23rd March 2010 http://www.dailymail.co.uk/health/article-1259892/Thousands-60s-hooked-tranquillisers-turned-virtual-zombies.html
Four times a day, Keith Andrew dutifully swallows the tranquillisers prescribed by his GP.
It's a ritual the 74-year- old has repeated for the past 45 years. 'My wife Joan says these drugs turned me into a zombie, but the truth is I wouldn't know, as I have hardly any memory of the past 40 odd years,' says Keith, a retired electrical engineer.
He was first prescribed tranquilisers - in the form of Valium - in 1965. 'We'd bought a new house to renovate and it had a big garden.
'I became stressed about finding the time to do the work on it as well as my full-time job. It was a change in me, as I wasn't the anxious type.
'The tablets calmed me down at first, but within a few months I began to feel nothing at all - they dulled all my emotions and I withdrew into a shell.
'I lost interest in all my hobbies like watching rugby and gardening.'
His family suffered, too - Keith felt unable to express any feeling towards his two children, David and Catherine.
'Joan did everything for them, I just went to work and fell asleep in a chair when I came home. I then started to have regular panic attacks and insomnia, too, and didn't want to socialise.
'My weight also dropped dramatically within a year, from more than 11st to just 7st 10lbs at my lowest. I was in a terrible state.
'What I didn't realise was that it was the pills I'd been prescribed for anxiety that were actually making me ill.
'My GP put me on repeat prescriptions and didn't mention its side effects. I never connected my symptoms with the pills and thought it was just down to my anxiety and breakdown, so I never thought to mention it to him.'
Keith is one of an estimated 1.5million people in the UK addicted to benzodiazepines, a group of drugs prescribed by GPs for anxiety.
Many of today's addicts are the elderly, a lost generation who were prescribed the drugs decades ago. Some continue to suffer debilitating-side effects as a result of taking the tablets, including feelings of paranoia, lethargy, fatigue, dizziness, and memory and balance problems. Many won't realise the drugs are the problem.
For those who try to give up the withdrawal effects are severe, but unlike addictions to heroin and cocaine, there is virtually no specialist assistance to help them quit.
Indeed, MPs are now so concerned about the lack of help available to these patients they have complained to the Equalities and Human Rights Commission. This is on the basis that they have been discriminated against by not having access to specialist rehabilitation help which users of hard illegal drugs have.
'These people are not drug abusers but victims,' says Jim Dobbin, MP for Rochdale, and chairman of the All Party Group on Involuntary Tranquilliser Addiction. 'Many suffer from side effects, and don't know where to go for help.
'The Department of Health provides no funding for involuntary tranquilliser addiction, with the exception of a handful of cases. We want the Government to recognise the problem and to help people come off these tablets by providing prescription drug withdrawal clinics in every area.'
Benzodiazepines are a group of drugs which include diazepam (previously known as Valium), alprazolam (brand name Xanax), oxazepam (Serax) and lorazepam (Ativan) and chlordiazepoxidex (Librium).
Many have a strong sedative effect, helping to ease the insomnia that often accompanies anxiety, producing drowsiness and slowing down mental activity. They are designed to provide short-term relief, and cannot tackle the underlying causes of anxiety.
In 1988, the UK's Committee for Safety of Medicines issued guidance to GPs advising that benzodiazepines should be prescribed for no more than two to four weeks, because of the high risk of addiction.
Withdrawal help: Dr Arun Ghosh set up a private prescription drug withdrawal clinic - the first of its kind - at Abbey Sefton Hospital, Liverpool
This was confirmed by research published last month by the Universities of Zurich and Geneva which found that anxiety drugs such as Valium and Xanax use the same potentially addictive pathways in the brain as illegal drugs such as heroin.
Although UK benzodiazepine prescriptions have fallen since their peak of 31 million a year in 1979, there were still 10.7 million prescription for the drugs written in 2008.
'There is still work to be done in getting the message across to GPs that benzodiazepines are not the most appropriate treatment for anxiety and sleep problems in many cases,' admits Dr David Baldwin, chairman of the Royal College of Psychiatrist's psychopharmacology group.
'There are better alternatives for treating anxiety such as psychological therapies such as cognitive behavioural therapy.'
'Undoubtedly, some GPs prescribe benzodiazepines too readily and inappropriate prescribing does happen.'
And the problem, as Keith has learned from bitter experience, is that little is being done to tackle this.
Five months after Keith was first prescribed the drugs, he felt well enough to return to work.
His GP said he could have Valium on repeat prescription, says his wife Joan. 'No one mentioned anything about it being addictive - but I suppose they didn't know back then.'
'His character changed, putting a big strain on our relationship, and I admit there were times when I wondered if I should leave. Somehow though, I knew the old Keith was still in there somewhere and I didn't want to desert him.'
In 1979, Joan persuaded her husband to switch GP's practice, where she hoped he'd be weaned off his tablets.
She says: 'Although the practice were sympathetic, they referred him to a psychiatric clinic who switched him to another benzodiazepine called Xanax.
'If anything the side effects - anxiety, restlessness, agitation and agoraphobia were even worse, and an hour after taking his pills he was pacing the room waiting for his next dose.
'We had no idea though, at the time, that his new drugs could be causing these symptoms.'
The couple put up with these problems for years - indeed it wasn't until his symptoms lead to a breakdown in 2007 that Keith was finally told the drugs were the cause of his problems.
Even then help came not from medical staff but a support worker from the Oldham Drug and Alcohol Service.
Joan says: 'She was the first person to mention that the drugs that might be causing his problem - it was also the first time anyone offered him help to come off his prescription in 42 years.'
