Select Committee on Health Minutes of Evidence


Memorandum submitted by Barry Haslam (PI 76)

PERSONAL HISTORY

  I am an ex-Senior Accounting Technician, now aged 61 years. From 1976 to 1986 I was G P prescribed benzodiazepine drugs eg Librium, Valium, Ativan. At the peak of my iatrogenic addiction in 1985, I was ingesting 30 mgs of Ativan daily (the equivalent of 300mg of Valium) (Para 1)

  As a direct result of the above "medical treatment", the period from 1976 to 1986 is a complete blank. I have no memory of family life (1 have two daughters), no memory whatsoever of my 10 year coma. (Para 2)

  I am now permanently brain damaged (Ref 1) and suffer from brain atrophy, cognitive defects, hypothyroidism, neuro pathway pain—right side of body, semi-deaf in both ears, mood swings, violent headaches, narrow airways disease, chronic fatigue syndrome and aggression. (Para 3).

  Despite the above, I love life. I love my wife, family and grandchildren. I have been re-born. (Para 4)

  For the past 14 years I have been Chairman of a drug support group— Oldham (Tranx). I have counselled thousands of people both in this country and abroad over the past 18 years, all done voluntarily. I have written articles for the local and national press via interviews, (Ref 2) and on TV. I have written a report on benzodiazepine drugs for the European Commission (Ref 3), and presented the report in February 2004 to Mr David Byrne, The Health Commissioner in Brussels at the request of Euro MP Mr Chris Davies. (Para 5.)

  In addition I have worked closely with Mr Phil Woolas MP Deputy Leader of The House of Commons, and Oldham PCT . . . (Ref 4.A,B,C.) The result being that from August 2004, Oldham will have a benzodiazepine drug withdrawal service for legal drug addiction. We have 5,200 long term benzodiazepine drug addicts in Oldham and need a large increase in funding from Government to fully address the problem. (Para 6)

1.  Patient use and Past Consumer of Benzodiazepine Drugs

  See Paragraphs 1-3.

2.  Drug Innovation

  Barbiturate drugs were replaced partly by the Benzodiazepines. The World Health Organisation (WHO) in 1964 said "that barbiturates and Benzodiazepines could have been expected to produce dependence of substantially the same kind". (Para 8)

  The medical profession welcomed the benzodiazepines as an alternative drug of treatment due to easy overdosing with barbiturates and alcohol resulting in death, (Para 9)

  However, benzodiazepines cause suicidal ideation (Ref 5) and many deaths by suicidal poisoning as illustrated clearly by Home Office statistics (Ref 6) of 761 deaths between 1990-96 (Excluding 1994). (Para 10)

3.  The Conduct of Medical Research

  Medical research by the drug companies eg, Roche and Wyeth were in the main short term trials of a few weeks only. Yet both these drug companies actively promoted their products of Valium and Ativan for long- term treatment of patients. In essence, the patients became human guinea pigs (Ref 7 A,/B) both in terms of length of enforced addiction and in excessive recommended dosage. (Para 11)

  DUTY OF CARE! Was the producer (Wyeth) in possession of evidence about the performance of their drug which if it had been passed to the prescriber would have caused the prescriber to modify his prescribing behaviour? The dosage recommendations are clearly excessive for Ativan eg the equivalent of up to 40 mg of Valium daily dosage for mild anxiety. (Para 12)

  In Canada and the USA 0.5 mg Tablets of Ativan were available unlike in the UK where only l mg and 2.5 mg tablets were available. Indeed such is the strength and short half life (Leading to addiction) that Professor C Heather Ashton of Newcastle University advocated that 0.25 mg and 0.125 mg tablets be made available for Ativan tablets. (Para 13)

4.  The Provision of Drug Information and Promotion

  In April 1967, the ABPI published the 3rd edition of its Code of Practice for Member Firms. Both Roche and Wyeth were members. (Para 14)

  They include:

    "Methods of marketing must never be such as to bring discredit upon the pharmaceutical industry" (Para 15)

    "Information furnished to the medical profession about a medical speciality product must be accurate and balance and must not be misleading either directly or by implication" (Para 16)

