Behavior

TRANQUILIZERS: THE NEW, APPROVED OPIATE OF THE PEOPLE

SHEILA GORMELY March 22 1976
Behavior

TRANQUILIZERS: THE NEW, APPROVED OPIATE OF THE PEOPLE

SHEILA GORMELY March 22 1976

TRANQUILIZERS: THE NEW, APPROVED OPIATE OF THE PEOPLE

Behavior

Two days each year, Ontario’s Addiction Research Foundation monitors prescriptions filled by 140 drugstores. In 1970, the stores filled 603 prescriptions for minor tranquilizers. By 1974, the two-day total for such drugs as Valium and Librium had climbed to 1,085. That alarming increase—almost 80% in four years—underlines a debate now building around the almost epidemic proportions of minor tranquilizer use in North America. In the United States, more than 60 million pre-

scriptions for Valium alone are written in one year. The all-time pharmaceutical best seller. Valium’s worldwide sales are conservatively estimated at one billion dollars a year. Some 33 million Americans take it regularly. For its inventors, Swiss-based Hoffman-LaRoche, Valium and Librium (both belonging to the benzodiazepine class of synthetic chemicals) have returned millions of dollars, captured some 50% of the minor tranquilizer market, and made it the largest drug company in the world. ( A single share sells for more than $35,000.)

Now, however, the very drugs prescribed to relieve emotional stress and tension are provoking nearly as much anxiety as they allay. The Canadian Medical Association has officially expressed “alarm” about over-prescriptions of minor tranks, and their abuse by consumers. Valium and Librium have become so at home in the Canadian family’s medicine chest that they ranked first and third respectively among products that poisoned children under six during 1973. The U.S. National Council on Drug Abuse reports that Valium is the major choice of drug abusers and says its role in overdose cases has doubled since 1970. A random NCDA survey of 170 patients showed that 65% had Valium prescribed for six months or . longer. In response, the U.S. government last year made prescriptions for minor tranquilizers valid for six months only and now permit only five consecutive renewals.

These statistics are all the more disconcerting because minor tranquilizers— which depress part of the central nervous system, thus relaxing muscles and inducing sleep—may be addictive and carry a long list of real and suspected side effects (among them, an increased risk of giving birth to babies with harelips and cleft palates, if taken during pregnancy). Valium ads in medical journals caution users against mixing them with alcohol or other depressants, such as antihistamine. They also suggest that Valium (the name is derived from the Latin for “to be strong and well”) and Librium may lower blood pressure, inhibit sexual drive or cause nausea, headache, vertigo and hallucination. Those dangers concerned the CMA’S late secretary-general,J. D. Wallace; shortly before his death earlier this month, Wallace said: “It’s a tranquilizer on demand syndrome. There’s a feeling by the patient that he has a right to a prescription. And doctors, with no time to talk people out of the idea, give in. It’s the fad of the century.”

But taken in moderation and for a short term. Valium—which came on the market in 1963—and Librium (introduced three years earlier) are considered both safe and effective. Most physicians strongly defend their use. “I’d rather have a guy addicted to Valium than alcohol,” says Dr. Joe Greenberg, a Toronto general practitioner. “These are tough economic times, and the reality is you have to work and make money. If giving a guy some pills will help him do it, I will.” Other Valium defenders include orthopedists (who prescribe it for muscle spasm), internists (for hypertension), surgeons (for patients, the night before operations), gynecologists (for women in early labor) and psychiatrists (for aiding alcohol or smoking withdrawal). If Valium were not freely available, psychiatrists add, those who become addicted to it would find some other dependency. Similarly, most gynecologists—after the thalidomide horror of the Sixties—warn patients to avoid all drug-taking in the early months of pregnancy, including Aspirin, alcohol and tobacco.

But most tranquilizers are prescribed not by specialists for specific medical ailments but by general practitioners for simple anxiety states. And it is this aspect of their use that is now under attack. This month, clinical pharmacologist Dr. Ian Henderson, head of the CMA’S pharmacal therapy subcommittee, is convening a 14day medical conference—staged by computer—to seek opinion on tranquilizer use from 10 Canadian medical and psychiatric experts. The results, Henderson hopes, “will give us a guideline for minor tranquilizers and a basis for research into their effects.”

Surprisingly, various U.S. studies indicate that white, middle-class housewives are prime candidates for tranquilizer abuse. “Many people think working women are under the most stress,” says the Addiction Research Foundation’s Dr. Ruth Cooperstock. “The truth is that women who work are healthier overall and far less likely to turn to tranquilizers than the woman who stays at home.”

Whatever the cause, and whoever the user, there is little doubt that minor tranquilizer use is zooming. But as Toronto child psychiatrist Barry Garfinkel notes, “It’s not the simple use of Valium or Librium that constitutes a social problem. Ethically, the drugs are neutral. What we really need to get a grip on are the underlying problems.”

SHEILA GORMELY