The NHS must help blameless victims

T He woman in front of me was a drug addict and desperate for her next fix. Wide- eyed, her hands shaking, she pleaded with me to help her. She couldn’t go on like this, she said.

We tend to think of drug addicts as pale, thin youngsters injecting or smoking heroin or crack. Drug addicts are people who live in hostels or on park benches and beg on the street.

Yet this woman was in her late 60s. She’d had a successful career with an accountancy firm. She was married with two grown-up children, owned her own home, cared for her elderly mother, swam regularly and had an allotment.

But while she might not have fitted the typical image of a drug addict, that’s what she was.

The important difference was that rather getting her drugs from a drug dealer, she got them from her doctor. She was one of the tens of thousands of people who have become addicted to prescription medication.

Twenty-five years ago, after a series of stressful life events when her father died, her husband’s business failed and her daughter had a health scare, she was prescribed diazepam. She is still taking it.

This drug, previously marketed as Valium, is a benzodiazepine; one of a group of tranquilliser medications prescribed to reduce anxiety symptoms and help people relax.

once marketed as a panacea, they are far from it. In fact, these drugs have left a trail of ruined lives. While they can be useful in the very short term — no more than a few days — too often people are given repeat prescriptions for months, even years.

The problem is they are highly addictive. Former drug addicts have told me they are far harder to get off than heroin.

Indeed, many refer to detoxing from them as a ‘die-tox’ because the symptoms — including insomnia, violent shaking, hallucinations, crippling anxiety and panic attacks — are so bad that people feel they are dying.

In a tragic twist, when they stop taking them, their initial anxiety typically returns, but far worse than before, known as ‘rebound anxiety’. For some, this worsened anxiety becomes permanent.

People also develop a tolerance, meaning they need more and more to have the same effect.

I hate this group of medicines — or rather, the way they are all too easily dished out — because I have spent years working in drug dependency clinics and seen at first hand the misery they cause.

Yet these addicted patients are poorly served by the nHS system, which focuses on illicit drugs.

As prescription drugs are given out by a doctor, they are not associated with crime — unlike, say, heroin.

And as those addicted to benzodiazepines and prescription opiate painkillers are often able to function from day to day, they are not considered a priority in the same way as alcoholics.

Patients with prescription drug addiction are ignored or sent to outpatient drug dependency units for detox. Yet these places are set up primarily to deal with heroin and crack use.

The situation is made worse by the way these specialist drug services are set up and paid for. They need to be commissioned by the local health authority.

In one service I worked for, the commissioners hadn’t bothered to set up a contract with the benzodiazepine addiction clinic, so eventually the unit refused to see patients because they weren’t being paid. The patients were distraught, but we had to direct them back to their GPs. YeT

GPs are given little, if any, training in how to manage this form of addiction. I would often see patients unsuccessfully detoxed from a benzodiazepine prescription by their GP. on questioning, I would find they had been tapered off the drugs as much as ten times too fast.

We have known about the problems with these drugs for years. It is truly shocking that they are still being prescribed so readily, especially as 17 organisations, including the Royal College of Psychiatrists, the Royal College of GPs and the Department of Health, have produced a statement warning doctors not to prescribe them if possible.

Despite working in mental health for more than a decade, I have only prescribed them a handful of times. The far safer — and more reliable — option for anxiety and sleep problems is psychotherapy, but, of course, this is costly and time-consuming.

But a bit of money and time spent at the beginning could save a lot of grief and heartache later.

The situation is not much better for prescription opiate painkillers such as tramadol, which are also addictive for some.

Again, there are no specialist services for such patients, so they are managed by GPs or sent to drug dependency units where the only option is to switch to methadone, another opiate used for heroin addiction. Patients must then come in daily to receive the drug, which they often struggle to fit in with work.

Why is it like this? I think a large part is that doctors feel ashamed patients are hooked on medications they have prescribed, so they avoid discussing it.

GPs reach too readily for the prescription pad when patients have psychological issues.

As these patients don’t look like homeless, destitute drug addicts, they may be seen as not really having a problem. With benzodiazepines they are often older women who are less likely to make a fuss, so they are ignored.

There is also a sense that anyone addicted to these drugs should just be able to stop.

With only a handful of organisations and local charities offering these innocent victims any help, the Mail is campaigning for a 24hour national helpline to support them. It’s the very least the nHS — which helped create these addicts — could do.