    "Claims for the usefulness of a product must be based on an up to date evaluation of all the evidence and must reflect this evidence accurately and clearly" (Para 17)

    "Communications on medical specialities must reflect an attitude of caution". (Para 18)

    "Observance of the Code is a requirement of membership" (Para 19)

    Clearly Roche and Wyeth broke the Code of Practice and clearly did not give a damn for the recipients of their drugs. They rode roughshod over principles all the way to their bank. (Para 20)

  On 5 March 1980, (Ref 8) Roche (Producers of Librium and Valium) wrote to all GP's and consultant psychiatrists a "Dear Doctor" letter. Clearly, they were concerned about their market share and a fall in profits and went on the offensive. Dr John Marks (a former Roche employee), whose thinking was in line with the 1980 CRM (Ref 9) systematic review of the benzodiazepines decision, to fudge the report on benzodiazepines. "The number dependent on the benzodiazepines in the UK from 1960 to 1977 has been estimated to be 28 persons". This lie was printed despite approximately 350 million prescriptions being issued during this period. Dr Marks, a few years later, revised his opinion on the true addictiveness of benzodiazepines. This came too late. The pattern was set and the damage done, all due to the criminally inept yellow card ADR System. (Para 21)

  Watts 1972 cited in Parish 1973 pp 30-31 "The patient must be warned that tablets are only to help him over the crisis. Longer courses are very hazardous and likely to provide drug dependent patients. When their use was accepted in our area as a reasonable form of treatment, so many people were on tranquillisers that a partner suggested we might as well put Chlordiazepoxide (Librium) into the tap water" (Para 22)

  Wyeth issued deliberately misleading advice re data sheets from 1974—1981-82. "it is advisable to avoid abrupt discontinuation of Ativan as some sleep disturbance MAY result. This applies especially when high doses have been given for prolonged periods." (Para 23)

  "The dependence potential of the benzodiazepines is low but this increases when high doses are used, especially when given over long periods." (Para 24)

  The date of the first warning in UK data sheets was 1984-85 yet the USA data sheet warned of possible physical and psychological dependence to Diazepam in 1971 and Canada 1973. (Para 25)

  "Little is known regarding the efficacy of safety of benzodiazepines in long term use". The date of the first warning in the UK Valium data sheets was 1984-85. (Para 26)

  Roche admitted to the US Senate hearings in 1979 that it had NOT itself undertaken or sponsored any research into dependence. Roche has deliberately or otherwise altogether omitted any reference to the development of "tolerance in data sheets for Valium. This could be expected to cause prescribers to seriously underestimate the risks of dependence involved with this drug. (Para 27)

5.  Regulatory Review of Drug Safety and Efficacy

  The 1980 CRM's (Committee on the Review of Medicines) "Systematic Review of the Benzodiazepines" states: "This report further observed that sleep laboratory studies show most hypnotics tend to lose their sleep-promoting properties within three to 14 days of continuous treatment. There was little convincing evidence that benzodiazepines were efficacious in the treatment of anxiety after four months continuous treatment" (Para 28)

  I could take members of the Committee to Oldham people who have been benzo addicts for 20-40 years so much for efficacy! The only reason they are still taking their drugs is to keep withdrawal symptoms to a minimum (Para 29)

  The UK Regulatory Authority MHPRA (Ref 10), just like its predecessor (MCA) is far too closely linked, almost incestuously so, to the drug industry. A completely new organisation, independent and with new Parliamentary powers and chaired by Mr Charles Medawar, needs to be set up as a matter of urgency. (Para 30)

6.  Product Evaluation Including Assessments of Value for Money.

  How do you start to put a monetary value on human suffering, loss of freedom, loss of employment. loss of memory, loss of family and loss of your soul to these mind altering drugs called benzodiazepines? (Para 31)

  Home Office statistics from 1990-96 (Ref IOA) (excluding 1994) show that benzodiazepine drug deaths by poisoning equal 1,810 compared with 291 heroin deaths, and 43 deaths from cocaine. Surely Class "A" drugs are more dangerous—or so the Home Office Minister Mr David Blunkett (Ref 11 A/B) tells us! (Para 32)