The first step was to swap from Xanax back to diazepam - which is easier to withdraw from because it is metabolised slower than Xanax, allowing a smooth, gradual fall in drug concentration levels in the blood.
It has taken three years for Keith to gradually reduce his daily dosage from 30mg to 5.5mg.
It's not been easy, he says: 'The withdrawal symptoms - including headaches, agonising stomach pains, problems with swallowing and anxiety have been horrendous.'
Keith is one of the lucky ones - he lives in one of only a few areas in the UK where specialist help is available to help benzodiazepine addicts quit.
Support is often provided by charities - indeed the group that helped Keith, Oldham TRANX, was founded by Barry Haslam, an accountant who suffered long-term brain damage due to benzodiazepine addiction.
Barry was prescribed ativan, librium and Valium for ten years, after suffering anxiety trying to juggle two jobs alongside accountancy exams. He claims they wiped his memory and left him with brain shrinkage, visible on a scan.
Benzodiazepines: Prescriptions have fallen since their peak of 31 million a year in 1979, there were still 10.7 million prescription for the drugs written in 2008
'Benzodiazepines turned me into an angry man. I had felt calmer initially but those effects quickly wore off.
'One Christmas I nearly hit my wife and put my fist in the wall instead.
'In that split second, I realised that my behaviour was so out of character it must be the drugs that were responsible and decided to quit.
'My GP offered me no help, so I slowly reduced my dosage on my own.
'The withdrawal side effects were horrendous. I was violently sick every day and over 15 months I lost 7st - half my body weight.
'I suffered night sweats that were so severe that I had to change the sheets every day and had hallucinations and horrendous nightmares. My skin felt like it was crawling with maggots and I became terrified of going out.
'When I recovered, though, I was determined to help others quit and have been campaigning about the dangers of benzodiazepines for 24 years.
'Every town needs a dedicated clinic to help prescription-drug addicts quit - it is difficult to do alone, and GPs just couldn't cope with the extra workload.
Oldham Primary Care Trust has estimated there are up to 5,000 benzodiazepine addicts in its area alone.'
Another ex-addict now helping other patients is Tess Higham, 80, a former headmistress from Ormskirk, Lancashire. She was prescribed Valium following a breakdown after she was widowed with four children in 1966.
'Initially the drugs made me feel less anxious and well enough to go back to work. But, it seemed my body quickly got used to them and I was soon on higher dosages. Soon I was just put on repeat prescriptions - they literally handed them out like smarties.
'After a while, they lost their effect, and I started to suffer from terrible side effects - although I didn't realise it was the drugs at the time.
'I had constant aches and pains, had no energy and felt no emotion. The worst aspect was the terrible depression I felt. My concentration became so bad, I chose to resign from my teaching job.'
In 1988, Tess asked her GP if she could come off the tablets and she was admitted for a two week withdrawal programme in hospital.
'My consultant just took the "cold turkey" approach of stopping my tablets. The withdrawal symptoms were horrendous - my body was flooded with adrenaline and I barely slept day or night for weeks.
'My head felt as if it was being squeezed in a vice. Once, I suffered a convulsion which was so violent I was later told it could have triggered a heart attack. It was almost two years before all the withdrawal symptoms disappeared.'
Tess joined the Council for Involuntary Tranquilliser Addiction (CITA) a Merseyside-based charity, and worked as a volunteer telephone counsellor.
'I was 60 by the time I got off the drugs, so I tried to encourage others that it's never too late to quit. I'm 80 now, and I've had 20 years of a normal life again.
'People who called the helpline were mostly elderly and deeply ashamed when they realised they were "addicts". Most of them said they had no one else to turn to.
'What I heard time and again was that their GPs had told them it was too much bother to go through withdrawal at their age. Many of them had become agoraphobic - suffering alone at home.'
'GPs are good at putting people on these drugs but not so good at taking them off,' says GP Dr Arun Ghosh, who last year helped set up a private prescription drug withdrawal clinic - the first of its kind - at Abbey Sefton Hospital, Liverpool.
'The biggest users of benzodiazepines are the elderly.
'As a GP, I feel frustrated there is so little assistance for the profession-to help patients quit these drugs.'
The new clinic takes referrals from PCTs all over the country, but Dr Ghosh says it is a drop in the ocean given the scale of the prescription drug addiction problem.
He says: 'Every city needs one of these clinics - we are getting some referrals from PCTs but it's a bit hit and miss. The trouble is, the cost of the drugs is cheap and the cost of getting patients off them at a clinic like ours is high, at around £10,000 per patient for four weeks.
'There just isn't the financial incentive for them to refer to us.'
Royal College of General Practitioner's chairman Professor Steve Field says although benzodiazepine dependence is still a problem, the number of prescriptions has dropped dramatically.
'This is a problem we've known about for a long time and the teaching at medical schools to trainee GPs covers the problems of drug dependency. GPs are increasingly prescribing alternatives for anxiety such as talking therapies, yoga and relaxation techniques.
'The problem is not as bad as it was, but there are still too many benzodiazepine prescriptions issued - it's still not good enough.'
Joan Andrew feels relieved her husband is nearly off benzodiazepines. 'I never thought I'd hear Keith laugh again, but he's got his sense of humour back and he's interested in sport again.
'It's lovely for our children, they never really knew the real Keith. It's not a fairytale ending yet, though - he feels he still has a long way to go.
'I'm angry no doctor or psychiatrist ever suggested Keith should stop taking benzodiazepines. GPs should be more careful about how long they prescribe these drugs.'