This is the second of a two-part series. You can read yesterday’s Part 1 here.
BY THE 1970s benzodiazepines had become ‘the opium of the masses’. This was according to Malcolm Lader of the Institute of Psychiatry in London, best known for his book Psychiatry on Trial (1977), documenting abuse of psychiatric labelling and treatment in the Soviet Union. His clinical research, including brain scans, indicated neurological damage in people taking benzodiazepines for protracted periods (as was increasingly common due to prescribers’ neglect and the ordeals of withdrawal).
In 1981 Lader asked the Medical Research Council to hold a meeting on the iatrogenic harm of these drugs. The meeting, chaired by Professor R Cawley, produced a consensus that benzodiazepines needed more careful prescribing and monitoring, but the recommendations were limited to better training for GPs. Lader wrote to Cawley with further evidence of cortical atrophy, but the prevailing view was that benzodiazepines were safe and effective if managed appropriately.
Another expert at the Institute of Psychiatry, Isaac Marks, added to Lader’s findings of cerebellar shrinkage and ventricular enlargement. This led to a transatlantic spat, as American psychiatrists were keen prescribers of benzodiazepines. Unlike in the NHS, doctors in the healthcare system in the US were individually incentivised by pharmaceutical companies. Marks was upsetting the apple-cart. Consequently, nothing meaningful was done to protect patients from these highly addictive substances. Sadly, Professor Lader (who died in 2020) did not persist with his benzodiazepine work. Was he told by the powers-that-be in medicine or government to desist?
The Department of Health has been willing to provide services for people with addiction to illicit drugs, alcohol and gambling, but not to prescribed pills. This institutional neglect was highlighted in a recent investigation by BBC’s Panorama, and by a letter to the BMJ by Lord Crisp (former chief executive of the NHS), Baroness Hollins (past president of the Royal College of Psychiatrists and the BMA) and numerous psychiatrists. The aim of the letter was to ‘urgently call upon the UK government to fund and implement withdrawal support services, including a national helpline’. Instead, patients have been left to organise their own care and support networks. The authors of the BMJ letter asserted: ‘We believe that the NHS has a clinical and moral obligation to help those who have been harmed by taking their medication as prescribed.’
A recent meta-analysis (an intensive review of studies) of the long-term cognitive effects of benzodiazepine use, led by Professor Simon Crowe at La Trobe University in Australia, concluded that ‘while these medications are useful in the short term, the published evidence indicates that when they are used for longer periods, they often culminate in significant harm’. Data from the 19 reviewed studies showed that current long-term benzodiazepine use (i.e. over one year) impairs memory, perceptual processing and expressive language, and that such cognitive deficits persist after withdrawal for more than three years.
Despite accumulating evidence of brain damage, the MHRA under June Raine has ignored concerns. Campaigner Barry Haslam (see Part One) has written reams to the responsible bodies, but to no avail. The authorities in the UK have shown little interest in confronting the pharmaceutical industry on the injurious effects of common psychiatric drugs. As in the Covid-19 regime, most doctors keep their heads down, with merely a few courageous psychiatrists, notably Peter Breggin, Joanna Moncrieff and David Healy, raising alarm.
Mental health has been captured by Big Pharma, an industry that thrives more on customers than cures. The claimed mode of action of psychiatric drugs is based on the doctrine of mental illness as a manifestation of chemical imbalance, which only a chemical intervention can relieve. The serotonin hypothesis for depression, for example, led to selective serotonin reuptake inhibitors (the first of which, Prozac, was launched in 1987). Such treatment appears scientifically sophisticated, but the effects are not as specific as marketed, as Charles Pierro explained in The Light newspaper (July 2023): https://www.discountmags.ca/magazine/the-light-issue-35-july-2023-digital-m/in-this-issue/nUy-UDsEP1689845334037 ‘Psychiatric drugs are powerful psychoactive substances that act on the brain in a global rather than selective way, and disrupt the function of multiple neurotransmitters. In doing so, each psychiatric drug produces a wide range of predictable, and sometimes unpredictable, effects on a person’s thoughts, feelings and behaviour’
Tranquillisers and antidepressants are ‘blunt instruments’, Pierro observed, not ‘magic bullets’. Mental health care needs radical reform, turning from the one-track medicinal route to a humanistic approach. Talking therapy and interpersonal engagement in the meaning of life are necessary in a world that is becoming more alienating as digital technology takes over. Atomisation of society reduces our status as human beings, causing stress, depersonalisation and lack of resilience. Psychiatric drugs, as we have seen, often do more harm than good.
The NHS has failed, and continues to fail, benzodiazepine victims. As the Daily Mail reported last year, a helpline launched in 1984 by the Bristol & District Tranquilliser Project is threatened with closure. https://www.dailymail.co.uk/health/article-11399929/How-helpline-desperate-victims-prescription-pills-faces-closure-save-just-65-000.html This charity, founded by Val Stevens, a past sufferer of benzodiazepine dependence, was so unique that many people far from Avon sought its help. NHS funding was secured, but now financial support is being withdrawn.
Tranquilliser dependence should not be left to medical regulators, practitioners and drug manufacturers to resolve. Nothing has really changed in five decades. It is a political problem in need of a political solution. Let us leave the last word to Barry Haslam, who has not retired from the cause at eighty years of age:
‘Nobody in parliament has had the guts or moral courage to confront Big Pharma and all the vested interests involved. It is only we the victims who are fighting for dedicated withdrawal services and after-care facilities. We care massively, whilst government does not give a damn about the iatrogenic drug dependent victims, and they never have done. All the political parties are guilty of cowardice and have run away from accountability. This is the crux of the matter. I have been campaigning for the last 37 years. How much longer do we the victims have to wait for government acknowledgement and recognition of this national Pharmageddon?’