Benzodiazepines: Psychiatry’s Weakest Link  

Benzodiazepines may be the most popular, widely used, and immediately effective of all the psychiatric drugs. At the same time they are perhaps one of the most dangerous, addictive, and abused mind-altering substances on the planet. Since the 1980’s psychiatry and their partners in the pharmaceutical industry have spent billions of dollars marketing these drugs and justifying their efficacy in the “treatment” of anxiety and insomnia. Psychiatry has been able to create a patient base of millions of people who are dependent on these drugs and are forced to remain “co-dependent” customers of psychiatrists and other medical doctors in order to procure them.

Closely paralleling the timeline for the ‘benzo’ explosion was an equally nefarious promotional campaign by Big Pharma and certain leaders in pain medicine, called The Fifth Vital Sign Campaign. Starting in the early 1990’s the results of this campaign led to a proliferation of pain clinics throughout the country and millions of people becoming dependent on opiate pain drugs. This widespread expansion of opiate prescriptions became the impetus for the rapid growth of heroin addiction that now extended well beyond the boundaries of urban ghettos into middleclass, and even upper class communities.

Psychiatry could never have known or predicted that benzodiazepines would soon become the drug of choice, frequently added to an opiate/heroin drug cocktail because of its synergistic ability to greatly magnify the effect of the overall drug high. They could never have foreseen a time when as many as 60% of all opiate users end up taking benzos on a regular or part time basis, and 30% of all fatal opiate overdoses involve the deadly combination of these two drugs. 

Both psychiatry and the leaders in the pain “medicine” industry could never have imagined that in 2015 the opiate overdose epidemic would be so catastrophic that it would, in a powerful way, become interjected into the upcoming presidential election. A situation where multiple candidates have been confronted in public meetings by voters demanding to know what their solutions are for the opiate overdose epidemic sweeping the country.

Today this situation has progressed to the point where there is no turning back or safe way out for psychiatry when it comes to their promotion and prescribing of benzodiazepines. Millions are now dependent on these drugs and they will suffer horrible withdrawal if their drug prescriptions were somehow restricted or removed from the marketplace. The outcry and outrage would be thunderous, and justifiable so.  And at the same time, opiate prescriptions and heroin use has become so pervasive in our society that there is no turning back from “the perfect storm of addiction,” that is, the ever popular, and oh so deadly, drug cocktail of opiates and benzodiazepines.

Because there is no obvious or immediate way out of this institutional conundrum for psychiatry and the medical establishment, things will only get worse in this country, with even more drug related deaths that continue to devastate families and create greater public outrage. Could the benzodiazepine crisis and its connection to the opiate overdose epidemic be part of psychiatry’s fatal undoing? Could it be the weakest link in a chain of oppression that ultimately demands and requires our activism to ultimately crack it open and shatter it once and for all?

The institution of psychiatry wields enormous power in our society. It has been granted legal power and authority to restrain, psychiatrically label, Electro-shock, drug, and hospitalize (some would say, imprison) people against their will. Some people would declare that millions suffer from these particular abuses of power. Psychiatry, along with its partners in the psychiatric/pharmaceutical industrial complex, have also coerced and/or persuaded millions of people that their mind numbing (and often brain damaging) psychiatric drugs are the so-called solution to the inevitable conflicts that human beings encounter within their environment in a world filled with trauma based experiences.

A growing minority of people on this planet see all this power and control by psychiatry as various forms of psychiatric abuse, or, more pointedly, as major violations of human rights. These same people are actively searching for ways to permanently end these violations. Some even believe (like me) that psychiatry lacks any legitimate claim to medical credibility or legal authority, and therefore should be stripped of all such coercive power and control in our society, and be left to wither away into obscurity. However, any honest and objective assessment of today’s movement against psychiatric abuse would have to conclude that we are, at best, only a serious nuisance to the institution of psychiatry at this time in our history.

So what is to be done and where do we start? History tells us that “where there is oppression there will be resistance.” Today, there are only the very beginnings of serious resistance against the institution of psychiatry. Many activists against psychiatric abuse have suggested that the following struggles are presently some of psychiatry’s weakest links, and each one could be strategically identified as the main target of our organizing efforts at this time: Electro-shock (ECT), the drugging of children and the elderly, anti-psychotic/neuroleptic drugging of those labeled as psychotic, the widespread use and dependency on SSRI/antidepressants, or the spate of mass shooting by individuals psychiatrically drugged and “mistreated” by the current mental health system.

