It has often been said that the chronic illness of Canada’s health care system is due not just to a shortage of money, but equally to problems within the system. Take prescription drugs, for example, particularly tranquilizers.

At least since the early 1980s, it’s been known that benzodiazepines (Valium, Ativan, Xanax, Halcion and many others) are highly addictive and especially dangerous for seniors. And yet their use continues to rise, with 20 million prescriptions written in Canada last year.

Just in the past five years, 16,500 seniors have died of adverse reactions to drugs, many of them benzodiazepines. And this is only the tip of the iceberg. We have no mandatory reporting system in Canada, which means that no more than 10% of adverse reactions are ever recorded. Some health professionals, put that figure as low as 1%.

Shocking? Deeply troubling? Indeed, but such are the findings of a superb investigative series that has been running on CBC radio’s The Current for the past few months. Titled Prescribed to Death, it focuses particularly on seniors and on benzodiazepines.

This is a particularly nasty family of drugs, more addictive than heroin or cocaine. Withdrawal from heroin in a detox center takes 5-7 days. For Ativan it’s 4-6 months. The CBC interviewed people who had been stuck on Ativan for decades, utterly powerless to break free.

Benzodiazepines have a way of trapping seniors in a vicious cycle of addiction, confusion, dizziness, a fall and injury (three times more likely for older people on psychotropic drugs), followed by declining health, depression and deepening dependence.

A gerontologist told The Current that he and his colleagues are “quite ruthless” about stopping the elderly from taking benzodiazepines. They are ineffective and dangerous, he said, and there are usually safer alternatives.

And yet, the CBC team found that nursing homes use these drugs routinely as “chemical restraints” to keep patients in a docile, easily-managed condition. In a word, zombies.

The cost of all this to the health care system is enormous, as injuries and addictions turn into chronic situations that keep the bills coming in for years. And that’s aside altogether.

The fact is, we are a society hooked on drugs. As a number of health professionals told the CBC, to solve the problem of benzodiazepines (and many other drugs) we must summon up the willpower to break with our “prescribing culture.” Too many practitioners find writing a prescription quicker and easier than taking the time to get to the root of a patient’s problem, which is often psychological. And too many patients want a quick fix, a pill or injection to reassure them that something is being done for their condition, even if it’s not the right thing.

Meantime, if you or someone you know is struggling to get off one of the benzodiazepines, you might want to consult The Ashton Manual at www.benzo.org.uk/manual/. It’s the work of Dr. Heather Ashton of Newcastle University, arguably the world’s leading authority on benzodiazepine withdrawal.

And if you’d like to know more about the CBC series, you can listen to the broadcasts at  www.cbc.ca/thecurrent/prescribedtodeath.

©Dr. Ashely Gordon, 2005.