http://www.benzo.org.uk/gadsby.htm
BENZODIAZEPINE AWARENESS NETWORK INTERNATIONAL
PRESENTS
Joan E. Gadsby
Benzodiazepines -
Time for Action
and Accountability!
(Tranquillizers and Sleeping pills)
An Integrated Approach to Positive
Partnership Solutions
to a Long Standing Serious Worldwide Health Epidemic
PRESENTATION TO "BEAT THE BENZOS" CONFERENCE
Croydon, England · November 1 - 2, 2000
© Copyright Joan E. Gadsby
October 27, 2000
Key:
Abstract ·
Common Benzos ·
Adverse Side Effects ·
Some Facts ·
Cognitive Impairment
· Call To Action ·
Benzo Milestones ·
Resolution to Canadian Govt
· Where do we go from here?
· Women's Mental Health
· Biography
Joan Gadsby · October 27, 2000
There are several excellent websites dedicated to the
problems associated with benzodiazepines:
To join the benzodiazepine withdrawal email support group go to:
ADVERSE SIDE EFFECTS OF
TRANQUILLIZERS AND
SLEEPING PILLS (Short and Long term)
SOME FACTS ON DRUGS AND
BENZODIAZEPINES
IN PARTICULAR
-
Canadians swallow more than $6 billion in prescription drugs each year.
-
Estimated health care costs of inappropriate prescriptions exceed $ 2.56 billion a year in Canada.
-
Prescription Drugs now exceed the cost of physician services in Canada.
-
Non "psychiatric" conditions account for 70% of benzo users.
-
43% of emergency room suicide attempts or overdoses involve tranquillizers and sleeping pills.
-
68% of people prescribed benzos receive their prescriptions from only one doctor.
Joan Gadsby · October 27, 2000
COGNITIVE IMPAIRMENT
RESEARCH:
BENZODIAZEPINES
(TRANQUILLIZERS & SLEEPING PILLS)
1987 "Sedative Hypnotic Dependence: Neuropsychological Changes and Clinical Course";
Results: Neuropsychological impairment has been observed not only in
connection with abuse or dependence, but also in long-term users showing no
signs of abuse or dependence. Impairment seems to be present even after a
period of abstinence.
1988 "Psychophysiology and Anxiety - Current Issues and
Trends"; S. Levander; Pharmacological Treatment of Anxiety, National Board
of Health and Welfare, Drug Information Committee, Sweden, 1; 43-51. Results: Treatment with benzodiazepines may have negative
therapeutic longtime effects, and may induce neuropsychological impairment,
which in the worst case may be permanent. 1988 "Cognitive Impairment in Long Term Benzodiazepine
Users"; Susan Golombok et al; Psychological Medicine, 18, 365-374, United
Kingdom. Results: Patients taking high doses of benzodiazepines
for long periods of time perform poorly on tasks involving visual-spatial
ability and sustained attention. This is consistent with deficits in
posterior cortical cognitive function. This implies that these patients are
not functioning well in every day life and that they are not aware of their
reduced ability. Further only after withdrawal do they realize that they
have been functioning below par. 1989 "Dependence on Sedative-Hypnotics:
Neuropsychological Impairment, Field Dependence and Clinical Course in a
5-Year Follow-Up Study." H. Bergman, S. Borg et al; British Journal of
Addiction 1989; 84: 547-553. Results: Despite some neuropsychological improvement,
cerebral disorder diagnosed in a group of3O patients who had been
hospitalized 4-6 years earlier is often permanent through the years with
neuropsychological status linked to long term prognosis. 1991 "Protracted Withdrawal Syndromes from
Benzodiazepines." H. Ashton;
Journal of Substance Abuse Treatment; 8:19-28. Results: Benzodiazepines may occasionally cause permanent
or only slowly reversible brain damage. 1993 "Learning and Memory Impairment in Older,
Detoxified, Benzodiazepine-Dependent Patients"; Mayo Clinic Proceedings
68:731-737. Results: A neurological study in which twenty deto4fied,
benzodiazepine-dependent patients were matched with twenty detoxified,
alcohol-dependent patients, along with twenty-two control subjects from a
community sample showed that the benzodiazepine group had "significantly
lower" scores on auditory-verbal learning tests. Most investigators believed
that use of a combination of benzodiazepines had a "cumulative effect on
memory" which "did not necessarily diminish with time". 1993 "Drug-Induced Cognitive Impairment"; Drugs and Aging
3(4): 349-357. Results: Drug-induced cognitive impairment is a common
cause of delirium and is frequently a confounding factor in dementia...
