Valium, a tranquilizer taken routinely by more than 15 percent of the adult population, is potentially addictive even in moderate doses, a panel of doctors and former Valium addicts told a Senate committee yesterday.
The former Valium users said they experienced agonizing withdrawal symptoms when they tried to drop the drug. They complained that their doctors never informed them of Valium's dangers when first prescribing it.
At the same hearing, the company that manufactures Valium -- Hoffman-La Roche Inc. -- was criticized for continuing heavy Valium promotional efforts sometimes targeted at people experiencing such everyday anxieties as "marital discord and financial tensions."
"The average person dealing with the ordinary stress of life does not need these drugs," said Dr. Richard Crout, director of the Food and Drug Administration's Bureau of Drugs.
Sen. Howard Metzenbaum (D-Ohio) also accused Hoffman-La Roche of financing a $4 million continuing medical education program at Cornell University as a way of propagandizing for Valium.
The company defended its product and its promotional efforts before the Senate subcommittee on health, describing the Cornell program as a legitimate medical training program, over which the drug company has no control.
Valium is the most widely prescribed drug in the United States. About 68 million prescriptions for Valiium and other Hoffman-La Roche tranquilizer, Librium, were written last year, according to government statistics. About 80 percent of those prescriptions were for Valium. Physicians commonly prescribe it to relieve anxiety and tension, and millions of Americans commonly take it when they get up in the morning, when they face a difficulty during the day and when they go to bed at night.
Sen. Edward M. Kennedy (D-Mass), who chairs the subcommittee, is sponsoring legislation that would require that more information on Valium's effects to be given to consumers.
Most of the users who testified yesterday said they were told little or nothing about the dangers of Valium when they started taking it.
Their doctors gave it to them for any number of complaints. The Rev. William Ryan, a Brooklyn, N.Y. priest, had complained of "anxiety and stress" associated with drinking. John Hinton, a New Jersey houswife, said a recent relocation, combined with seven children to care for, sent her to the doctor. Yvonne Tipton, of Delaware, got a prescription after telling her doctor she "couldn't handle" a relative's critical illness.
"My doctor told me that I should think of Valium as a diabetic thinks of insulin: as something to take the rest of my life," Tipton said.
The witnessess -- most of whom started off with standard doses -- said they gradually grew dependent on the drug in order to function each day. "I couldn't drive my car without Valium in me," said Tipton. Psychiartrist Theodore Clark who obtained his Valium from free samples sent through the mail by the drug firm, said he "couldn't see any patients until the mailman came. While other doctors would read their mail, I ate mine."
Most also testified that the smaller prescribed dose came to seem inadequate and they would increase it on their own. One woman said she had four doctors simultaneously prescribing Valium for her at separate pharmacies to keep the supply going.
Many also siad they mixed the Valium dependency with an alcohol dependency, and the two fed each other.
Those who quit, or tried to quit, did so after being shocked into a recognition of their addiction by a single event: Linda Schwarz-Moglia said she "passed out" after missing her dosage and "went into convulsions" that hospitalized her. Hinton said she realized she was addicted when she tried to stop and experienced "hallucinations, sharp pains in my head and trouble walking."
And Tipton, who started Valium to cope with grief, reached a point where "I couldn't feel grief anymore. I thought about it when my father died and I didn't seem to feel anything. I wanted to cry but I couldn't.
Those who terminated Valium use abruptly said they went through "withdrawal" pains similar to those experienced by alcoholics who quite "cold turkey": pains, cramps, agitation, insomnia and hallucination. "It was like somebody pured kerosene under my skin and then put a torch to me," said Dr. William Thomas, a physician who kicked the habit.
The doctors who testified critically about valium, including Dr. Joseph Purch, head of a celebrated U.S. Navy detoxification center in Long Beach, California, acknowledged that the drug has legitimate uses. They differed on the acceptable length of time a patient can safely use Valium.
Robert B. Clark, president of Hoffman-LaRoche, said while "inappropriate" usage "at extremely high doses for prolonged periods of time" can produce withdrawal symptoms upon termination, "our findings reveal that within the recommended dosage range, addiction is extremely rate. In fact," his prepared statement added, "addiction has been infrequently reported at any dosage level" and usually among patients also addicted to alcohol or other drugs.
Clark said Hoffman-LaRoche is discussing with the Food and Drug Administration ways of better informing consumers and physicians of the potential abuses of its drugs.