BENZODIAZEPINE ADDICTION - AN INTRODUCTION

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BENZODIAZEPINE ADDICTION -

AN INTRODUCTION

 

Dr Reg Peart

 

VOT Newsletter, 1995

 

Although the word dependence is more generally accepted

scientifically, I, like some medical institutions and journals, prefer

the word addiction because it more accurately reflects the nature of

benzodiazepine problems, and because the word dependence (neutral or

nebulous) can and is used to minimise the problems and sweep them

under the carpet. In essence I use both words in a synonymous sense.

 

There are four overwhelming facts to bear in mind when discussing

addiction:

 

1.

 

That ALL mind altering drugs, prescribed or otherwise, have the

potential for addiction: it is only a question of degree.

2.

 

That the individual sensitivity to these drugs is extremely

wide. This is not stressed enough or insufficient account is taken of

this by the medical profession or the drug companies. This aspect has

been known and accepted by support groups for over 50 years, i.e. the

primary consideration is the effect of the drug on the individual.

Other aspects like how much, how often, where, why and when are secondary.

3.

 

That the cause of drug addiction is the interaction between the

body and a drug is obvious but needs stating. Hence the probability of

becoming addicted is largely independent of such factors as race,

colour, creed, intelligence, physical stature, social stature,

profession, gender or sexual orientation etc. Hence factors relating

to pre-morbidity, underlying illness etc., personality defects or

disorders are largely irrelevant. I'll come back to the latter point.

4.

 

Conversely, the pattern in the decline of the addict in

physical, mental, emotional, sociological and spiritual terms is

overwhelmingly similar in a general sense. Of course there are

specific differences due to different drugs and especially their

accessibility or availability.

 

Professor Krivanek, the Director of the Clinical Drug Dept at

Macquarie University, Sydney, Australia, put things in perspective:

the only difference between a drug addict and the rest of society is

the drug.

 

There are many myths about addiction and I would like to quote Dr.

Phelps, who is the Clinical Professor at the Medical School of the

University of Washington and is a self declared recovering addict.

These myths are:

 

1.

 

Addicts are criminals.

2.

 

Only illegal drugs are addictive.

3.

 

Problems, pressure or stress can turn somebody into an addict.

4.

 

Addiction is immoral and addicts have weak characters.

5.

 

Addiction is a psychological problem - belief in this leads to

treatment of peripheral symptoms which doesn't work and both patients

and doctors come to believe the trouble must be in the patient's mind.

6.

 

There are different kinds of addiction - this leads to doctors

differentiating between physical and psychological addiction and

insisting that there are addictive personalities which lead to

addiction. In fact, addiction causes an addictive personality (if

there is such a thing). As is frequently the case for benzo problems

the medical profession puts the cart before the horse. I wonder why

they do not suggest that the diabetic personality causes diabetes, or

the hypoglycaemic personality causes low blood sugar problems.

 

I do not believe the medical profession has more than its fair share

of members with personality disorders, defects or problems. There are

other reasons why it is high in the league of addiction with 5% - 6%

of its members addicted to either prescribed drugs, alcohol or hard

drugs. Indeed some sections of the medical profession have higher

rates e.g. 10% - 12% for anaesthetists in the USA (Aust. Journal of

Addiction).

 

In recent years the World Health Organisation (WHO) has declared:

 

1.

 

33 benzodiazepines as drugs of addiction.

2.

 

That benzo addiction is the second largest addiction after

alcohol in the western world.

3.

 

That the definition of addiction is independent of the drug used.

4.

 

That this addiction (or dependence) syndrome includes seven key

elements:

1.

 

A subjective awareness of compulsion to use a drug(s)

usually during attempts to stop or moderate drug use.

2.

 

A desire to stop use in the face of continued use.

3.

 

A relatively stereotype drug taking habit i.e. a narrowing

in the repertoire of drug taking behaviour.

4.

 

Evidence of neuroadaption (tolerance and withdrawals).

5.

 

Use of the drug to relieve or avoid withdrawal symptoms.

6.

 

The reliance of drug-seeking behaviour relative to other

important priorities.

7.

 

Rapid reinstatement of the symptoms after a period of

abstinence.

5.

 

It is not tenable to consider physical and psychological

dependence as independent aspects (dualism of the brain and mind is an

outdated 19th century concept). Psychological addiction must be

considered in the context of the psychological changes produced by the

drug.

6.

 

That the result of addiction is a complex web of physical,

mental and social problems: all must be considered in any assessment

or diagnosis of addiction and that in general there is a chain of

causation (from the physical to the mental to the sociological).

 

This article is an extract from the talk given by Dr. Peart at the

Bristol Conference. Dr Reg Peart is National Co-ordinator of VOT,

Victims of Tranquillisers.

 

AIMS OF VOT

 

MISSION STATEMENT

 

1.

 

To PROMOTE the awareness of side effects and adverse reactions

caused by tranquillisers and other psychoactive drugs

2.

 

To PROVIDE help, support and information to those who have

suffered medical and legal problems resulting from these drugs

 

VOT was founded in the spring of 1993. The primary aim of VOT was to

act as a lobby pressure group to fight the injustice surrounding

withdrawal of funding of the benzodiazepine litigation and subsequent

dismissal of Legal Aid Certificates by the Legal Aid Board. However,

VOT now sees itself as a medico-legal support group as well as a

pressure lobby group due to the demands of claimants who were

originally suing the benzodiazepine manufacturers with the support of

legal aid and who are now continuing claims as Litigants In Person.

 

VOT also acts in a secondary role as a support group for people

struggling with withdrawal as a result of reduction of drug dosage and

those suffering protracted withdrawal after successful discontinuation

of drugs.

 

VOT aims are:

 

1.

 

To educate about addiction

2.

 

To lobby parliament for recognition of the potential of

medically prescribed drugs to cause irreparable harm to the mental,

physical and social well beings of the individual

3.

 

To seek justice for those individuals whose lives have been

ruined by benzodiazepines

4.

 

To support individuals trying to reduce dosage or to take legal

action

5.

 

To contact groups overseas

6.

 

To keep abreast of research

7.

 

To up-date and inform an already over-worked medical profession

of potential and actual drug problems

8.

 

To provide contacts for isolated members

9.

 

To contact other action groups for prescribed drugs and other

medical problems e.g. Thalidomide, Septrin and ECT

 

VOT

Victims of Tranquillisers

Flat 9, Vale Lodge, Vale Road,

Bournemouth, BH1 3SY,

England, United Kingdom

Telephone / Fax : 01202-311689

 

National Coordinator:

Dr RF Peart, BSc, PhD

 

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