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The Tranquilizer Trap

The scandal over benzodiazepines is getting quite different attention in the UK.

Earlier this week, The Times in Britain ran a front-page story on the results of a detailed investigation it had conducted into tranquilizers that Britons and North Americans are known to take in large numbers. “The Tranquilliser Trap: Scandal of 1 million hooked on benzodiazepines” uncovered “the plight of more than a million people [in Britain] addicted to tranquillisers prescribed by their doctor.”

“Doctors are still writing more than 11 million prescriptions a year for ‘benzos’ three decades after being encouraged to curtail their use,” the article begins. “Known by names such as Valium, Ativan and Xanax, they can be valuable in treating the most severe shock or trauma, but, according to current advice, should only be taken for up to four weeks.”

The article—requiring a subscription to the paper—goes on to report: “The Times has spoken to dozens of patients who have taken the tranquilliser for years, enduring shocking side effects. They have told of the harrowing process of trying to wean themselves off a drug considered more addictive than heroin.”

“Many are unable to work or engage with family and friends,” health editor Martin Barrow writes of the patients, and “some have contemplated suicide.” His article not only runs to three pages, but also is rare in detailing the scope and extent of some patients’ suffering while on the medication.

One reports: “The worst symptom is an excrutiating burning sensation as if my nervous system has been attached to an electric socket, sending piercing pain along my spine and to the ends of my fingers and toes.” Another explains: “I was heavily sedated and near-catatonic at my wedding, but tic-free.” The same can’t be said of other patients the Times investigated, and it quotes two drug company reps in full damage control, insisting that the problems arise only when the drugs aren’t taken “as directed.”

But there’s every indication the patients were following the advice of well-meaning doctors who weren’t themselves heeding now-thirty-year-old guidelines about the limited time for which the drugs should be prescribed, when at all. “A women who saw her GP with a minor complaint tells … how her life fell apart,” Barrow writes. She spends her time working at “a helpline for fellow benzo addicts” and “could easily spend all day on the phone, yet more than 1,000 calls go unanswered every month because she does not have the time.”

The Times article not only follows earlier reports in The Independent that Britain’s Medical Research Council sat on warnings from 30 years before that benzodiazepines such as Valium and Xanax can cause brain damage; it also appeared just two days after an interesting but incomplete op-ed in the New York Times on the exact-same crisis, this time offered with less (okay, almost no) pharmacological concern, with more interest in the drugs themselves as seemingly quirky holdovers from the 1960s and 1970s. In “Valium’s Contribution to Our New Normal,” Robin Marantz Henig observes: “When Americans are feeling out of sorts, we are still more likely to turn to anti-anxiety drugs than to any other kind. The leading successor to Valium, Xanax, outsells every other psychiatric drug on the market (48.7 million prescriptions last year). And even Valium is still out there, the classic little-black-dress of tranquilizers. In 2011, 14.7 million prescriptions were written for the drug that first made its cultural mark as a Rolling Stones song (“Mother’s Little Helper”) back in 1966.”

“The classic little-black-dress of tranquilizers”? Isn't that just a fraction casual? Among clichés and untruths, it’s up there with “Bottled Well-Being” (Time, 1980), “Aspirin for the Soul” (Changing Times, 1956), even “Turkish Bath in a Tablet” (Reader's Digest, 1962).

Given the circumstances, Marantz Henig is oddly blithe about the harrowing side effects that benzo patients have reported for years, even as the NYT itself thought to illustrate her article (left) with a woman gradually looking as frazzled as the one who reported, to the British Times, that such medication made her nervous system feel like “a vast swarm stabbing me with fiery stings.”

It’s too easy—obviously mistaken—to view each article as somehow representative of its national culture. Both have important things to say, including that the drugs have partly succeeded in creating “an artificially induced normal” that is poorly understood as such (Marantz Henig). But while such reflection seems very necessary, I can’t help thinking about the “1 million [Britons] hooked on benzodiazepines," as well as their North American counterparts, partly because such people write me regularly with often-harrowing accounts of what they and loved ones have endured on the medication, including while trying to quit it. At such times, we need more articles in the U.S. like that of The Times and The Independent in Britain—more in-depth accounts of this understudied, underreported problem.

In the meantime, for those seeking more information on how to taper benzo treatment slowly and with great care, the best I can do is recommend Dr. Heather Ashton’s detailed advice here, following her extensive study of the drugs over the years.

Update in The Times (October 5, 2012): "Doctor's orders ruined our lives, say 'benzo' addicts." Follow me on Twitter: @christophlane