Benzodiazepines – Fifty Years of Evidence which Doctors Still Ignore
Dr Vernon Coleman MB ChB DSc FRSA
I first wrote about benzodiazepines in 1973 when I helped organise a symposium on these drugs at the Royal Society of Medicine. I did so on behalf of the British Clinical Journal of which I was, at the time, the executive editor and that was, I believe the first time that benzodiazepines had ever been discussed critically at a medical meeting. The next issue of the British Clinical Journal, later that same year, was largely devoted to an appraisal and critical discussion about benzodiazepines drugs.
Since 1973, I have written hundreds of articles about these drugs, and made scores of television programmes. In the early 1980s, I recorded a series of special radio programmes dealing with benzodiazepine addiction. At the same time, I also wrote and distributed a newsletter on benzodiazepine addiction. At that time my mail from readers was arriving at my home in grey Post Office sacks.
I have dealt with benzodiazepines at some length in a number of my books (notably The Medicine Men (1975), Life Without Tranquillisers (1985), Addicts and Addictions (1986) and The Drugs Myth (1992).
The medical establishment still refuses to accept that these drugs are a real problem and in order to help those still fighting ignorance and prejudice within the medical profession, I have prepared a short analysis of the history of benzodiazepines and a list of some of the evidence which illustrates the size of the problem. The material on the list below is taken from my own books. I have deliberately included only papers published before the early 1980s so as to make clear that this problem was documented long, long ago.
1. The Valium story began in the 1930s when Dr Leo H Sternbach was working as a research assistant at the University of Krakow in Poland. He was investigating benzophenones and heptoxdiazines.
2. Dr Sternbach continued work on these substances in 1954 in the New Jersey laboratories of Hoffman La Roche. The result of his last experiment was called Ro5-0690 and was shelved as of little interest.
3. In 1957, Ro5-0690 was submitted for testing by Roche’s Director of Pharmacological Research and a report was published showing that the drug was a hypnotic, a sedative and a muscle relaxant. It was a new chemical substance.
4. In late 1958, Roche did more tests on the drug and found that it was effective at treating anxiety and tension. The drug was called chlordiazepoxide.
5. On February 24th 1960, the American Food and Drug Administration approved the drug which was launched a few weeks later a Librium.
6. Before the end of 1960 other drug companies, Include Wyeth Laboratories had introduced benzodiazepines of their own.
7. In 1961, a clinical report appeared in the journal Psyschopharmacologia which warned that patients were becoming addicted to chlordiazepoxide.
8. By the early 1960s, GPs were prescribing these drugs for an enormous range of physical and mental problems. It is difficult to think of a medical condition for which benzodiazepines were not prescribed.
9. In 1968, a paper in the Journal of the American Medical Association showed that benzodiazepines caused depression and suicidal thoughts.
10. In 1970 in a book called Discoveries in Biological Psychiatry, edited by Ayd and Blackell, Frank Ayd wrote: ‘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 or expediency’.
11. In 1972, the American Journal of Psychiatry published a paper describing how patients on diazepam had exhibited symptoms which included apprehension, insomnia and depression. The patients had previously been emotionally stable. When the patients were taken off the drugs, their symptoms disappeared.
12. In 1973, I organised a symposium at the Royal Society of Medicine. It was stated that when patients were taken off their benzodiazepines, they often felt much better than they had felt for years. The symposium was organised on behalf of the British Clinical Journal which I was editing. I immediately began writing articles about benzodiazepines for the national press.
13. In 1975, the British Medical Journal published an editorial referring to an article published in the Lancet in 1960 which had reported that a patient taking chordiazepoxide had assaulted his wife – the first sign of aggression in 20 years of marriage.
14. In 1979, the WHO estimated that there were 700 different benzodiazepines on the market. These drugs were the most widely prescribed in the world. It was generally agreed that there was no real difference in any of the drugs – they were all equally effective and equally troublesome.
15. In 1979, the Journal of the Royal Society of Medicine published a report showing that poisoning with tranquillisers and sleeping tablets accounted for 61,000 hospital admissions each year.
16. If you went to see a GP in 1970, you had a better than one in twenty chance that you would come away with a prescription for a benzodiazepine. By 1977, one in five people who were given a prescription was given a prescription for one of these drugs. Among women in the 45 to 59 age group, one in three was given a tranquilliser of some sort.
17. In my first book The Medicine Men (1975) I predicted that doctors would end up trying to wean patients off benzodiazepines.
18. In 1975, three doctors from the Drug Dependence Treatment Center at the Philadelphia VA Hospital, published a paper entitled Misuse and Abuse of Diazepam: An Increasingly Common Medical Problem. The paper referred back to papers published as far back as 1970 which had documented instances of physical addiction to benzodiazepines. The paper concluded: ‘All physicians should know that diazepam abuse and misuse is occurring and careful attention should be given to prescribing, transporting and storing this drug.’
19. In 1979, a psychiatrist testifying to a US Senate health sub-committee claimed that patients could become hooked on diazepam in six weeks. Another witness said it was harder to kick benzodiazepines than to get off heroin. A third witness said that tranquillisers were America’s second biggest addiction problem – after alcoholism.
20. In 1979, the British Medical Journal reported a study involving over 40,000 patients. The paper showed ‘a highly significant association between the use of minor tranquillisers and the risk of a serious road accident’.
21. In 1981, at a meeting of the American Association for the Advancement of Science, it was suggested that diazepam might be linked to cancer. It was argued that women whose breast cancers had developed more quickly had been taking diazepam.
22. In 1982, a British Professor of Psychopharmacology reported that brain scans showed that patients who had been taking diazepam for some years had damaged brains.
23. In 1982, the Journal of Psychology reported that if a patient takes diazepam he won’t be able to remember things he learns while taking the drug unless he takes it again. This discovery had massive implications for those patients taking the drug – and attempting to stop it.
24. In 1982, a report in Digestive Diseases and Sciences showed that diazepam may cause liver damage.
25. In 1983, a report in Drug Reaction Bulletin showed that between 11% and 20% of drivers involved in traffic accidents were taking tranquillisers.
26. A report in Medical Biology in 1982 showed that the calming effect of diazepam is counteracted by caffeine.
27. Between 1964 and 1982, the Committee on Safety of Medicines in London received reports of well over 100 different side effects said to be related to the use of diazepam.
28. In my book Life Without Tranquillisers I wrote: ‘if you are looking for a crutch and you intend to choose between tobacco and the benzodiazepines then you’ll probably be better off choosing tobacco.’
29. In the 1980s, when I was the medical columnist for The Star newspaper I ran a long campaign about benzodiazepines.
30. In 1988, speaking in the House of Commons, the Parliamentary Secretary for Health, introduced stricter controls for benzodiazepines. She said: ‘Dr Vernon Coleman’s articles, to which I refer with approval, raised concern about these important matters’.
Copyright Vernon Coleman
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