Today it is a society of immediacy, things have to be done quickly and benefits have to be made more quickly. With diseases the same model is followed, when we feel bad we hope to go to the doctor and complete it as soon as possible thanks to the miraculous pills he has given him. This model may have logic to cure the flu, but how can a pill heal a mental illness without other therapies? It's simple, it can't.

Benzodiazepines are a complete group of psychotropic substances that are used as hypnotic or anxiolytic. That is, they are drugs that treat insomnia and anxiety problems, as whoever takes them will feel a deep calm, as the pills inhibit the nervous system. These drugs have a major dependence effect, so the duration of treatment is accurate: if they are prescribed for insomnia between two and four weeks, to reduce anxiety between eight and twelve weeks. From this time, it is essential that the patient reduce the dose so as not to develop addictions and avoid the “rebound effect”. According to the Newsletter of Pharmacotherapeutic Information of Navarra in 2014, 8% of the population of this territory consume benzodiazepines, many of which have taken pills for at least 15 years. Lorazepam and diazepam, i.e. Orfidal and Valium are the most commonly used drugs.

One dependence on the other

Koldo Callado, professor at the Department of Pharmacology at the Faculty of Medicine at UPV/EHU, states that it is essential that physicians and patients be clear that benzodiazepines are not forever: “If after several weeks the symptoms have not improved, the illness may be different. Depression, for example, requires therapy and not just pills.” You cannot replace one problem with another, you have to try to solve it. One of the consequences of abandoning some drugs can be anxiety, and doctors often use benzodiazepines to calm the patient. If that patient develops addiction, one drug would simply be replaced by another. Callado believes that assessment is key, “physicians, when prescribing benzodiazepines, have to assume the responsibility of monitoring the treatment. We all have problems that cause us anxiety and nervousness, the pills can serve at every moment to reassure the patient, but they will not cure him”.

Concerns have been raised among physicians, but no alternative system has yet been proposed and the decision is in the hands of the health centres. However, the current model of society, according to Callado, makes people feel compelled to take medicine. The doctor is not entirely to blame.

The Osasunbidea technician, Ana Azparren, believes that in many cases the information can be sufficient for patients to progressively abandon the drugs. Azparren is one of the authors of the report Strategies for the deprescription of benzodiazepines. As explained, some minimal interventions can reduce dependence. By sending a letter to the patient or communicating that the treatment should be reduced during a meeting, the rates of withdrawal of medicines increase considerably.

The key to sleep

According to the Organization of Consumers and Users (OCU), the consumption of anxiolytic in the Spanish state increased between 2000 and 2012 by 57%. Since then, consumption has remained virtually the same. The report published by Osasunbidea shows the criteria for the withdrawal of benzodiazepines, but the main intention is another, according to Azpere, “more than criticizing physicians, we want to question our society’s habit of taking medications in the face of any problem.” Medicines can be beneficial, but they should be the last option. If people with insomnia do not abandon benzodiazepines on time, they will always depend on the pills to be able to sleep. However, there are alternatives without drugs. The “workshops of sleep” and psychotherapy that are organized in different health centers can be of great help for people with anxiety. The goal should not be to relax or sleep through the pills, but to achieve it naturally.

Benzodiazepines cause problems, but they are prescribed a lot, as the other drugs of the same effect are more dangerous. Consideration should be given to the advantages and disadvantages of the drug, making it clear what the long-term damage may be.

Damage to the cognitive system is the most frequent, especially memory loss and difficulties to keep attention, but also physical pain, as consumers have a feeling of weakness. Although the marginal effect is not correct, depressions occur frequently. Knowing this, it is significant that no systematic plan has been made for people who for many years have been dependent to leave benzodiazepines.