  If people taking tranquillisers did not drive (Ref 12), there would be an estimated 110 fewer road deaths and 1,600 fewer accidents each year. (Para 33)

  The Economic and Social Costs of Mental illness, Policy Paper 3 produced by 13 the Sainsbury Centre for Mental Health (Ref 13), in June 2003 estimated that the economic and social costs of mental illness for England 2002-03 totals £77.4 billion. When you consider that benzodiazepine drugs mimic mental health symptoms in addiction and withdrawal modes, and these drugs produce paradoxical symptoms, eg insomnia, depression, rage, anxiety and aggression, just what part of that £77.4 billion cost is directly and indirectly caused by benzodiazepine drugs? (Para 34)

  The BMJ, June 2004 stated that 10,000 deaths per year were from bad reactions to medication side effects at a cost of £466 million per year (Para 35)

  Trust me I'm a Doctor, but at what cost to the nation! "The health of my 14 patient will be my first consideration"—(Ref 14) The Declaration of Geneva Hippocratic Oath, 1948. (Para 36)

  I estimate that total deaths caused by benzodiazepine drugs from 1959 to 2004 are 18,450. (Para 37)

7.  Recommendations for Action by the Government or Others

    (a)  An independent full Public Inquiry to be ordered by Government as a matter of urgency into mind altering benzodiazepine, SSRI and "Z" Drugs. (Para 38)

    (b)  To completely change the UK Regulatory Authority under its present set up (as per para 30) (Para 39)

    (c)  To sack the Health Minister Ms Rosie Winterton MP, and her special 15 advisers forthwith. Appoint Mr Phil Woolas MP (Ref 15) (Presently Deputy Leader of the House of Commons) in her place and ex-addicts of benzodiazepine drugs, who are the real experts, as special advisers. Mr Woolas would be a master of his brief on benzodiazepine drugs, unlike Ms Winterton who has not got a clue, and has relied far too heavily on her special advisers on benzodiazepine drug matters of importance. (Para 40)

    (d)  for government to adopt in its entirety the recommendations for European Best Practice Guidelines of Beat The Benzos Report (Ref 16) "A call for EU guidelines on the prescribing of benzodiazepines, Europe's most harmful drugs" by Barry Haslam, 7 October, 2003 as a matter of urgency to the victims of these drugs. (Para 41)

    (e)  The Government to explain to the nation just why benzodiazepine drugs have been so freely and criminally prescribed in Britain when, under the 1991 Chemical Weapons Convention, drugs such as Valium or other calmatives would be outlawed. This protocol prohibits any chemical which can cause death, temporary incapacitation, or permanent harm. (Ref 17) (Para 42) So it's in order for Valium to be considered by the MOD as a chemical weapon and banned under the Chemical Weapon Convention, BUT—GIVE IT TO UK PATIENTS—THAT'S ACCEPTABLE? (Para 43). Go tell Mr. Blair I have found his weapons of mass destruction, they are in Britain NOT Iraq, they have been hidden since 1959 and are called benzodiazepines. (Para 44)

    (f)  For Paul Boateng MP (Ref 18) (now Chief Secretary to the Treasury) to honour his pledge of 25 April, 1994 to Barry Haslam and loosen the treasury purse strings for services and compensation when he said "Clearly the aim of all involved in this sorry affair is the provision of justice to the victims of these drugs (Ativan)" (Para 45)

    (g)  Drug companies, Roche and Wyeth, producers of Valium and Ativan respectively, should be urgently investigated by the DTI and Serious Fraud Squad, into corporate fraud and corruption. (Para 46) Roche and Wyeth should also be the subject of Police Authority investigations into charges of Corporate Manslaughter and other criminal acts. (Para 47)

    (h)  With regard to legal benzodiazepine drug addiction (1.2 million UK addicts long term), the Department of Health's record for services is a disgrace, abysmal and heads should roll. There is not one UK designated benzodiazepine drug withdrawal clinic at the present time. This despite 45 years of producing these neuro-poisoning chemicals and 45 years of super profits for the drug companies. (Para 48)

  Professor C Heather Ashton of the University of Newcastle states (Ref 19)

    "Facilities for benzodiazepine dependent people need to be developed. Detoxification units dealing with dependence on alcohol and illicit drugs, are not appropriate for prescribed benzodiazepine users who have unwittingly become dependent through no fault of their own. Such places usually withdraw the drugs too rapidly and apply rigid contract rules which are quite unsuitable for benzodiazepine patients struggling with withdrawal symptoms.

