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Good Health: Keeping you and your family well
Janet WATERTON does not look like a drug addict, but her doctors turned her into one. In 1992, the medical records clerk from Bude in Cornwall was prescribed a type of drug known as benzodiazepine for her hip pain.
there are 12 million prescriptions for ‘benzos’ — common brand names include Xanax and Restoril — every year.
the drugs, which also include diazepam (formerly marketed as valium and known as ‘mother’s little helper’), are used to treat severe anxiety and nervousness.
they work by depressing a part of the brain responsible for controlling consciousness and have a strong tranquillising and sedating effect.
and they are used as a muscle relaxant to treat pain, which is why Janet, a 62-yearold mother of two married to edgar, 66, a retired mechanic, was prescribed them.
the problem is the brain soon becomes tolerant to the drug, so patients need higher doses to get the same effect. they are also addictive, so are meant to be prescribed for only two to four weeks.
But the withdrawal effects have been described as worse than coming off heroin and include muscle spasms, panic attacks, nightmares and insomnia.
and side-effects can include depression, insomnia, anxiety and depression.
this leaves patients caught in a trap: they can’t come off the drugs, but staying on them leaves them feeling ghastly and often unable to function normally.
Janet spent 13 years on benzodiazepines and, she recalls, the experience was terrible. the drugs made her feel ‘like a zombie’ and she lost three stone, ending up at just seven stone. ‘I looked like a bag of bones,’ she says.
She spent most of those years ‘rotting in bed — I just wanted to lie there with the curtains shut’.
Over two years, Janet tried to reduce her dose with help from her GP. after 11 years on the drugs, Janet paid £7,500 from her savings — money she could ill afford — to go into a private drugs detox unit.
During the detox she suffered terrifying withdrawal symptoms including electric shock sensations in her brain, insomnia and sweats, only to be re-prescribed the drugs by a psychiatrist two years later.
‘at the time I wanted to go back on them again as I was feeling anxious and wasn’t sleeping,’ says Janet.
It took another detox in a private hospital in 2010 to get her off the drugs, with the £22,000 cost paid by her husband edgar’s pension lump sum.
Last December, Janet received a £200,000 settlement from Devon Partnership NHS trust for being prescribed benzodiazepines a second time when she had a known problem with the drugs and been through detox.
‘nothing can compensate me for the hell I’ve been through,’ she says. ‘I still suffer from insomnia, pins and needles and electric shock-like pain.
‘People like me need a dedicated service to help them come off benzodiazepines and we shouldn’t have to use our life savings and pensions to pay for it.’
‘BENZOS MADE ME FEEL SUICIDAL’
THERE are many more stories like Janet’s. Claire Hanley was prescribed Xanax for anxiety after she landed a high-flying job at the european Parliament.
‘all I’d said to my GP was that I was a bit worried about getting everything right in my new job as a parliamentary assistant,’ says Claire, 38, who lives in twyford, Hampshire.
‘I wasn’t even that anxious, but he said they would really help me cope. the GP who prescribed the pills said they were harmless.’
Far from easing anxiety, Claire says that within days they made her more anxious. She also started suffering from panic attacks and insomnia, and became depressed.
after a few weeks, she tried to take her own life with an overdose — one of many suicide attempts over 13 years on the pills.
Claire couldn’t sleep, had muscle pain and developed knee problems that affected her walking. ‘When I asked doctors what was happening to me, they said I had a mental illness and I believed them,’ she says. ‘I had to quit my job after a year.’
On her return to england, her GP simply switched her to other benzodiazepines, increasing the dosage. ‘there was never any discussion about me coming off them,’ she says.
‘at the time I just thought I was going crazy. It didn’t enter my head that the tablets I’d been prescribed for anxiety could be causing all the new symptoms I was suffering.’ there are at least 260,000 people in Britain who, like Janet and Claire, are being prescribed benzodiazepines for six months or more.
Many of them are taking the drugs for years, according to a new study published by Dr James Davies of the University of Roehampton. He has suggested this was likely to be a conservative estimate — previous estimates put the number of people addicted to prescription benzodiazepines at a million or more.
For decades, patient groups, addiction charities and experts have warned about the over-use of benzodiazepines, with calls to provide specialist help for patients to come off them to be provided on the NHS.
they’ve also called for doctors to change prescribing habits. Such calls have been largely ignored.
PATIENTS TREATED LIKE DRUG ADDICTS
PROFESSOR Malcolm Lader, a psycho-pharmacologist from King’s College London, identified so-called benzo dependency syndrome — where patients develop dependence even at lower doses and when taking the drug as prescribed.
