Benzodiazepines. It's a difficult word to say and, for most people, an even harder one to define. In the Global Drug Survey 2015, almost 14% of the 2,393 Irish respondents said they'd taken benzos over the past 12 months, with two-thirds doing so without a doctor's prescription.
Discussing the GDS 2015 findings with Hot Press, the Minister with Responsibility for Drug Strategy, Aodhán Ó Rírdáin, said, "I believe young people aren't taking heroin up in the same numbers that they used to, but other substances are a problem with teenagers. Benzos and different types of prescription drugs being among them."
Those comments are welcomed by Dr. Paul Quigley, an addiction GP with a special interest in benzos, who's worked for over 20 years in the Ballymun area.
“Rather than scaremonger and throw words like ‘epidemic’ around, which hasn’t resolved anything in the past, the Minister has recognised benzos as being part of the drugs landscape,” Dr. Quigley reflects. “He’s a smart guy, who’s taught in the north inner city, and knows that the methadone population is generally benzo co-addicted. One of the reasons for that is the low quality of the heroin in Dublin over the past 30 years. People use benzodiazepines, which are easier and cheaper to get, to boost it up. Another is that a lot of doctors have historically been happier to treat with valium than provide methadone."
We’ll return to the idea of methadone users being an ageing population later. A campaigning voice who’s worked with Dublin’s Northern Area Health Board HIV and Addictions Service, Dr. Quigley continues: “There are lots of different benzos, including the well-known valium, dalmane, temazepam etc, and they ‘do what it says on the tin’. Sedate. They help people to sleep, to reduce worry, and to cope, and these have often been recognised by doctors as genuine mental health issues and as legitimate prescribing needs.
“Benzos were marketed very heavily in the ‘70s and lots of money by Big Pharma was made before the problems of dependence and addiction were identified. Now they’re regarded by doctors as being rather disreputable, but they are still very heavily prescribed long-term by many GPs.
“The z-drugs – zopiclone etc – were marketed about ten years ago as a safer non-addictive version of benzos, and are also heavily prescribed. But they also have addiction and misuse issues. Precisely because they are effective sedatives. In short, any sedative has misuse potential. The stronger, or the more short- acting the sedative, the higher is the risk.”
As concerned about benzos as he is, Dr. Quigley reckons there’s little that Minister Ó Ríordáin can do to stem their use.
“Like alcohol, problematic benzo and z-drug use is deeply ingrained in our society at all levels, so demand for prescribed, internet supplied or street supplied benzos and z-drugs is unlikely to fall,” he reasons. “In global terms they are as cheap as chips – maybe 1 cent per tablet – so control of supply is almost impossible.
“We need to step back and see the bigger picture. Benzos are a sensitive issue, which the medical profession has been very reluctant to examine openly. We don’t even have statistics for private benzo prescribing, but it is very substantial indeed. Unless the profession is willing to be more open about what doctors are actually doing with benzos, rather than what doctors are saying about benzos, ‘the benzo problem’ will continue to grow.”
Dr. Quigley also questions the viability of the safe injecting rooms, which the Minister has made a cornerstone of his harm reduction agenda.
“I can’t see consumption rooms taking off in Dublin,” he cautions. “We don’t have the structures to manage something like that, and the potential clientele are very disorderly. There’s even a waiting list for methadone downtown, because Trinity Court is overwhelmed with homeless treatment applicants.”
Suggesting that Minister Ó Ríordáin and his governmental colleagues need a keener social agenda as well as a harm reduction one, Dr. Quigley concludes by observing that, “Addiction and social exclusion is chicken and egg, but the bottom line is that homeless, directionless people are looking for the cheapest, most reliable ‘bang for the buck’. Benzos boost up poor quality heroin, and are combined with alcohol and cannabis. Like self-harm, or suicide, ‘getting out of it’ with sedatives is one response to insoluble life problems and feelings of despair. That’s the bottom end of the society, and the most visible, disturbing aspect of the drugs’ iceberg.”