Page 508 - Week 02 - Thursday, 25 February 1993
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MRS CARNELL (12.05): Madam Speaker, I too support the recommendations of the committee. As did Mrs Grassby and Mr Moore, I very much enjoyed being part of the committee on this reference. The reference does have a certain personal importance to me, and when we were initially deciding on what we should look at I did push quite hard for it. After many years at the coalface of this problem, it continues to concern me that benzodiazepine addiction is overlooked, and overlooked regularly and in an ongoing manner, by the community at large.
Initially, when the name of the report was suggested - "A Tranquil Addiction?" - I was concerned because it could have been seen to play down the importance of the subject. On further thought, though, I felt that it did quite specifically show what the problem was. It is a tranquil addiction. It is an addiction that is not obvious in the community, yet it is an addiction that in its own way is substantially more widespread than addiction to heroin, marijuana, or possibly even cigarette smoking. Certainly, one cannot look past alcohol as being our greatest problem in the drug area in the community, and that is something the committee is looking at in its last reference.
As Mr Moore said, benzodiazepines are interesting drugs because they are probably one of the safest groups of medication we have at our disposal. Benzodiazepines are used predominantly for stress and anxiety, but they are also very important muscle relaxants and are used regularly for sporting injuries and other problems related to muscle tension. They are also used for chronic sufferers of tension headaches - something that is a very common affliction in the community - and are substantially safer when used for those conditions than is any alternative drug, even any alternative analgesic, when used for tension headaches and problems like that. This is the great problem of benzodiazepine addiction. Because they are so safe, if we make them less available to medical practitioners and therefore to the community, medical practitioners will be placed in a position of having to use drugs that are less safe. That caused a lot of discussion at the committee level, as Mrs Grassby said, about how we could make benzodiazepines less available, how we could stem the flow. The AMA and other people who spoke to the committee suggested that in anything we do we must keep at the forefront of our minds this problem: If benzodiazepines are not prescribed for complaints such as stress and anxiety or as muscle relaxants, what will be prescribed is compound analgesics, with their obvious kidney and liver problems, tricyclic anti-depressants, with very nasty toxicity problems and easy capacity for overdose - and the problem goes on.
The committee had to come to grips with the fact that we were dealing with a very safe but very addictive drug, and that makes it particularly difficult. The next thing the committee had to come to grips with was the nature of the patients involved, and unfortunately the patients are predominantly women. I fully agree with the committee; I do not believe that it is because women are more likely to be anxious or stressed. I believe that it is because in the past general practitioners have been more likely to prescribe benzodiazepines for women. It has been perceived that women need that little help along, which I think is totally inappropriate and also not true.
The patients are certainly not, as Mr Moore said, in the lower socioeconomic group. They tend to be middle-class women, in many cases, and men in fewer but still a substantial number of cases. This causes a problem for our support services. Support services are generally not aimed at that group. It is particularly
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