Mother's Little Helper
5 February 1984
LAST YEAR Hoffmann-La Roche sued the authors of a J,ook called Stopping Valium. The book brought together much of the bad news about the benzodiazepine group of drugs - of which Valium is the Big Daddy. But that was not what Hoffmann-La Roche were objecting to. No, their action was against the authors’ use of the Valium trade mark in the book. In the end Roche lost their case because the authors were able to prove that Valium has become to minor tranquillisers what Hoover has become to vacuum cleaners.
Valium is the most profitable drug in history and enjoys an entry in the Guinness Book of Records as the most widely prescribed drug in the world. Along with its less famous cousins in the benzodiazepine family, it is prescribed principally to alleviate anxiety. In 1980 nearly 40 million prescriptions for these drugs were written by family doctors alone in the UK, at a cost to the National Health Service of almost $45 million. Every year 14 per cent of the adult population in the UK take a benzodiazepine, either as a sleeping pill or a tranquilliser.
According to one study, 1.5 per cent of adults in the UK have been taking one of the benzodiazepines for a year or longer. A quarter of a million people have been on them for five years or more. And there are thousands of people who have been on these drugs continually for periods of up to 15 years.
The figures are even worse in the US, where at least one third of adults have had at least one prescription for one of the minor tranquilisers and where the National Council for Drug Abuse dubbed Valium the ‘most abused drug in the US’.
A report in the British Medical Journal in November last year showed that people taking this group of drugs were between five and nine times more likely to be involved in accidents at work. National statistics for traffic accidents have yet to be obtained, but someone well within the breathalyser limit for alcohol can be dangerously incapable if they have also taken a dose of Valium. And in the US, the Drug Enforcement Administration has reported that Valium is more often involved in drug-related deaths and emergencies than heroin, marijuana or alcohol put together.
Apart from the danger of overdose and accident, many other ‘side’ effects are commonly associated with taking minor tranquillisers. These include apathy, low blood pressure, lack of co-ordination, impaired intellectual functioning, giddiness, loss of weight and impaired skills. More rarely these drugs have been linked with violent outbursts. One study suggested a link between baby battering and consumption of minor tranquillisers. And another suggested the long term use may cause atrophy of the brain. A further study of 19,000 live births in the US found that birth defects were five times higher in babies whose mothers had been taking these drugs during pregnancy.
Elderly people are particularly vulnerable to the effects of these drugs. According to the British Medical Journal elderly people are more likely to be prescribed these drugs and much more prone to serious and distressing side effects. Even more worrying is evidence that elderly people on drugs like Valium are likely to be labelled senile when their ‘senility’ could easily be reversed by stopping the drug. One Scandinavian study found that one-third of old people admitted to psycho-geriatric units suffering from confusion were simply exhibiting the side effects of their psychoactive medication.
So are the side effects worth it? Unfortunately the evidence is that the benzodiazepans only work in the very short term. Those products marketed as tranquillisers - like Valium, Ativan, Tensium - only relieve anxiety for up to about four months. And those marketed as sleeping pills - like Mogadon, Dalmane, Nitrados - are only effective for between three and 12 days.
The effects on the mind may be relatively short-lived. But the effects on the body linger on and on - only to be banished by further doses of the same drug. So, in a very short time the only point in taking the drug is to keep withdrawal symptoms at bay. (See box) And there is now an extensive literature proving that people become addicted to these drugs even when taking them in accordance with their doctors’ instructions.
There is something particularly tragic about addiction to a drug which appears to have no long-term benefit. When I ran a telephone advice service on the BBC’s Radio London a distressingly large number of calls I received were from people - usually women - who had been taking one of a variety of benzodiazepine drugs for many years without, it seemed, any pleasant long-term effects whatsoever.
Today there is a growing awareness amongst doctors and the general public that drugs like Valium have been over prescribed. Whether that awareness will ultimately lead ‘us towards non-chemical means to deal with the apparent epidemic of unhappiness, anxiety and stress which seems to be engulfing the Western World is open to considerable doubt. The consumption of alcohol rises all the time as does alcohol addiction. Glue sniffing appears to be reaching epidemic proportions. The use of heroin is rising. The sales of psychoactive drugs, both legal and illegal, continue to generate enormous profits for those who sell them.
Perhaps the hopeful sign in the West is that tobacco consumption is falling. But good news in the developed world is bad news for the Third World. The tobacco industry has increasingly switched its marketing towards the Third World where cigarette smoking is increasing. If we in the West do begin to consume less mood-altering drugs, there seems little doubt that our prosperous and vigorous pharmaceutical industry will direct its sales efforts toward the Third World.
But if these matters make us in the developed world too anxious there is always Evacalm, Valium, Atensine, Diazepam, Valrelease, Diaxemuls and Solis to name but one. And if we have too many sleepless nights we can try Mogodon, Remnos, Nitrados, Somnite or Somnased to name but one again. To paraphrase Henry Ford, we can have any minor tranquilliser or sleeping pill we like as long as it is a benzodiazepine. And if that doesn’t do the trick there are always the antidepressants. So there’s really no cause to worry, is there?
Ron Lacey is Social Work Advisor for MIND.