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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 March 31; 334(7595): 698.
PMCID: PMC1839204
From the Frontline

Our chemical romance

Des Spence, general practitioner, Glasgow

I love music. At 9 am, hunched over my computer, I try to buy tickets on Ticketmaster before the touts do. Briefly the NHS internet is jammed, and I can almost hear the desperate sound of mouse clicks across the country. At 9 02 I whoop inappropriately loudly, as I receive my email confirming the My Chemical Romance tickets. At 9 05 I call in my first patient, apologise for being late, and say, “No, I have no idea what that animal noise was.”

It is the pain, the energy, the lyrical ambiguity—but most of all it is the passion of music that appeals. Music is a form of escapism that lifts your mood and quells anxiety. Music transcends generations, cultures, and time—it is one of nature's gifts to humanity. I can't prescribe music, but I can prescribe benzodiazepines.

Hate is a strong word and, like love, much abused by modern literature and culture. But in a truly biblical way I hate benzodiazepines. Whole neighborhoods seem to be dependent on benzodiazepines, a drug that transcends the generations—abused by one and all. In general practice, drug seeking behaviour and chiselling for benzodiazepines are a constant battle. I also know that many of my prescriptions are diverted into the black market of prescription drugs: thriving small businesses, not unlike touting—a 10 mg diazepam tablet (“a blue”) is worth £1. The streets are awash with our prescription drugs and also a multitude of imports and fake drugs. I do not know how to stop this and, trust me, I have tried.

Psychological pain is not abstract—it burns like no other kind. The temptation to self medicate is strong. I am guilty of having tried alcohol to ease the pain, but alcohol merely snuffs out the last few remaining stars in the darkness. Benzodiazepines are no different. A recent reclassification of drugs placed benzodiazepines up with ketamine and amphetamines (Lancet 2007;369:1047-53)—it is where they belong.

Benzodiazepines are a blunt instrument and just another example of medicine's staggering oversimplification of life. Psychological pain has purpose—it is something that we need to work through. Friendship, family, loyalty, and time heal—the scars serve to remind and educate.

I have worked with benzodiazepines for 20 years and I believe we should consider withdrawing them from clinical practice. They offer no answers. A slow strangulation of dependence and tolerance is their only certainty. Benzodiazepines help collude in the deceit that medicine or medications have anything to offer towards true happiness. I am grateful that I find solace in music.

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