sedatives such as benzodiazepines have a particularly high risk of cognitive
impairment... 1994 "Lack of Cognitive Recovery Following Withdrawal
from Long Term Benzodiazepine Use"; P.R. Tata, Psychological Medicine 24,
202-213. Results: Twenty-one patients with significant long-term
therapeutic benzodiazepine use were given psychometric tests of cognitive
function, pre- and post-withdrawal and at 6 months follow-up. The results
demonstrated significant impairment in patients in verbal learning and
memory, psychomotor, visuo-motor and visuo-conceptual abilities, compared
with controls, at all three time points. Despite practice effects, no
evidence of immediate recovery of cognitive function following
benzodiazepine withdrawal was found Modest recovery of certain deficits
emerged at 6 months follow-up in the benzodiazepine group, but this remained
significantly below the equivalent control performance. 1995 "Neuropsychological Changes During Steady State Drug
Use, Withdrawal and Abstinence in Primary Benzodiazepine Dependent
Patients"; U. Tonne et al, Acta Psychiatry; Scandinavia, 91, 299-304; 1995. Results: Impairment on neuropsychological tests during
steady-state drug use and withdrawal, and after discontinuation of
benzodiazepines, was studied in primary benzodiazepine-dependent patients.
This study confirmed earlier observations of neuropsychological deficits in
long-term benzodiazepine-using patients and demonstrated that these changes
are "partly" reversible by discontinuing drug intake. 1996 "Intellectual Impairment and Acquired Intellectual
Deterioration in Sedative/Hypnotic Drug Dependent Patients"; Department of
Psychology and Psychiatric Clinic at Stockholm University, Sweden. Results: Every second patient dependent on
sedative/hypnotic drugs showed signs of intellectual impairment... The
general test profile indicated an acquired intellectual deterioration. Obstacles to
Getting the Benzodiazepine Obstacle 1: Lots of
studies, little action. Solution 1:
Redirection of research funding toward action-oriented strategies, including
professional help and supervision for chemically dependent persons, public
awareness and education campaigns targeting doctors and consumers; i.e.,
through media, conferences, brochures, product inserts, pill hotline, etc. Obstacle 2:
Prescribing guidelines are not being followed; i.e., CPS, CMA, HPB, Drug
Formulary, Therapeutics Initiative. Solution 2:
Recognition and acknowledgment of established guidelines by doctors, their
regulatory bodies, the Health Protection Branch (HPB). Enforcement of
guidelines through mandatory monitoring of doctors prescribing practices by
the Colleges of Physicians and Surgeons. Disciplinary measures and mandatory
education for doctors who do not follow guidelines. Use of independent,
objective health watchdog organizations (i.e., Therapeutics Initiative).
Maximum utilization of PharmaNet program and warning letters from the HPB to
doctors. Obstacle 3:
Doctors' lack of ongoing education. Solution 3:
Compulsory educational upgrading of doctors (including testing) based on
research findings replacing outdated drug treatments. Better education
strategies from the College of Physicians and Surgeons, the CMA, and
Pharmacare to encourage awareness and compliance, i.e. academic detailing. Obstacle 4: Lack of
legal accountability. Solution 4: The
development of government policy to assist those seeking restitution for
medical malpractice associated with inappropriate prescribing; i.e.,
specific legal action fund with mandatory contributions by pharmaceutical
companies and doctors - also utilizing fines levied against offending
doctors. Legislation to ensure that health care practitioners are held
accountable for improper prescribing. Obstacle 5: Lack of
objective information provided the consumer. Solution 5:
Mandatory product labeling and package inserts for prescription drugs with
full disclosure of all potential side effects, dangers of long-term use, the
intense withdrawal reactions associated and cognitive impairment with benzos;
i.e., European system. Awareness building and educational initiatives; i.e.,
use of media, brochures. Government regulations on pharmaceutical
advertising targeting doctors and consumers. Expansion of drug store role
re: warnings with prescriptions; i.e., Shoppers Drug Mart model. Obstacle 6:
Incentive for pharmacists to follow up questionable prescriptions. Solution 6:
Incentive-oriented government initiatives which reward the implementation of
flagging systems in pharmacies; i.e., B.C. Pharmacare program doubling
pharmacists' dispensing fee for successful prescription intervention (after