All of these struggles are clearly legitimate targets and each has its own strategic merits. But along with certain potential strengths comes some inherent weaknesses. Some of these struggles mentioned above have specific limitations based on the difficulty of its victims having the current ability to be aroused into action, and also on how the masses at large view certain segments of the population who have been psychiatrically labeled. Some of these limitations certainly apply to the issue of mass shootings, where the related fear mongering generated by these tragedies, and the calls for MORE mental health treatment, has substituted for any objective critique of the actual damage already done by a harmful mental health system. And additionally, are we just sort of waiting around for another tragedy of even greater proportions to happen before we can spring into action with exposure of psychiatry’s harmful “treatments” that all too often push certain vulnerable people over an emotional cliff?

There is another struggle that, so far, has not yet gathered as much momentum as a suggested area where our movement could gain much needed ground against the institution of psychiatry. This struggle may very well have the most potential to actually weaken the overall chain of psychiatric oppression in today’s world. I am proposing that psychiatry’s mass promotion of benzodiazepines and the related prolific medical prescribing of this category of drug, and especially its connection to the opiate overdose epidemic that is sweeping the country, is today’s weakest link in the powerful chain of oppression that the institution of psychiatry wields within present day society. What follows is a list of some of the strengths and objective criteria that support the idea for making this the main focus of our organizing efforts in the coming period:

