In Pills We Trust

Benzodiazepines – nicknamed benzos for short – might be classed as ‘minor tranquilisers’, but there is nothing ‘minor’ about their effects. For those that don’t know, household names like Valium, Xanax, Klonopin, Librium and Temazapam are all classed as benzos. Commonly prescribed for anxiety, sleep problems, alcohol dependence and other sources of discomfort, benzos act as a sedative, slowing down the body’s functions. In former benzo-addict Joe Simpson’s* words, “You just feel good. You feel relaxed, calm, anxiety-free, happy, warm. Life’s good. You’re in a little bubble. You can sleep. You can relax. That hectic day at work doesn’t matter. Nothing’s stressful. Everything’s fine.”

Benzos first arrived on the scene in America in the late 60s. Developed by big pharmaceutical companies, they were billed as a wonder drug, a cure-all for everything from acute anxiety to everyday stress and mild teenage angst. Between 1969 and 1980, Valium was the biggest-selling drug in America. These so-called ‘happy pills’ became increasingly popular amongst suburban American housewives, as the Rolling Stones song, “Mother’s Little Helper” so luridly recounts.

In more recent years, benzos have become something of a party drug. With rappers like French Montana, Max B and Lil Wayne rapping about Xanax and sizzurp (codeine and soda), benzos have become increasingly popular. Most people who go out and get on MDMA, coke, ket and pills will most probably have tried Valium at some point to take the edge off a comedown. Moreover, it’s not like you need to venture on to Silk Road to pick it up – benzos can be easily acquired from dealers, mates or online. Plus, there are no penalties for possession.

“If you do benzos on a heavy long-term basis, you might as well be an alcoholic or a heroin addict. You can die from withdrawals” – Joe Simpson

Of course, there’s a catch. Benzos are highly addictive. So much so, that coming off them can kill you. “They're physically addictive,” explains Simpson. “If you do benzos on a heavy long-term basis, you might as well be an alcoholic or a heroin addict. You can die from withdrawals. When I stopped taking them, I started to have adverse withdrawal affects such as extreme anxiety and agitation. The physical affects were shaking, headaches, muscle aches, cramps and spasms. Banging headaches. I even thought I was going to have a seizure at one point.

“It wasn’t good, to be honest. I was getting migraines and having nightmares. I also had severe depression, anxiety and irrational paranoia. The rebound anxiety is worse than the original anxiety. It was like having a bad trip and flu that lasted a fortnight.”

Simpson is not alone. Benzo addiction is a massive, albeit hidden, problem throughout Britain. Widely prescribed by doctors, there are currently one million long-term prescribed benzodiazepine users in the UK. To put this into context, there are an average of 180 long-term prescribed users per general practice. Although government guidance states that the benzos should be prescribed for a maximum of two to four weeks, doctors in Britain are continuing to prescribe them for months and even years.

Community pharmacists dished out approximately 10.7 million prescriptions for benzos in 2013. What’s more, the number of prescriptions handed out is growing; there has been a 29 per cent increase in Valium prescriptions over the last 12 years. To put it simply, benzo addiction is a fast-growing problem. In 2014, there were 372 drug-related deaths involving benzos. Not only is this an eight per cent increase from 2013, it is the highest mortality rate since records began in 1993.

Simpson’s route into addiction was via a dealer rather than a doctor. “I’d been out the night before and done pills. I looked a state so my dealer slipped me three blue Valium. He said, ‘Take two today and save another one for tomorrow and you won’t have a comedown. I took two, had a cup of tea, fell asleep for ten hours and woke up feeling fine. He let me buy 20 the next time I saw him and before I knew it, I was buying 100.”

This was ten years ago. Simpson has had a penchant for the little blue nuggets ever since, though it’s only more recently that things have spiralled out of control. “When I started doing various benzos every day for about three months, I clocked it was getting out of hand,” he says. “I was doing nearly six times the amount you’d be prescribed for severe anxiety. At one point I was doing the equivalent of 100mg of Valium a day. I might’ve been holding down a 30k a year salary job but I realised it wasn’t a good look so I tried to stop taking them. When I ran out of the pills, I went from a high dose to zero.”