  Much needed are clinics specialising in benzodiazepine withdrawal where clients can receive individualised, flexible, understanding and supportive counselling. At present only too few voluntary support groups (Ref 20) valiantly strive to fill this gap with minimal finances. Proper financing would also allow provision of residential accommodation where clients in need could go for short breaks in a supportive non-hospital atmosphere at crucial times during their withdrawal process". (Para 49) Psychiatric units are completely the wrong environment and setting to withdraw legal drug addicts (iatrogenic). This procedure adds insult to injury. Benzodiazepine drug addiction is a chemical addiction problem, not a mental health issue. In my opinion, this has been deliberate Department of Health Policy to cover up the short-comings of the Medical Profession and Government. (Para 50)

  Legal benzodiazepine addicts get their "Fix" from their doctors. If this was not the case and they had to rob to feed their habit! Then the resulting chaos would make illegal heroin/cocaine addiction look like a "tea party". (Para 51.)

  A no fault compensation scheme for benzodiazepine drug injured victims should be funded by the manufacturers. Such a scheme exists in New Zealand for all drug injuries. Failing this, Government could slap a "windfall tax" on the manufacturers themselves, thereby obtaining optimum funding for compensation and finally putting in the required withdrawal and support services the benzodiazepine legal drug addicts so desperately need and deserve. (Para 52).

REFERENCES
1Manchester DSS Tribunal Report, January 1997.
2Oldham Chronicle, 16 June, 2004.
3A report on Benzodiazepine drug dependence submission to the European Commission—Barry Haslam. 7 October, 2003.
4AOldham Chronicle, 9111 August, 2002.
4BOldham Chronicle 30 January, 2004.
4COldham Chronicle, 15 April, 2004.
5Increase in Suicidal Thoughts and Tendencies, Association with Diazepam Therapy JAMA, 25 March, 1968, Vol 203, No 13.
6Statistics of the Misuse of Drugs.

Addicts notified to the Home Office—J M Corkery.

Deaths from Poisoning by Solid or Liquid Substances—compiled by Barry Haslam, 26 July, 2002.
7ABarry Haslam letter dated 9 October, 2002, to Ben Holgate, Legal Director Wyeth.
7BMCA Letter Mrs. Leigh Henderson to Barry Haslam, 7 December, 2000.
8"Dear Doctor" letter from Roche, 5 March 1980.
9Systematic Review of the Benzodiazepines, Guideline for Data Sheets. Committee on the Review of Medicines (CRM)—BMJ 29111 March, 1980.
10Statement on the position of Professor Sir Alasdair Breckenridge, Chairman, Medicines and Healthcare Products Regulatory Agency—Charles Medawar, 16 March, 2004.
11ALetter from David Blunkett MI' to Barry Haslam, 24 February, 1994.
11BHome Office Deaths Statistics—Barry Haslam, 12 May, 1998.
12The Guardian, 23 October 1998.
13The Economic and Social Costs of Mental Illness Policy, Paper 3. The Sainsbury Centre, June 2003.
14The Declaration of Geneva Hippocratic Oath, 1948.
15Parliamentary debates (Hansard) Westminster Hall, 7 December, 1999.
16"Beat the Benzos" Campaign—Barry Haslam A Call for EU Guidelines on the Prescribing of Benzodiazepines. Europe's Most Harmful Drugs.
17The Observer 26 May, 2002.
18Paul Boateng MI's letter to Barry Haslam, 25 April, 1994.
19Benzodiazepines—How They Work and How to Withdraw.

Medical Research Information from a benzodiazepine withdrawal clinic—Professor Heather Ashton, Revised Edition August. 2002.

Tranquilliser problems?—Tranx (Oldham)





 
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