Chapter Seven

Managing benzodiazepine withdrawal

Moira Hamlin and Diane Hammersley

Introduction

Why manage tranquilliser withdrawal?

Recent years have seen an increase in media attention to the problems of dependence on tranquillisers, much of it focusing on the disabling physical and psychological side effects. Many tranquilliser users and ex-users have written or spoken about their difficulties and distress in trying to withdraw from these drugs. Many have described feelings of guilt at the discovery of their own ‘addiction’ or anger that they had become dependent involuntarily.

The search for information and sound advice has led many to start or join self-help groups or to seek advice from their general practitioners or drug-counselling agencies, both statutory and voluntary. The public has already received the message that tranquillisers are not the once-hoped-for safe alternative to barbiturates, but have many adverse side effects as well as a dependence potential. New guidelines on prescribing have been issued, limiting the use of tranquillisers to a maximum of four weeks and then only as a treatment of last resort (Committee on the Safety of Medicines 1988; Royal College of Psychiatrists 1988).

It is for those already dependent on tranquillisers, for a few weeks or over twenty-five years, that attention is now being directed towards finding a safe effective way to help those who wish to withdraw. Increasingly it is being recognised that tranquillisers were only ever of use as a temporary measure of symptomatic relief (Committee on the Review of Medicines 1980). Those who withdraw from them may also require further help to deal with psychosocial problems, of which anxiety was an indication.

It is understandable that people dependent on tranquillisers should feel that the best thing to do is to stop taking them immediately. Indeed some have been advised to do so, especially when on very

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