In the 1980s and early 1990s, benzodiazepines were responsible for the largest-ever class-action lawsuit against drug manufacturers in the UK. The lawsuit involved 14,000 patients and 1,800 law firms and over £50 million pounds was spent on legal aid and by the drug companies. The suit alleged that the drug manufacturers were aware of the dependence-causing potential of the benzodiazepines, but that they intentionally withheld this information from medical prescribers like doctors.
Simultaneously, 117 general practitioners and 50 health authorities were sued by the patients in an attempt to recover damages for the suffering and loss caused by the harmful effects of benzodiazepine dependence and withdrawal syndromes. This was notable in that it led to some prescribers requiring patients to sign an informed consent form prior to being prescribed benzodiazepines and to recommend that all patients be warned of the dependence and withdrawal potential of benzodiazepines prior to their prescription or initiation of benzodiazepine drug “treatment”.
The class-action suit against the benzodiazepine drug manufacturers never reached a settlement or verdict due to the fact that legal aid board funding was withdrawn in 1993-1994 (legal aid in England provides government funding for legal assistance to those who cannot afford to pay a lawyer to give them legal advice or represent them in court). Changes in British law actually resulted from this landmark trial, making class action lawsuits more difficult. The withdrawal of funding precipitated the demise of the case and trial. There were also allegations that the consultant psychiatrists and expert witnesses had conflicts of interest.
Alarmingly, in the few years which would follow the collapse of the litigation, 1994-1997, the iatrogenic benzodiazepine problem persisted — becoming more insidious. In just that short period of three years, the number of prescriptions for sedatives/hypnotics increased overall by several percents and the prescriptions for Valium alone escalated by fifteen percent. The prescribing of the new sedative/hypnotic drugs, Z-drugs such as Zolpidem(Ambien/Edluar/Intermezzo/and Zolpimist/) and Zopiclone(Zimovane/Imovane), also perilously climbed in that time period, reaching about 2 million per year by 1999. This burgeoning of Z-drug prescriptions occurred in spite of the fact that the number of reported adverse events for that class of drugs was much greater (x 100) at the time than any of the benzodiazepines.
The lessons of history clearly have not been learned and new dependence epidemics have since emerged with the Z-drugs and now also SSRIs and other psychopharmaceuticals, perhaps because this class-action legal effort was not ultimately successful, causing no monetary or ethical motivation to require stricter regulations and the much-needed prescribing practice changes.
On a smaller scale, there has been some successful litigation and monetary compensation (as well as more failures) to individual patients or their families. Ultimately, “hitting them in the pocketbook”, which is sadly the only place that seems to count, may be the only way going forward; appealing with medicolegal ethics, evidence, guideline recommendations and accounts of devastating harm and losses have seemed to fall on apathetic and closed ears for nearly sixty years.
In the words of benzodiazepine expert Professor Malcolm H. Lader, a professor of clinical psychopharmacology at the Institute of Psychiatry at the University of London:
There is a change taking place, which is that if a general practitioner prescribes for longer than the agreed time—two weeks or four weeks—they can be sued by the patient for substandard clinical care, and I suspect in the longer term the prescribing of these drugs will be as much dependent on lawyers’ attitudes as it will be on doctors’ attitudes.
Filing a complaint about negligent medical providers to your State Medical Board (or another prescriber regulatory agency, depending on where you reside) may also be in order to bring the benzodiazepine prescribing (and irresponsible, dangerous withdrawal) problem to their attention. With any settlements or successful litigation, it is important to expose them publicly, where there is no gag order; fear, shame, and monetary loss seem to be the only great motivators. Avoiding formal complaints and litigation can be a significant motivator for medical providers to get quickly educated about iatrogenic benzodiazepine (or any other dependence-causing psychopharmaceutical) and Z-drug dependence, withdrawal, and injury.