Prescription drugs for anxiety and insomnia used heavily in Finland
Hundreds of thousands of Finns use benzodiazepines
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By Tuomas Peltomäki
Prescription medications against anxiety and sleeplessness have increasingly become a part of everyday life for Finns.
More than 190,000 people took anti-anxiety drugs such as diazepam last year. More than 100,000 people took drugs to help them fall asleep, and another 70,000 took actual sleeping medicines.
The number of people taking drugs against anxiety corresponds to the entire population of the cities of Turku and Uusikaupunki. The number of people taking pills against insomnia corresponds to the entire population of Tampere, plus half of that of Vantaa.
Most sleep and anti-anxietydrugs are benzodiazepines, which are easily prescribed to those who are stressed, bullied, shy, or otherwise suffer from anxiety in their everyday lives.
However, the drugs can easily lead to dependency. The National Supervisory Authority for Welfare and Health (VALVIRA) has warned that their use is connected with “a serious danger of physical and psychological dependence and abuse”, and that therefore they should be prescribed for as short a period as possible.
Prescriptions for benzodiazepines should be given for no more than 4-12 weeks at a time, and the patient should be weaned of the medication in that time.
In practice, however, doctors tend to flout these guidelines, and benzodiazepines are often prescribed repeatedly for years, and even decades.
Professor Jarmo Hietala of the Turku Psychiatric Clinic, believes that as much as 40 per cent of use of benzodiazepines is long-term use. He and Dr. Tero Taiminen have written an article on the harms caused by long-term use of the drugs. The article has just been approved for publication in Lääkärilehti, the journal of the Finnish Medical Association.
“We want to take issue with this long-term use. The cognitive damage caused by benzodiazepines is well known, but they are taken into consideration fairly little”, Hietala says.
Negative effects include the slowing of the thinking and observation processes, problems with memory, and exhaustion. These exist especially with the elderly, or with those who use the drugs heavily.
Hietala notes, however, that many people really need benzodiazepines, which are a very effective medicine for the treatment of temporary anxiety.
“On the other hand, there are patients who use the medication according to instructions, and the medication does relieve anxiety, even if it is taken regularly for ten years.”
Hietala says that it might be worth stopping to consider other types of treatments if a patient takes pills for ten years for the same anxiety.
“That is why we are worried about long-term use. It jams up the situation. People seek immediate help from medicines, and do not think beyond that.
One reason that people end up taking benzodiazepines for long periods of time is the lack of time that doctors at public health care centres have for seeing patients.
In Finland, a patient spends about 15 minutes consulting with a doctor.
When a victim of bullying, or someone suffering from some other type of anxiety arrives at a clinic to see a doctor, the easy and compassionate solution is to prescribe a course of benzodiazepines and to take it from there. There is not much time for anything else in a quarter of an hour.
“Well, people do what is possible. Especially if people do not know when a patient will get the next appointment”, says Taina Mäntyranta, an official at the Ministry of Social Affairs and Health.
Although it is easy to get into the benzodiazepine habit in the Finnish health care system, getting out of it is more difficult.
“However, withdrawal from benzodiazepines is not comparable to dependence on narcotics – it is much easier.”
Helsingin Sanomat / First published in print 21.5.2011
Helsingin Sanomat
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| 24.5.2011 - THIS WEEK |
 Prescription drugs for anxiety and insomnia used heavily in Finland |
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