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Visions Journal

A reminder that this article from our magazine Visions was published more than 1 year ago. It is here for reference only. Some information in it may no longer be current. It also represents the point of the view of the author only. See the author box at the bottom of the article for more about the contributor.

When Sedatives Do More Harm than Good

The Use and Misuse of Benzodiazepines

Harkirat Kaur

Reprinted from "Seniors' Mental Health" issue of Visions Journal, 2002, No. 15, p. 12-13

Benzodiazepines are a class of sleeping pills and tranquilizers that are often prescribed to help people deal with sleep problems, muscle tension, anxiety, depression and stress. They are most commonly prescribed to older women. Also known as sedatives, nerve pills, and muscle relaxants, they work by depressing or slowing down the central nervous system.

Benzodiazepines can be helpful in the short-term for reducing anxiety and aiding sleep during a crisis in a person’s life. However, they only provide temporary relief, as they treat the symptoms and not the cause. They should also only be taken for a short period of time (seven to ten days), as prolonged use can result in physical and mental dependency and severe withdrawal symptoms. Signs of dependency can include feelings that the effects are wearing off, the need to increase the dosage over time, the taking of extra pills in stressful situations, unsuccessful attempts to quit or reduce the dosage, inability to cope without the drug, and cravings.

While benzodiazepines are classed as “minor tranquilizers” to differentiate them from “major tranquilizers” (which are used to treat psychiatric problems like schizophrenia), this can be misleading as the effects of benzodiazepines are not “minor” at all. Some people can experience extreme side effects. These can include physical complaints like drowsiness, dizziness, heart palpitations, headaches, nausea and sensitivity to light, noise, touch or smell, as well as cognitive impairments like confusion, poor concentration, forgetfulness and moodiness. Perhaps even more disturbing is that often, when benzodiazepines are taken on a long-term basis, they can instead worsen the symptoms of depression and anxiety that they were supposed to be alleviating. In addition, a 1999 study conducted at the National Institute of Public Health in Oslo found that women taking tranquilizers and sedatives (including benzodiazepines) were at a much higher risk of falling and consequently suffering from hip fractures than the general public.

Unlike other medications, the side effects of benzodiazepines often do not go away when drug use is stopped. In fact, women often experience intense withdrawal symptoms when trying to reduce their reliance on the drug. Joan Gadsby, a vocal critic against benzodiazepines, points out that sudden withdrawal from these drugs can sometimes even precipitate psychosis, and in extreme cases, death. Moreover, combining benzodiazepine use with alcohol or other drugs can be lethal.

There are several possible reasons why benzodiazepines are most commonly prescribed to older women. Perhaps this is partly because many medical and neuropsychiatric conditions that are associated with sleep disturbance are common in the aged, such as strokes, dementia and heart failure. Moreover, benzodiazepines are often prescribed to older women to help them deal with the symptoms of menopause. A 1995 study conducted by BC’s former mental health advocate, Nancy Hall, found 30% of North Shore senior women to be taking benzodiazepines.

Since the risk of over-reliance on benzodiazepines is so high in older women, it is important for them and others to learn ways to gain control over the use of their medication. The way they can do this is to educate themselves about the medications, ask the doctor and pharmacist for clarification, discuss it in relation to other medications they are taking, never borrow or share medications, and talk to the doctor if the pill does not seem to be working, or is making them uncomfortable.

Besides learning responsible use of medications, there are other ways in which a person can deal with transient stress and anxiety. For instance, there are many alternative ways to try and get a good night’s rest. Making the bedroom as conducive to sleep as possible, drinking warm milk or water before bed, and avoiding caffeine in the evening are some things that can help reduce sleep problems. Learning relaxation techniques, finding enjoyable activities, and leading a healthy lifestyle by eating well and exercising can help alleviate anxiety as well. In addition, a person can build strength by connecting with others. Support from friends, family, counsellors, or support groups can be invaluable in helping a person deal with temporary anxiety and stress in their lives. Cognitive-behavioural therapy has much success for more chronic anxiety or anxiety disorders.

In conclusion, benzodiazepines are a class of drugs that can be helpful in the short-term to relieve a person of anxiety. However, more needs to be done to educate users of these drugs on their side effects and the possibilities for over-dependency. Benzodiazepine users also need to know that there are alternatives, and that it is possible to lead a healthy life without having to rely excessively on tranquilizers, and without excessive anxiety.

About the author
Harkirat is a Simon Fraser University co-op student presently working for CMHA BC Division

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