Nearly two million people in Britain are addicted to drugs prescribed for them by their doctors. But. unlike the 80,000 heroin addicts who are mostly young and male, most tranquilliser addicts are women and predominantly elderly. Pain, misery, addiction or even death have frequently been associated with legitimately prescribed drugs. In the United States 130,000 deaths occur each year from drugs prescribed by medical practitioners; in Britain nearly one in thirty hospital admissions are due to prescribed drugs and about 2,500 people each year approach the charity Action for Victims of Medical Accidents for help.
With hindsight, some of the mistakes with addictive drugs seem incredible; when heroine was extracted from morphine in 1874 it was hailed as the new "miracle drug" for the safe treatment of morphine and opium addiction because it was considered safe and non-addictive. And it was to take over fifty years before the Rolleston Report identified heroin addiction in 1926. More recently, methadone was used extensively between 1971-1978 to treat morphine addiction and as an analgaesic substitute for morphine but, being itself highly addictive, led to a further spread of addiction.
Psychotropic drugs, prescribed for anxiety and depression, alter the patient's moods or mental processes. These drugs are much more likely to be prescribed for women; and extensive study in Oxfordshire found that psychotropic drugs accounted for one-fifth of all prescriptions and that women received more than twice as many tranquillisers and anti-depressant drugs as men. (Skegg et al British Medical Journal, 1977). The frequency of tranquilliser prescriptions increases with age; women over 75 years of age receive more of these than any other group.
In part, the larger quantities of mood altering drugs prescribed for elderly women can be attributed to the higher incidence of dementia in old age and the fact that most of the more common causes of dementia affect women more than men. But the excessive numbers of prescriptions for tranquillisers are not entirely justified on medical grounds alone. In recent years the closure of substantial numbers of hospital beds has led to increasing numbers of mentally and physically infirm elderly people being "cared for" in the community.
Providing safe care for mentally infirm old people in their own homes causes considerable problems for relatives. All too often tranquillisers have to be used to control the old person's behaviour and. even if the drugs are not addictive, the quality of life for the person is impaired. Caring for a demented person in a family home can prove to be a nightmare. Family life disintegrates due to disturbed nights, incontinence, noisy, aggressive behaviour and the need for somebody to be in attendance at all times. For such families there is no respite: holidays and nights out cannot be taken together and friends are deterred from visiting.
For middle aged women, in particular, caring for an elderly mother causes considerable anxiety because the traditional caring role is reversed and the awareness of the possibility of helplessness and insecurity for themselves in the future becomes all to evident. In such situations the temptation to resort to the use (and often the abuse) of tranquillisers is difficult to resist. Indeed, members of the family providing care may take tranquillisers themselves to cope with the difficult social circumstances forced on them by the lack of provision for care of the elderly. But for both the dependent elderly and their, mainly, female carers, tranquillisers are used as substitutes for social remedies which are not forthcoming under capitalism because workers are viewed as economic units.
The Royal Commission on Population put into perspective the disadvantageous position of the elderly under capitalism:
The burden of maintaining the old does not consist in the money paid out as Old Age Pensions. It consists in the excess of the consumption by the old over their production. It is the fact that (with some exceptions) the old consume without producing which differentiates them from the active population which makes them a factor reducing the average standard of living in the community, (pi 13)
This view of the elderly as redundant economic units has led to inferior standards of accommodation in the majority of hospitals for the long-stay elderly and the mentally ill.
The difficulty of attracting staff-in adequate numbers to work in poor conditions and inadequate facilities can lead to over-reliance on tranquillisers to control the patients as too few staff try to cope with relentlessly increasing numbers of admissions in the drive to make hospitals more "efficient" regardless of the social costs. And in private hospitals and nursing homes there is a greater temptation to resort to the use of tranquillisers to control disturbed elderly residents as trained nursing staff are reduced to a minimum in the drive to make profits.
Capitalist governments operate double standards when confronted with problems of drug abuse. In the past dangerous, addictive drugs have been sold abroad: human misery being an acceptable price to pay as long as profits are made. Drugs of doubtful therapeutic value but which have undesirable or even serious side-effects are produced and, where legislation prevents their use in this country, sold in countries which permit their use. Thus the addiction to tranquillisers and the misery that they cause, like addiction to tobacco and alcohol, only become the concern of the state when the efficiency of the workforce, and consequently profits, is threatened.
In 1987 only £500.000 was allocated to help tranquilliser addicts compared with £24.5 million for the much smaller group of heroin addicts. But. unlike heroin addiction, the use of tranquillisers is legitimate, respectable and widespread, with 14 million prescriptions being dispensed in Britain last year. The enormous profits which the drug industry makes has led to general practitioners being the targets of aggressive advertising campaigns to promote tranquillisers as a panacea for their patients' problems. But for patients who are prescribed benzodiazepine tranquillisers (Lorazepam; Oxazepam; Diazepam. Chlordiazepoxide) for periods of longer than four months physical dependency occurs even at therapeutic dose levels.
Withdrawal symptoms include anxiety, apprehension, tremor, insomnia, nausea and vomiting; in fact, many of the problems for which these drugs were prescribed in the first place.
Sexual dysfunction may be caused by both the phenothiazine group of drugs and the benzodiazepines. The phenothiazines, especially Phenergan, have been associated with cot deaths in infancy. The problems of toxicity and unpleasant side-effects of drugs arise because of the hasty and incomplete research carried out by pharmaceutical companies in their attempts to market their products ahead of their rivals. The continued demand for drugs to relieve anxiety is assured because competitiveness causes fear and insecurity. Capitalism's booms and slumps, wars, alienation at work and impoverishment in old age all generate anxiety for workers. And for women, the problems of isolation within the home for housewives or the stress of the "double shift" for working mothers leads to them consulting their doctors for the relief of tension more often than men.
Women's economic dependence on men (who themselves are economically insecure) has served capitalism's interests by providing future generations of workers within the conventional framework of the family.
Patrick Jenkin when he was Secretary of State for Social Services, stated.
I don't think that mothers have the same right to work as fathers. If the good Lord had intended us to have equal rights to go out to work, he wouldn't have created men and women. (Man Alive, October 1979)
The barriers placed in the way of working mothers by such attitudes; relegation to mostly part-time, unskilled, alienating work; low pay — women earned less than three-quarters of the average wages paid to men in 1982 — have all combined to place a greater emotional strain on women. The operation of factories around the clock to maximise profits leads to shift workers being forced to adopt unnatural life-styles. Insomnia causes some workers to resort to taking sleeping tablets to cope with this. Doctors are helpless to remedy the political causes of all these problems and offer tranquillisers to help patients cope with intolerable social circumstances.
Further abuses of tranquillisers occur in prisons where drugs are used to control prisoners who fail to "adjust" to their environment.
Undeniably, tranquillisers can be of value. Used carefully they can help to relieve distress. But it is the application of drugs under capitalism, which fails to heed the lessons of the past while the present is profitable, which is at fault. Medical advances, in common with all forms of technological advances, will be abused until the workers decide to place human needs before profits.
Carl Pinel
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