He started campaigning in the Seventies and says he has been trying to get the NHS to do something about it ever since, but has met a brick wall.
Professor Heather ashton, from newcastle University, devised a protocol to help patients come off the drugs gently — the ashton Manual — and set up the first NHS benzodiazepine withdrawal clinic. But it is one of just a handful of such centres.
If patients get referred for treatment at all, they can end up being sent to drug dependency services for illegal drugs.
Patients feel that when they do go to the doctor, ‘they are blamed for being in that position’, says Dr andrew Green of the British Medical association (BMA).
Following a two-year consultation with patient groups, the BMA has finally acknowledged the scale of the problem.
It is calling for a national helpline and specialist support services to help patients who are hooked on benzodiazepines and other prescription medicines.
Dr Green admits the BMA had realised there was a problem with benzodiazepines for ‘quite a long time’. He adds: ‘But until this consultation exercise, what we didn’t realise was the scale of the problem or the depth of feeling it causes in those affected.
‘Patients feel let down by the NHS and say the services are not there for them.’ Professor Maureen Baker, chair of the Royal College of GPs, supports the BMA’s call for a helpline and dedicated withdrawal services.
She suggests the drugs should be prescribed long-term only ‘in
exceptional circumstances’ — for example, in patients with chronic anxiety under psychiatric care.
However, she also puts the blame partly with patients. ‘Benzodiazepines are highly addictive and when doctors prescribe appropriately, the drugs are far too easily available over the internet once the prescribed course has ended.
‘This is dangerous as withdrawal from benzodiazepines requires careful management by healthcare professionals, which isn’t possible when access to drugs is driven underground.’
Professor Lader dismissed the BMA’s announcement as ‘too little, too late’.
He says the problem is not theirs, but the NHS’s, and the root lies with ‘the GPs — they just won’t listen’. He has called for pharmacists to be given legal powers to challenge GP prescribing decisions.
‘GPs won’t like it, of course. They think they are god incarnate, but pharmacists could play a role as information specialists,’ he says.
‘There should be an automatic stop on prescribing these drugs at three months and pharmacists could be the first line of defence.’
He also says more hands-on treatments should be available within GP surgeries as an alternative to drugs, including early access to cognitive behavioural therapy (CBT) and relaxation techniques.
Meanwhile, patients are taking matters into their own hands, with a growing number of those prescribed benzodiazepines long-term taking legal action against their doctors and seeking compensation.
Oliver Thorne, of Slee Blackwell Solicitors, Barnstaple, who represented Janet Waterton, explained that patients are being prescribed these drugs by NHS clinicians and becoming addicted through no fault of their own.
‘There is no provision within the NHS to address this problem,’ says Mr Thorne. ‘So patients end up having to try to pay for treatment out of their own pocket for a problem that wasn’t of their making,’ he says.
£1.35 MILLION FOR 19 YEARS OF SUFFERING
LUKE MONTAGU, the Viscount Hinchingbrooke, 46, battled benzodiazepine dependence for years after being prescribed them following a sinus operation when he was 19.
He’d had a reaction to antidepressants given after the surgery, which left him feeling ‘wired’ and suffering from insomnia.
‘So I was then prescribed benzos to help me sleep,’ he says. For the next 19 years he was prescribed a combination of drugs, including the benzodiazepine clonazepam, until he eventually came off them in a private clinic seven years ago.
‘Withdrawal from benzos is the most horrific thing I’ve been through in my life,’ he told Good Health.
‘For the first few years after I came off the drugs I couldn’t function at all and was stuck at home unable to work. I suffered from memory loss, pins and needles, extreme agitation and insomnia. Even now I’ve been left with permanent nerve pain.’
He has since received a £1.35 million out-ofcourt settlement from his doctor.
Lord Hinchingbrooke, founder of the Council for Evidence-based Psychiatry, which campaigns for responsible prescribing, says that the over-prescription of benzodiazepines is ‘a national disgrace — and it’s shocking it’s taken the medical profession this long to act’.
‘We’ve had promises from successive public health ministers, but then they’d get reshuffled and nothing would get done.’ He said he hoped the BMA step was a mea
culpa moment for the medical profession to come forward and acknowledge there was a problem of their own making.
In March, Claire Hanley started reducing her dose and is considering legal action against her doctors.
‘To be honest, all I really needed was someone to talk to,’ she says. ‘I believe these drugs robbed me of the prime of my life. I haven’t married or had children and still struggle to get out of bed some days.
‘The benzodiazepine scandal is on the same scale as thalidomide except no one can see the damage that has been done to us.
‘Our bodies and minds have become our own personal torture chamber and we are going through hell.’