contacting the prescribing doctor). Obstacle 7: High
demand for the drugs due to doctor-induced chemical dependency; lack of
alternatives for patients. Solution 7: Provide
health care coverage for psychologists (not just drug-oriented
psychiatrists). Multifaceted educational process encouraging doctors to
counsel re: whole health factors - lifestyle/diet/exercise; provide
information, support and referrals to addiction specialists, detox
facilities, naturopathic physicians, and community support and activity
programs. Obstacle 8: Lack of
infrastructure, skill and knowledge surrounding safe withdrawal. Solution 8:
Education drives targeting doctors geared to better identification and
recognition of benzodiazepine dependency, short- and long-term withdrawal
syndrome, the dangers of sudden withdrawal. Need for well-trained doctors to
provide medical supervision Explore UK model: doctors sending letters and
information to patients at risk. Create accessible infrastructure for safe,
supervised withdrawal; i.e., insured detox centres, (percentage of
pharmaceutical sales/profits to be allocated to set up infrastructure);
systemic acknowledgment. Obstacle 9:
Minimization and denial of the problem by government, drug companies,
doctors. Solution 9: Create
awareness of socio-economic costs of drug dependent patients to the health
care system, justice system, productivity and safety in the workplace, and
road safety; i.e., car accidents. Encourage transition toward redirection of
monies supporting current chemical dependency and its complications to
strategies addressing and alleviating the problem. Obstacle 10:
Industry education is often led by those who will profit from excessive
prescribing; i.e., drug manufacturers. Solution 10:
Provide and require issue of continually updated, objective prescribing
guidelines from impartial regulatory bodies not profiting from the promotion
of prescription drugs; i.e., CMA, Health Protection Branch, Therapeutics
Initiative. Strict controls and independent approval of advertising, product
literature. Expand BC's "academic detailing" program nationally. Obstacle 11:
Conflicting relationship between profit-motivated drug companies and
research and development funding. Solution 11: People
before profit. Guidelines, conflict of interest regulations and code of
ethics set for allocating drug manufacturers' contributions to research at
Universities and for clinical trials to protect the public's health.
Independent body directing research dollars. Well publicized and audited
clinical trials fully accessible to the public. Obstacle 12:
Government's reliance on drug profits encourages drug-based health care -
resulting in lack of insured alternatives not producing profit. Solution 12:
Acknowledge falsely economical "quick-fix" of drug treatments for normal
emotional responses. Progressive systemic change encouraging human approach
to wellness with long-term benefits. Provide insured alternatives: i.e.,
psychologists - allowing patients to avoid unnecessary, damaging drug
therapies promoted by drug companies and doctors. Investigation of
alternatives offered by naturopathic doctors and other holistic
practitioners. Obstacle 13: Lack
of financial resources to rectify the problem. Solution 13: Expose
the waste of money linked to long-term benzo dependency; i.e., doctor's
office visits, emergency services etc versus the short-term cost of
assisting in recovery. Initiate the redirection of money by reducing
consumption. Prevention equals savings. Obstacle 14: Lack
of coordinated, integrated effort by key stakeholders: doctors, pharmacists,
pharmaceutical companies, academia, consumers. Lack of leadership and
commitment. Solution 14:
Legislative, regulatory acknowledgment encouraging open communication
between stakeholder groups focusing on prevention education and consumer
protection. A central information/advocacy centre with an integrated
approach to positive solutions Leadership and commitment. Joan Gadsby · October 27, 2000 Recommended
Resolution to Canadian Government Whereas the benzodiazepine family of
pharmaceuticals include powerful tranquillizers and sleeping pills which are
meant to be carefully controlled by prescription: Whereas the side effects of
benzodiazepines include: potentially irreversible cognitive impairment (e.g.
dementia, delirium, induced amnesia, memory loss, impaired concentration,
judgment, and decision making); uncontrollable behaviour and paradoxical
reactions (e.g. violence, paranoia, rage, disinhibition); psychomotor
impairment (e.g. loss of ability to coordinate motor functions, dizziness,
blurred vision, impaired spatial awareness); psychiatric symptoms (e.g.
