Benzodiazepines have been available for more than 30 years. At the time of their introduction, these drugs were heralded as a safe alternative to the widely prescribed and addictive barbiturates, and were greeted warmly by the medical profession and by patients. However, the addictive potential of benzodiazepines has been increasingly recognised, placing growing pressure on prescribers and patients to limit their use, especially in the long term.
These precautions seem to have been effective, in that prescribing has decreased and the eruption of problems arising from addiction among patients on prescribed drugs appears to have passed its peak. On the other hand, benzodiazepines have been taken up by street drug abusers, not only at conventional doses and by the oral route, but also in larger doses and intravenously.
Alarming new reports from several continents indicate a serious abuse problem, with major attendant risks in terms of mortality and morbidity in the future. Our understanding of the effects of large doses of benzodiazepines administered by the intravenous or oral route is extremely limited, and further clinical research into the physical, psychological and sociological implications of benzodiazepine abuse needs to be undertaken.
Plant M. What aetiologies? In: Edwards G, Busch C, editors. Drug problems in Britain. A review of ten years. London: Academic Press, 1981: 245–80Google Scholar
Turner D. The development of the voluntary sector: no further need for pioneers? In: Strang J, Gossop M. Heroin addiction and drug policy. The British system. Oxford: Oxford Medical Publications, 1994: 223–4Google Scholar
The La Roche affair. In: Gossop M. Living with drugs. London: Ashgate, 1993: 53-5Google Scholar
Department of Health and Social Security Advisory Council on the Misuse of Drugs. Treatment and rehabilitation. London: HMSO, 1982Google Scholar
Department of Health. Drug misuse and drug dependence: guidelines on clinical management. London: HMSO, 1991Google Scholar
Scottish Office Home and Health Department and Scottish Health Services Advisory Council. The management of anxiety and insomnia. A report by the National Medical Advisory Service. Edinburgh: HMSO, 1994Google Scholar
Klee_H, Fauzier J, Hayes C, et al. Aids-related risk behaviour, polydrug use and temazepam. Br J Addict 1990; 85: 1125–32PubMedCrossRefGoogle Scholar
Wright JD, Pearl L. Knowledge and experience of young people regarding drug misuse, 1969-94. BMJ 1995; 310: 20–4PubMedCrossRefGoogle Scholar
Robertson JR, Ronald PJM, Raab GM, et al. Deaths, HIV infection, abstinence, and other outcomes in a cohort of injecting drug users followed up for 10 years. BMJ 1994; 309: 369–72PubMedCrossRefGoogle Scholar
Ross HE. Benzodiazepine use and anxiolytic abuse and dependence in treated alcoholics. Addiction 1993; 88: 209–18PubMedCrossRefGoogle Scholar
McDermott P. McDermott’s guide to the depressant drugs. Manchester: Lifeline Publications, 1993Google Scholar
Tantam D, Donmall M, Webster A, et al. Do general practitioners and general psychiatrists want to look after drug misusers? Evaluation of a non-specialist treatment policy. Br J Gen Pract 1993; 43: 470–4PubMedGoogle Scholar
Gill ON, Noone A, Heptonstall J. Imprisonment, injecting drug use, and bloodborne viruses: a threat of transmission but an opportunity for prevention. BMJ 1995; 310: 275–6PubMedCrossRefGoogle Scholar
Scivewright N. Benzodiazepine use among injecting drug users [letter]. Addiction 1994; 89: 1701–3CrossRefGoogle Scholar
Barnas C, Rossmann M, Roessler H, et al. Benzodiazepines and other psychotropic drugs abused by patients in a methadone maintenance program: familiarity and preference. J Clin Psychopharmacol 1992; 12: 397–402PubMedCrossRefGoogle Scholar
Darke SG, Ross JE, Hall WD. Benzodiazepine use among injecting heroin users. Med J Aust 1995; 162: 645–7PubMedGoogle Scholar
Griffiths RR, Wolf B. Relative abuse liability of different benzodiazepines in drug abusers. J Clin Psychopharmacol 1990: 10: 237–43PubMedCrossRefGoogle Scholar