1. Millions of people have been prescribed ‘benzos’ and continue to take them for many years. In the year 2013 there were 94 million prescriptions in the U.S.; most of these are long term prescriptions creating major dependency issues with serious emotionally crippling effects for many of its daily users.
2. There is a significant schism within the ranks of medicine regarding the safety and efficacy of prescribing benzos for more than 2-4 weeks. An emerging number of medical experts, doctors, and other activists are now speaking out about the dangers of long term benzo use and the related withdrawal problems when trying to taper off of these drugs. At the same time, many of these people are also publicly criticizing those in the medical establishment who still deny or downplay the dangers of benzodiazepines.
3. These drugs are not just prescribed and causing damage to people who are declared disabled with major psychiatric diagnoses, but their damage has spread widely to so-called higher functioning segments and strata within our society. The benzo problem has clearly become pervasive among broad sections of the people.
4. Women are two times more likely than men to be prescribed benzos, and these gender issues dovetail with other related issues of women’s oppression and related resistance within our society.
5. There are major examples of both more subtle and overt resistance on various social media and the internet, as evidenced by such websites as Benzo.orgUK; Benzo buddies.org; Benzo support.org; Benzo withdrawal.org; and Benzo Beware on Facebook. These sites offer underground support and highly active forums helping benzo users find ways to lessen the damaging effects of these drugs and aiding these people in their struggle to safely taper off of them. A process that we now know could take years for some survivors.
6. Those people (perhaps in the tens of thousands or more) seeking help on internet forums and social media are often fighting through feelings of confusion, desperation, shame, and quilt. They often feel (with good reason) betrayed and abandoned by their prescriber who will frequently blame the patient for problems managing these drugs as their dependency often escalates into multiple forms of iatrogenic crises. And while there is great desperation for those folks currently dependent on benzos, there is an incredible amount of justified anger and fury directed towards psychiatry and organized medicine, as well as, an active search for the answer to the question: “how the hell did this happen to me!?”
7. Many of today’s more outspoken survivor activists have educated themselves and discovered the real answer to this question. Some very articulate writers have even published books and written numerous magazine articles about their odyssey through the world of medically induced benzodiazepine dependency. Authors such as Matt Samet (Death Grip: A Climber’s Escape from Benzo Madness), Melissa Bond (Killer Brain Candy and Cracked Open), and Barry Haslam (Benzodiazepine Drugs: My Story of Survival) are also well known bloggers at Mad in America (MIA) with very powerful stories to tell. And Stevie Nicks, the famous rock singer, has written and spoken out angrily about losing 8 years of her life to Klonopin. Blog postings about benzodiazepines and their related problems are some of the most popular and widely read and discussed articles at MIA.
8. Popular movie stars and other famous people such as Heath Ledger, Phillip Seymour Hoffman, and Whitney Houston, to name a few, all died with benzos in their system; Ledger and Hoffman both died from the combination of opiates and benzodiazepines and Whitney Houston had benzos, alcohol, and muscle relaxants in her bloodstream.
9. Fifty to sixty percent of all opiate drug users also use benzos on a regular or occasional basis. Opiate addicts readily seek out benzos because of their ability to potentiate or magnify the effect of the overall drug high. The benzodiazepine crisis (a major issue in its own right) also intersects in very decisive and deadly ways with the epidemic of opiate overdose fatalities that is presently sweeping the U.S and other countries in the world. In the recent period 25,000 or more people are dying yearly of opiate drug overdoses in the U.S. This figure combines both legally prescribed opiates with illegally procured heroin. It is most likely an overall low ball figure due to the fact that toxicology reports are often not completed on certain deceased individuals. This amounts to at least 68 deaths per day; almost 3 deaths per hour. The World Health Organization estimates that 69,000 people die worldwide from opiate overdoses.
10. Stanford researchers sent out warnings in 2014 (based on a significant JAMA study by Jones et al., 2013) that at least 30% of all opiate overdose fatalities involve the combination of opiates and benzodiazepines. The significance of this 30% figure cannot be underestimated or repeated enough times. Using this percentage as a guide, almost 15 or more people die every day from the very lethal added effect of benzos to an opioid laced drug cocktail.
11. The rise in benzo prescriptions, starting in the early 1990’s, parallels the similar rise in opiate pain drugs prescriptions and the related proliferation of financially lucrative pain clinics spreading throughout the country. This new trend in opiate drug prescribing was carefully engineered by Big Pharma with their infamous Fifth Vital Sign Campaign. From the years 2002 to 2009 benzo prescription rose at a rate of at least 12.5% a year paralleling the rise in opiate drug use and the much written about epidemic of fatal opiate overdoses.
12. Many opiate users/addicts know how to use their opiates, but they often forget about the benzos they consumed earlier in the day, as well as, underestimate the dangers of combining these two categories of drugs. By themselves benzos are usually not life threatening when taken in excess (unless you are driving heavy machinery etc.), but it is their combination with opiates and other sedative/hypnotics that, all too often, depresses lung and heart function to life threatening levels. Death always lurks very close by in these situations.
13. Some government and public health officials are now speaking out about the dangerous high number of opiate drug prescriptions in this country. It has now become well known to drug experts that 50% or more of all new opiate addicts move on to heroin use through legally prescribed opiate pain killers. However, no government or public health officials are speaking out about the intimate connection between the record high number of benzo prescriptions and the raging epidemic of opiate overdose fatalities. Psychiatry and their partners in Big Pharma, have been the key initiators and promoters of the dangerous explosion of benzo use and dependency in our society over the past 40 years. So far they have been able to skate relatively free with little public exposure or condemnation for their particular role in this explosion in drug use, and the high number of deaths it causes, especially with opiate overdoses.
14. The opiate overdose crisis is a major problem in society that even the most arrogant politicians, public officials, and other so-called experts are humbled by. They are totally unable to provide any real answers or viable solutions. This particular drug crisis has already become a significant issue in the upcoming presidential election. The very first question addressed to Hillary Clinton at her first N.H. public gathering was focused on asking what she would do about the opiate overdose epidemic. Other candidates from both parties have also faced similar questions. Carly Fiorina, a rising candidate in the Republican Party, had a step daughter who died in 2009 from an opiate drug overdose; there is no public evidence that benzos were also involved in her death (although research tells us that there is a 30% chance of this being the case). None of these candidates will be able to provide any realistic answers to these questions. The often promoted idea of putting more opiate addicts on methadone and suboxone/buprenorphine (both synthetic opiates), without addressing the benzo problem, will only exponentially increase the dangers of more fatalities occurring in the future.

The purpose of this blog is to shine the spotlight on the dangerous and sometimes deadly role of benzodiazepines in present day society, and to get people to start to think strategically about how we can take advantage of the opening that psychiatry has provided us given their instrumental and complicit role in this crisis. Here are some beginning thoughts on what we could do in the coming period to exploit psychiatry’s weakest link:

1. Attend and speak out at all the town and city meetings happening all over the country that have been organized by government and health officials to address the opiate overdose epidemic. Focus exposure on the role of psychiatry and their intimate connection in the involvement of benzo promotion and prescription, and its significant connection to opiate overdose fatalities.
2. Write Op-Ed articles like here http://www.southcoasttoday.com/article/20140422/Opinion/404220303 and http://www.southcoasttoday.com/article/20150802/OPINION/150809968 in local newspapers exposing the benzodiazepine crisis and its’ connection to the opiate overdose epidemic.
3. Research the amount of benzodiazepine prescribing in your area by using the Propublica.org website. For example, I discovered that, in the year 2013  with Medicare prescriptions, 4 out of the top 5 and 15 out of the top 25 prescribers of Xanax in the state of Massachusetts (out of 30,000 doctors) were all located in the New Bedford/Fall River area of the state. This area happens to also be a major hotspot for opiate overdose fatalities.
4. Speak to certain local politicians and representatives in your cities and towns and educate them about the critical role of benzos in the opiate epidemic. For example, I approached one representative in a local city and she was so outraged by the material I gave her that she asked me to create a power point presentation on the dangerous role of benzos for a government subcommittee on mental health and addiction issues.
5. Organize and promote major educational conferences in key U.S. cities, such as Boston, New York, Chicago, and Los Angeles, that bring together some of the best scientists, doctors, and survivor activist/authors who can educate and speak out with experience and authority on the benzodiazepine crisis.
6. Have those people already involved in various internet forums dealing with benzo dependency raise these issues (in the forums) as part of survivor’s attempts to liberate themselves from these drugs and the very direct experience of psychiatric oppression.
7. Everyone needs to get aroused and become creative in their thinking in order to develop a definitive strategy for the coming period, including those tactics that pertain to the upcoming elections and the platform that it may provide for voicing certain anti-psychiatry activist causes.

It is becoming more and more obvious that today’s benzodiazepine crisis, and its connection to the opiate overdose epidemic, lays bare psychiatry’s weakest link and provides enormous future opportunities to greatly weaken the overall chain of psychiatric oppression.

However, these opportunities for political exposure and organized resistance also have some important challenges that need to be addressed. While benzos are clearly very highly addictive and many drug addicts frequently use them, we must be very careful not to allow the spotlight in the benzo crisis to somehow focus on the millions of people who are tragically dependent on these drugs through no fault of their own. People dependent on these drugs have been victimized and suffer from iatrogenic damaged by psychiatry, Big Pharma, and the medical establishment. For this reason it is necessary to avoid labeling people dependent on benzos as addicts, which only tends to imply some element of choice and intentional involvement in a pattern of self-harm.

At the same time we must be aware that people using benzodiazepines on a regular basis have great fear (and for good reason) that they could run out of or be denied access to these drugs by doctors who often betray and/or abandoned them. Given the horrible effects of withdrawal symptoms, those people dependent on benzos might be afraid that all of this attention we raise about the dangers of this category of drug could make it more difficult for them to both access the drugs and/or safely (over a long period of time) taper off of them. For this reason, we must include, in all our political exposure on this issue, specific demands that the people damaged by benzodiazepines need to be given compassionate help and the very best that science and medicine can provide in order to aid them in overcoming dependency problems. Fighting back in an organized way against the institutions that have abused them will also help benzo survivors in their difficult personal battles.

To all those desirous of a world free of human rights violations, psychiatry has unknowingly gifted us a tremendous opportunity to expose and weaken their institutional chain of oppression. We must not fail in our historical responsibility to “seize the time” and give psychiatry its own version and taste of the highly pervasive condition called the “benzo blues.”

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References:

1. American Academy of Pain Medicine press release March 6, 2014, Stanford University researchers (Ming-Chi Kao) warn: Prescriptions for Benzodiazepines Rising and Risky When Combined with Opioids.
2. American Society of Addiction Medicine; Opioid Addiction Disease 2015 Facts and Figures.
3. Fiore, Kristina; Killing Pain: Xanax Tops the Charts; MedPage Today; Feb. 25, 2014.
4. Jann, M; Kennedy, WK; Lopez, G; Benzodiazepines: a major component in unintentional prescription drug overdoses with opioid analgesics; J Pharm Pract.; Feb. 27, 2014.
5. Jones, Jermaine D.; Mogali, Shanthi; and Cormier; Sandra D.; Polydrug abuse: a review of opioid and benzodiazepine combination use; Drug Alcohol Depend.; 2012, Sept. 1; 125(1-2); 8-16.
6. Jones et al; Pharmaceutical Overdose Deaths, United States, 2010; Journal of the American Medical Association (JAMA)2013; 309:657-9.
7. Ornstein, Charles; Jones, Ryann Grochowski; One Nation Under Sedation: Medicare Paid for 40 Million Tranquilizer Prescriptions in 2013; Propublica.org; June 10, 2015
8. Skepticalscapel blogspot.com, Pain is Not the 5^th Vital Sign; Aug 29, 2014
9. Whitaker, Robert; Cosgrove, Lisa; Psychiatry Under the Influence: Institutional Corruption, Social Injury, and Prescriptions for Reform; 2015