depression, psychosis, suicidal ideation and thoughts); and other symptoms
(e.g. sensory, deprivation; emotional anaesthesia, unintentional overdoses,
risk of congenital malformations in pregnancy and floppy baby syndrome: Whereas benzodiazepines are highly
addictive and withdrawal symptoms can be protracted for months and serious
(e.g. panic attacks, paranoia, depersonalization, depression, agoraphobia,
hallucinations, seizures and sometimes death): Whereas benzodiazepines have become
chronically overprescribed in Canada for the past 2 decades to an alarming
10% to 15% of the general population and up to 30% of seniors: Whereas benzodiazepines are often not only
(a) prescribed capriciously and inappropriately, but are also (b) prescribed
long term for years despite their intended short term or intermittent use
(e.g. 2-4 weeks is stipulated in guidelines dating back to the 1970's and
1980's and 7-10 days by Health Canada) and (c) without full disclosure to
patients of their deleterious short and long term side effects: Whereas the continued indiscriminate
prescription and use of benzodiazepines cause not only irreparable damage to
the lives of Canadians, but also well documented harm to the health of the
nation, loss to the economy and costs to the health care system including
health and safety in the work place, career devastation, family dysfunction,
productivity losses, insurance claims, car accidents, falls, lost years of
peoples lives, lost lives, costs to the legal and justice system, workers'
compensation board claims, social welfare costs, emergency admissions,
physicians' fees, pharmacists' fees, increasing drug costs and detox
facilities: Whereas neither Health Canada nor the
medical profession nor the pharmaceutical industry at large have taken
adequate steps to stem the misprescribing and use of benzodiazepines or to
properly inform Canadians of the perils of these drugs: Be it resolved that the BCWLC urge the
federal government collectively and the Minister of Health specifically to
call for a National Public Inquiry and series of nation wide hearings into
the prescribing and use of benzodiazepines to assess the damage caused by
these drugs; to develop a national strategic action plan to address their
indiscriminate or inappropriate prescription; to create an awareness program
to educate the public and medical profession about their side effects and
dangers; and to establish accountability when they are prescribed without
due care and contrary to established short term guidelines. Note: To the above resolution can be
added: 1. To obtain financial compensation
for personal injury from benzo addiction. To provide financial support for
treatment programs and patient withdrawal groups. To obtain funding for research into
long term damage (particularly cognitive impairment) caused by benzos. Joan Gadsby · October 27, 2000
"BEAT THE BENZOS" CONFERENCE Joan Gadsby CLASS ACTION LAWSUITS. MEDIA PUBLICITY. USE OF POLITICAL SYSTEM. IDENTIFY "CHAMPIONS" AMONGST
BUREAUCRATS. USE OF INTERNET AND WEBSITES. FORMATION OF INTERNATIONAL BENZO
AWARENESS NETWORK WITH LINKS TO OTHER BENZO GROUPS. TAKE BENZO ISSUE TO THE WORLD HEALTH
ORGANIZATION AND TO THE UNITED NATIONS. SHARE KNOWLEDGE OF LEGAL SYSTEM -
issues to overcome, i.e. what was known, when, lack of informed consent,
standard of care (where 2 bodies of opinion exist such as Canada) errors
in judgment, determination of negligence. Cataloguing of successful
lawsuits where and how achieved throughout the world. Settlements out of
court etc. MULTI STAKEHOLDER FOCUSED STRATEGIC
ACTION PLAN - private/public sector partnerships and non-profit
organizations. PRESENTATIONS, PUBLIC SPEAKING -
Opportunities at conferences, to stakeholders, to governments. STRONG LOBBYING OF MEDICAL GROUPS -
Associations, Addiction Specialists, Disciplinary medical bodies,
Colleges of Family Physicians etc. FORMATION OF "EXPERTS" COMMITTEE GROUP
on benzos from all related disciplines including survivors. CONTACT WITH UNIVERSITIES, COLLEGES -
Involved with medical education (new doctors and for continuing
education). RAISE FUNDS for ongoing activities -
advocacy, treatment facilities, support groups, education and research. Other books, television documentaries
etc. Joan Gadsby · October 27, 2000
WOMEN'S MENTAL HEALTH
The Honourable Lucie Pιpin
Debates of Senate Document Cover (jpeg image) Hon. Lucie Pιpin:
Honourable senators. I rise today to draw your attention to the problem of
mental health, particularly that of women. One of the areas of health
in which the greatest differences between men and women are observed is that
of mental health. This is not without repercussions on the quality of life
of women and those around them. Levels of depression are higher among women
than men, suggesting that women and men experience stress differently.
The rate of
hospitalization for psychiatric treatment is higher among women than men.
Women are more inclined than men to have low self-esteem and to experience
problems such as anorexia and bulimia. Women are more likely to he
overmedicated than men. The case I am about to
present is that of a woman who went through hell, but, who found - and is
still finding - the courage to fight against the excessive prescription of
drugs. This woman is Joan Gadsby, the author of
Addiction by Prescription,
a essay in which she relates her own story, of course, but one in which she
offers a lucid analysis of the disastrous effects of overmedication. The
drug with which Ms Gadsby had trouble was benzodiazepine, a tranquillizer
and sedative. While this drug may meet
certain expectations in the short term, it has a number of undesirable side
effects: learning problems, such as confusion; behavioural problems, such as
aggressiveness; psychomotor problems affecting such things as eye-hand-foot
coordination; psychiatric problems, such as depression or suicidal ideation:
and finally, problems of addictiveness. Honourable senators, drugs
must be used with restraint. Naturally, for a variety of reasons, patients
may depart from the recommended dose of a medication. However, such
departures may also arise from a belief that the solution to problems lies
in pills, and that the relict they provide is preferable to the symptoms a
patient would experience without them. I am not here to judge the
Canadian medical profession, much less the pharmaceutical industry.
