benzodiazepines and not just a figment of the individual's imagination or a coincident symptom of emotional disorder."
"It is often inadvisable to prescribe benzodiazepines to a patient in an acute crisis as the amnesic property of these compounds may not allow patient to make an optimum response to the situation which they are facing. In cases of loss or bereavement, the psychological adjustment to this trauma may be severely inhibited by benzodiazepines and any tendency to denial could be reinforced." (p107)
"It is recognised that the use of benzodiazepines has been (and is still) far too widespread and they are frequently prescribed for trivial and imprecise indications. This has arisen from the belief that benzodiazepines were safe compounds."
"It is now acknowledged that the risks of benzodiazepines far outweigh the benefits in many cases and we would recommend that benzodiazepines should not be used in general for vague or mild disorders and should be prescribed for short-term relief when the problem is (i) disabling (ii) severe or (iii) subjecting the individual to unacceptable distress and even then should ideally be prescribed for no more than one month." (p108)
"It is now acknowledged that the risks of benzodiazepines far outweigh the benefits in many cases and we would recommend that benzodiazepines should not be used in general for vague or mild disorders and should be prescribed for short-term relief when the problem is (i) disabling (ii) severe or (iii) subjecting the individual to unacceptable distress and even then should ideally be prescribed for no more than one month...The prescribing of benzodiazepines in cases of depression may have serious consequences and may precipitate suicide. Withdrawal from benzodiazepines in many cases may precipitate depression." (p108) - Priest RG, Montgomery SA. Benzodiazepines and Dependence: A College Statement. Bulletin of the Royal College of Psychiatrists 1988;12:107-109.
"Thousands of people could not possibly invent the bizarre symptoms caused by therapeutic use of benzodiazepines and reactions to their withdrawal. Many users have to cope, not only with a frightening range of symptoms, but also with the disbelief and hostility of their doctors and families. It is not uncommon for patients to be "struck off" if they continue to complain about withdrawal symptoms. Even when doctors are concerned and understanding about the problem, they often have little knowledge of withdrawal procedure, even less about treatment. The drugs newsletter on benzodiazepines issued in this region will help them. Is anything being done elsewhere?" - Trickett S. Withdrawal from Benzodiazepines. Journal of the Royal College of General Practitioners 1983; 33: 608.
"We have much more difficulty getting people off Ativan than we do heroin, mainly because with heroin ... within a couple of weeks they're off and then the problem is staying off. But with Ativan it's much more prolonged and they take up a lot more time in terms of treatment than do heroin users." – Jim Corcoran, Torbay Drug Addiction Team, Brass Tacks, BBC2, October 20, 1987.
"There's no scientific evidence to indicate that one particular tranquilliser is worse than another ... To act just against one would he wrong because there is a problem with the whole group." – Professor Michael Rawlins, member of the Committee on the Safety of Medicines and chair of its Subcommittee on Safety, Efficacy and Adverse Reactions, Brass Tacks, BBC2, October 20, 1987.
"We have enough data here that certain of the benzodiazepines [sedatives and tranquilizers] are capable, after a single dose, of significantly disrupting certain kinds of cognitive and/or intellectual functions. Furthermore, this phenomenon outlasts the antianxiety effect of these drugs ... People are seeking an easy way out, looking for shortcuts on a path of life that has none; in the end not only will they be disappointed but they will end up by diminishing their humanness, the essence that separates man from animals." – Dr. Louis Gottschalk, neuroscientist, University of California.
"Although vast quantities of minor tranquillisers have been prescribed it must be stated that not all have been dispensed judiciously by some practitioners. Such misuse is indicative of physicians who unwisely accede to the demands of patients or who supplant sound clinical judgement for expediency. The disregard of these doctors for the potential abuse of minor tranquillisers and for the welfare of their patients is further manifested by their prescribing large quantities with no restrictions on refills and with no insistence that the patient return at regular intervals for evaluation of the response to or the need for the medication... these practices not only warrant condemnation but invite drug abuse. Clearly the abuse of some psychoactive drugs may call for the indictment of the physician and pharmacist rather than the drugs." – Frank Ayd MD, editor of the International Drug Therapy Newsletter in: 'Discoveries in Biological Psychiatry', 1970.
"Going to a psychiatrist has become one of the most dangerous things a person can do." – Peter Breggin, MD.
"Adverse drug reactions (defined as unintended effects of substances used in the prevention diagnosis or treatment of disease) are common. They are responsible for 3-5% of hospital admissions, occur in 10-20% of hospital inpatients, and have recently been reported in 40% of patients receiving drugs in general practice." – M. Rawlins, Adverse reactions to drugs, Brit Med J, 21 March 1981, 282,974-976.
"Doctors who treat the symptom tend to give a prescription; doctors who treat the patient are more likely to offer guidance." – J Apley 1978.
"If there's a pill, then pharmaceutical companies will find a disease for it." – Jeremy Laurance, The Independent, April 17, 2002.
"Physicians pour drugs of which they know little to cure diseases of which they know less, into humans of whom they know nothing." – Voltaire (1694-1778).
"The art of medicine consists in amusing the patient while nature cures the disease." – Voltaire (1694-1778).
"One has a greater sense of intellectual degradation after an interview with a doctor than from any human experience." – Alice James.
"A physician is a person that treats a patient until they die, their money is all gone, or they are cured by nature." – René Descartes, 1596-1650.
"Physicians are like kings, - they brook no contradiction." – John Webster, The Duchess of Malfi, Act V, Scene ii (1623).
"The only difference between a drug addict and the rest of society is the drug." – Krivanek, 1988.
"Doctors have throughout time made fortunes on killing their patients with their cures. The difference in psychiatry is that it is the death of the soul." – R.D. Laing, MD.
"Medical research has made such progress, that there are practically no healthy people any more." – Aldous Huxley.
"Mankind has so far survived all major catastrophes. It will also survive modern medicine." – Gerhard Kocher.
"I am dying with the aid of too many doctors." – Alexander the Great.
"The level of science in psychiatry lies between astrology and witchcraft." – Anon.
"Mystification is the psychiatrist's defense against the danger of being found out." – Leonard Roy Frank
"Psychiatry is to medicine what astrology is to astronomy." – Leonard Roy Frank.
"Half the modern drugs could well be thrown out the window, except that the birds might eat them." – Martin Henry Fisher.
"Be careful about reading health books. You may die of a misprint." – Mark Twain.
"Anyone who goes to a psychiatrist ought to have his head examined." – Samuel Goldwyn.
"The website 'benzo.org.uk' is really outstanding." – Marcin Slysz, Product Manager, Roche Polska.
See also: Quotations Gallery
Doctors & Experts · Prof Heather Ashton
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