Simple check:

• Were you informed that benzodiazepines are highly addictive and that they should in general not be prescribed for any more than 2~4 weeks?

• Were you informed about the nature of withdrawal symptoms and how these can develop during the treatment, even whilst still taking the prescribed drugs, due to the forming of tolerance?

• Were you told that it is very dangerous to stop taking the drugs suddenly and the reasons why?

• Were you given alternative treatment options based on a risk analysis?

• Were you given the opportunity that, despite all the risks, the benefits outweighed those risks and any possibility of relying on safer non-drug methods such as lifestyle changes, practical coping techniques etc?

Detailed descriptions of informed consent

In article 4.4 of Addiction Report 4, Dr. Graeme Judson (specialist in addiction medicine) provided a list of considerations regarding prescribing, informed consent and monitoring. Most of these are based on examples in accordance with New Zealand law, and recommendations established by the World Health Organization, but may help to give some indication of whether or not there has been adequate informed consent in your own case.

Simple check:

• Has your prescribing doctor been asking you questions to check for the potential forming of tolerance at each of your consultations?

• Has your prescribing doctor been asking you questions to check for the potential forming of withdrawal reactions / symptoms at each of your consultations?

• Has your prescribing doctor been asking you questions to check for the potential forming of adverse effects at each of your consultations?

• Has he been keeping record of monitoring for the forming of potential dependency and adverse effects in the patient file?

• If you have reported problems, has your prescribing doctor responded in an appropriate manner? (See below)

Detailed descriptions of monitoring

In article 4.4 of Addiction Report 4, Dr. Graeme Judson (specialist in addiction medicine) provided a list of considerations regarding prescribing, informed consent and monitoring. Most of these are based on examples in accordance with New Zealand law, and recommendations established by the World Health Organization, but may help to give some indication of whether or not there has been adequate informed consent in your own case.

Did your prescribing doctor provide you with proper informed consent? (See above)

If the answer is “no”, then it reasonable to have your doubts.

Has your prescribing doctor been carrying out proper monitoring for potential forming of dependency and other adverse effects? (See above)

If the answer is “no”, then it reasonable to have your doubts.

Does your prescribing doctor have knowledge of what signs to look out for? (See Could You or Someone You Know be Dependent?)

If the answer is “no”, then it reasonable to have your doubts.

Has your prescribing doctor showed an understanding of the risks regarding adverse effects when prescribing for more than the recommended 2~4 weeks? (See adverse effects)

If the answer is “no”, then it reasonable to have your doubts.

Has your prescribing doctor showed an understanding of the risks regarding socioeconomic costs when prescribing for more than the recommended 2~4 weeks? (See socioeconomic costs)

If the answer is “no”, then it reasonable to have your doubts.

Consider this

• I had the opportunity to quiz a group of doctors about benzodiazepines at a reputable hospital. They were unable to answer about 90% of my questions, and yet some of them were prescribing them. They also said that information on benzodiazepines did not form any part of their curriculum at med school (needless to say, the government is responsible for this).

• I had the opportunity to talk to a pharmacist during my court case. When I raised the issue about benzodiazepines, he said “Oh, benzodiazepines are not addictive” and yet they are one of the most addictive substances there are (See How Addictive are Benzodiazepines?).

Further Reference

In Section of Addiction Report Four, Dr. Judson (Specialist in Addictive Medicine) discussed prescribing issues in my own case which may act as a further point of reference.

The short answer is no. Needless to say, drug companies have their own agenda which is to sell drugs.

For example, the package insert provided to me simply stated the following cautions:

• Alcohol should be avoided as it has additive effects.
• Drowsiness and lapses in concentration can occur, so due care is needed when driving, or operating dangerous machinery.
• If changing medical care provider, make sure to advise doctors and pharmacists of the fact you are taking thy drugs. (Yes, they actually use the honorific form “thy” when referring to this stuff…)

Where it failed:

• There was no actual drug names, only the brand names
• There was absolutely no mention of the fact these drugs are only recommended in general for 2-4 weeks as dependency can rapidly form.
• There was no mention that benzodiazepines don’t mix well with other drugs and only one should be taken at a time.
• There was no mention of the many tens, if not hundreds, of adverse effects and withdrawal symptoms associated with long term use (more than 2~4 weeks).
• There was no warning at all stating that it is dangerous to stop taking these drugs suddenly or the reasons why.
• There was no advice given on how to withdraw from these drugs.
• There were no recommendations stating what signs to look out for and what to do when problems occur.
• The information was misleading with statements like: “This medication stabilizes your mood”, “This medication improves your physical and mental wellbeing” “This medication improves irritability, palpitations, headaches etc”

(NB: I had no history of psychological complaints or palpitations but I got both these for the first time AFTER being wrongfully prescribed these drugs. Also, other people have complained of headaches AFTER being prescribed these drugs. By the time I had finished the course of so-called treatment, I was a total mental and physical wreck).

This problem with package inserts also proved to be a significant problem in my court case.

The courts willingness to base their decision on documentation from the pharmaceutical company was alarming when it is only common sense that their main priority is to protect and sell their product.

To quote from the Japan Times Newspaper article dated: Tuesday, March 13, 2012.

“Another issue of contention in the case was whether the daily dosage of benzodiazepines Douglas was prescribed was high enough to result in dependency. Most surprising of all, the high court relied on the packaging produced by the pharmaceutical company to determine the dosage at which benzodiazepines could be deemed addictive.”

Also see Justice or Not?

Later it became apparent that the package insert referred to by the judge in the verdict was not the same as the description / explanation that was inserted into my medication package.

This begs the question “How can something be called a ‘package insert’ if it’s not actually inserted into the package?” Isn’t it meant to be information for the customer? Nevertheless, it later became apparent that the information contained in the so-called package insert was inadequate anyway as it too failed to address the above.

“To rely on the drug companies for unbiased evaluations of their products makes about as much sense as relying on beer companies to teach us about alcoholism.” Marcia Angell MD, (Former) Executive Editor, New England Journal of Medicine