Nevertheless, I want you to think about the problem behind overmedication.
It is probably easier for society to individualize problems by applying
individual solutions than to wonder about the source of these problems and
propose global solutions. It is also probably easier for a doctor to
prescribe medication than to consider longer-term alternatives. Of course,
the medical profession constantly reviews its use of medication, so that
doctors are more aware of the negative impact of overmedication. However,
there are still cases - too many, unfortunately - where doctors prescribe
too much medication, because they feel it is the best, the easiest or the
quickest solution. Honourable senators, I am
asking you to join me in reflecting on the role of medication in our
society. The Senate Standing Committee on Social Affairs, Science and
Technology has undertaken a vast study on Canada's health System. I truly
hope that, in the course of its proceedings, the committee will be receptive
to the problem of overmedication and its negative impact on Canadians. Tragedies such as the one
experienced by Joan Gadsby must never he repeated. Thank you for your
attention. Sources: International
research compiled over 9½ years from various sources.
Joan E. Gadsby - Biographical Information
Born
Kincardine Ontario, Canada; grew up in St. Catharines, Ontario
Bachelor of Arts, University of Western Ontario, London, in Psychology,
English and Journalism Moved
to North Vancouver, British Columbia 1963 and resident since Former
elected poll topping Councillor, District of North Vancouver for 13
years Author
of book "Addiction By
Prescription" - one woman's triumph and fight for change published
by Key Porter Books, Toronto, Canada April 2000. Internationally
endorsed by experts, chosen as non fiction choice for a Canadian writer
and available internationally online at
www.amazon.com and
www.chapters.indigo.ca or through bookstores. Book was one of the
biggest hits at the Frankfurt Germany Book Fair in October 2000 and will
be available in other languages in the future. Also released in
paperback spring 2001 Wellness and Health
Promotion Consultant to corporations, governments, healthcare and other
organizations and to individuals on the subject of prescription drug
addiction Co Executive Producer
and Research Consultant of television documentary
"Our Pill Epidemic"
which has been broadcast nationally on CTV (available for international
broadcast and in video.) Videos available in North America
1-800-471-5628 International formats email
info@crownvideo.com Project
Leader/Consultant for development and implementation of national multi
stakeholder strategic action plan and awareness campaign for
benzodiazepines (currently in proposal stage seeking private/public
sector funding) Recognized
international authority and public speaker on the responsible and
informed use of benzodiazepines (tranquillizers and sleeping pills).
Numerous guest appearances on national television, radio, other media
and at trade, health and wellness shows Future Projects Co Executive Producer
- International TV Documentary Creative Developer and
Executive Producer of film/movie of the week project based on my book
"Addiction By Prescription" Second Book - "Against
the Wind" - the fight for and process of systemic change Other Selected as one of
Canada's notable women, Canadian University Women's Club - 1994 National and British
Columbia Board Member, Women Entrepreneurs of Canada 1999 - 2001 and
member of International Alliance of Professional and Executive Women Member Vancouver Board
of Trade Vice President of
International Benzodiazepine Awareness Network (BAN) committed to
responsible and informed use of tranquillizers, sleeping pills and
antidepressants Many other
professional/business affiliations and recognitions. Extensive volunteer
and community work. Personal Data - An
active mother and a classic car and convertible enthusiast who enjoys
daily running, fitness, sports, dancing, boating, nature photography,
fashion designing, music, travel, and reading Visit homepage on
www.benzo.org.uk. Joan can be contacted at address, phone, fax
(below) or email
joangadsby@pacificcoast.net November 19, 2001
More articles, letters and information at
Problem Reduced and Some Solutions
WHERE DO WE GO FROM HERE?
October 27, 2000
PROBLEMS OF OVERMEDICATION
Thursday, October 5, 2000
Market-Media International Corp.
4507
Cedarcrest Ave., North Vancouver, BC, V7R 3R2, Canada
Phone: (604) 987-6064 Fax: (604) 987-6063
Joan E. Gadsby's Main Page
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