In the end, Simpson confided in his family and agreed to go to the doctors. “The GP pretty much said to keep taking what I was taking but on a lower dose. He booked me an appointment with a drug specialist. That wasn’t for a further two weeks so I had to self-medicate with what I had or what I could find on the black market in the meantime. I was mostly buying on the internet. At one point, I even had a contact on eBay,” Simpson explains.

During the initial assessment with the drugs specialist, Simpson was forced to surrender all of the pills he possessed. “I went into as little detail as possible about how I got them. The only detail I mentioned was that I’d been doing them without a prescription,” he explains. “After this, they put me on a prescription. It was the exact equivalent of what I’d weaned myself down to.”

After spending days, weeks and even months in a semi-tranquilised state, Simpson is now clean. “I was self-medicating because I was prone to insomnia, depression and anxiety. And probably because I was taking too many recreational drugs,” he explains. “I worried about normal life situations so I ended up taking benzos before first dates and job interviews.”

Nevertheless, Simpson has also experienced the darker side of benzos. “I've passed out at my work desk. In fact, I’ve missed whole days of work because I’ve woken up at two in the afternoon. If you mix them with booze, it can go the wrong way. I’ve woken up on trains in the middle of nowhere.”

But while Simpson got into benzos illicitly, for many others, the problem begins in their local doctor’s surgery. Britain’s high prescription rates means benzos are prescribed for everything from a bad night’s sleep to bereavement, exam stress and heartache. And let’s face it, who’s going to say no when your all-knowing GP hands you a pack of vallies because you’re stressed and sleeping badly. Especially when they don’t tell you about the potential risks, tolerance and withdrawal symptoms that could emerge.

With repeat prescriptions surprisingly easy to get hold of in a busy GP practice, it’s easy to start taking far more than you initially intended. What’s more, it’s possible to develop a tolerance after regular use for just a fortnight. The warm, calming, effect – almost like cotton wool over the brain – doesn’t take much getting used to. In turn, benzo addicts often remain addicted for ten, 20, or even 30 years – the majority of their lives.

Doctor’s prescriptions for benzodiazeprines are creating involuntary addicts. In recent years, we have seen increasing numbers of GPs sued for failing to adhere to benzo safety recommendations published more than two decades ago. What’s more, according to lawyers and medical experts, the “indefensible” long-term prescription of benzos has led to increasing cases of clinical negligence where patients have been left physically and psychologically damaged. Those who haven’t been properly weaned off the drugs have been left disabled by pain for months and even years.

“People on benzos can end up feeling very depressed and anxious and then they tend to take more. It’s very difficult to come off” – Joe Simpson

Drug addiction experts argue that coming off benzos is more difficult than heroin. Withdrawal symptoms include acute anxiety, insomnia, depression, vivid nightmares, headaches, vomiting, shakes, cramps and, in the worst cases, seizures which can cause death. Essentially, the brain awakens from slumber and over-wakes with emotions feeling stronger, noises louder and lights brighter. As such, it’s important that addicts are very slowly withdrawn from medication. What’s more, there is increasing evidence that benzo usage causes long-term damage such as Alzheimer’s and memory loss.

Nick Barton, Action on Addiction’s present consultant and former CEO, tells me that, in the long run, benzos exacerbate anxiety. “It’s a well-known fact that very often you end up producing the symptoms that you were trying to ameliorate in the first place,” he says. “People on benzos can end up feeling very depressed and anxious and then they tend to take more. It’s very difficult to come off.”

Benzos essentially amount to putting a plaster over an open wound. Rather than tackling the root cause of the problem, they put you in a dreamlike daze for years, making it difficult to manage ordinary everyday situations without them. Of course, they can provide much-needed support for a short period in some cases. But while it might be better for an agoraphobic to be able to leave the house on Valium than be housebound, the same cannot be said for someone who is simply suffering from the everyday pressure and angst of everyday life.

Like other prescription drug addictions, benzo dependence is a far more prevalent problem than many of us realise. Not only are addicts adept at hiding their behavior, they often want to disassociate themselves from those with illegal addictions. All the same, addiction is addiction, regardless of whether the drug is prescribed or illegal. And while benzos might continue to be a commonly prescribed – and abused – drug in Britain, the overlooked victims of this silent epidemic continue to fall through the cracks.

* Joe Simpson’s name has been changed to protect his identity