Healthy Skepticism Library item: 5462

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Publication type: news

Battles J.
GPs 'fob off poor with sedatives'
The Sunday Times - Ireland 2006 Jul 9
http://www.timesonline.co.uk/article/0,,2091-2262035,00.html

Keywords:
benzodiazepines Valium addiction

Full text:

The Sunday Times – Ireland

The Sunday Times July 09, 2006

GPs ‘fob off poor with sedatives’
Jan Battles
PEOPLE living in poorer areas of Dublin are more likely to be prescribed potentially addictive sedatives to cope with daily life than those in less socially deprived parts, according to a new report.

Patients in poor areas are routinely being given benzodiazepines – a group of drugs including Valium that are used to treat anxiety and insomnia – instead of being referred for social or mental health services.

The drugs “seem to play a fairly central role in the life of Dublin’s most disadvantaged people, and may have become, especially for women, a standard means of coping with adversity”, said the study, which is published in European Addiction Research. A clear gap exists “between recommendations for prescribing and medical practice itself”, it says.

“The poorer you are the more likely it is the assistance you will get to deal with your problems will be sedatives,” said Paul Quigley, one of the authors and a doctor who runs methadone treatment clinics.

The research examined the prescription database of the General Medical Scheme (GMS) from the Eastern Regional Health Authority, which includes Dublin, Wicklow and Kildare. As this features drugs prescribed to medical card holders – about 30% of the population – it already includes the most disadvantaged people in the area.

Patients living in the most deprived areas were 21% more likely to receive the drugs than those in the least deprived on the GMS, with women in those areas 36% more likely.

“Benzodiazepines are very commonly prescribed,” said Quigley, a director of the European Opiate Addiction Treatment Association. “As well as being very useful for the purposes of sleeping and relaxing, they are dependence inducing. The official position of the profession is that doctors are discouraged from prescribing benzodiazepines but the reality is that doctors are continuing to prescribe them, as the research shows, in very large quantities.

“The pressures on the doctors from patients to obtain these drugs are huge. That results in a massive supply of benzodiazepines in the community that are both used and misused.”

A study commissioned by the health department showed that 11.6% of adult patients on the GMS were receiving benzodiazepines. Most prescriptions were for a month’s supply and generally they are repeat scripts. The dispensing rate of diazepam (the most popular type) has been rising significantly over the past few years.

“There are grossly inadequate mental health and social care services in Ireland and we are dealing with mental health problems by issuing sedatives in large quantities,” Quigley said. “We are depending on the public to use the drugs wisely and often they don’t. They are falling into the hands of the young people in the families, who are bingeing on them and developing new addictions.”

Quigley said general practitioners in poorer areas were under such pressure that they were not able to spend enough time with people to find out whether it was useful or not to prescribe the sedatives.

“While we may have 20,000 heroin addicts in Dublin, we probably have five times that addicted to one or other of a range of substances including benzodiazepines.”

Barry Haslam, who runs Beat the Benzos campaign in Britain, has been helping community workers here tackle the issue. “Ireland has got a particularly big problem with benzos. We have it bad here (in Britain) with over 1m long-term addicts but it’s worse in Ireland.”

Haslam was 33 when he was put on the drug for 10 years by his GP after suffering a breakdown while studying for his accountancy exams. “From 33 to 43 I have no memory whatsoever of life. I’ve found out subsequently that I’ve been badly damaged physically by these drugs.” Haslam went through “15 months of hell on earth” coming off the drugs.

A spokesman for Citywide, an umbrella group for drug treatment programmes around Dublin, said one Dalmane 30 tablet (brand name of flurazepam) is being sold on the street for between €3.50 and €4. “It is more profitable now and less risky for dealers to sell benzodiazepines than to sell heroin.”

Dr Ide Delargy, director of the drug misuse programme at the Irish College of General Practitioners, said: “There may be a certain expectation within communities that they would be given medication to overcome the life events that maybe people with more adequate outlets available to them may have other ways of coping with.”