Are we a nation of neurotics? Can a pill-popping populace function as well as one which copes with stress through other means? Or is it true, as Huxley writes of the future panacea, Soma, in Brave New World, that "a gramme is better than a damn"?
To many of the thirty million Americans who consume three billion tablets a year, Valium means a tranquillity trip. Whether ingested in the form of a 2- or 5- or 10-mg pastel colored tablet, or injected in liquid form, the benzodiazepine tranquilizer Valium is the best-selling, prescription drug in the world, followed closely by its chemical cousin Librium (see Tranquilizers). In one recent year, these two top "tranqs" grossed $230 million for their manufacturer, Hoffman LaRoche, which plowed back $12 million for elaborate advertising aimed at further increasing .the popularity of its products:
Although one in ten Americans uses Valium; the United States ranks behind Germany, France, and Japan in per capita sales. Of the sixty million Valium prescriptions written in the United States each year, the. majority have been prescribed for non specified medical complaints-anxiety which manifests itself in physical problems such as queasy stomach, nausea, or tremors or, as the ads proclaim, "for relief of psychic tension and its somatic symptoms." Females outnumber male users by 2.5 to 1.
Used medically as a muscle relaxant, anti-convulsant, and psychotherapeutic aid, Valium is a central-nervous-system depressant containing desmethyldiazepam, 3-hydroxydiampam, and oxazepam. It is five to ten times stronger than Librium, though less potent than barbiturates or major tranquilizers such as Thorazine. The drug is thought to work on the limbic system of the brain, creating the sedative, tranquilizing, muscle-relaxing effect which peaks about ninety minutes after ingestion and disappears twenty-four to thirty six hours later.
Valium is used by psychiatrists, anesthesiologists, cardiologists, neurologists, orthopedists, pediatricians, and obstetricians for its sedating and relaxing properties. Valuable in the reduction of spasms, it is used to control the convulsions of grand mal seizures and cerebral palsy and the contractions of tetanus, in addition to its preoperative use as a sedative. The drug is intended for short-tern use only, not for chronic emotional problems, and should not be considered a substitute for psychiatry.
Standard therapeutic dose is usually 3 mg taken three times daily. Over an extended period of time, tolerance will set in; higher doses will be required to achieve the same effect, and 30 mg a day can escalate to 100, 200, or even 300 mg a day, at which point the user is addicted and will experience withdrawal symptoms if he stops suddenly. Even with normal dosage, the drug should not be used continuously, for longer than a month. Proponents of Valium contend that addiction occurs, only if it is used at six to twenty times the prescribed dose for a period of months, or if 400 mg is taken daily.
Overdosing on Valium is difficult, although it has been implicated in 10 percent of all drug-abuse emergencies requiring medical attention, particularly when it had been combined with alcohol or other central-nervous-system depressants. Controversy . exists over the use of Valium in combination with methadone, administered by some drug programs which believe that the ingredients in the two do not affect each other. Others insist that Valium and alcohol or methadone create a potent "doper's cocktail," leading to further addiction and _ possible death.
As with most other drugs, overuse, misuse, and careless prescription-and not the drug itself-are to blame for deaths from Valium. The victims are mostly multiple-drug users who are not aware of the potent result of combining a seemingly Innocuous drug such as Valium with other substances. Valium is potentiated by alcohol, phenothiazines, narcotics, bar biturates, anti-depressants, and MAO inhibitors.
Adverse reactions may include drowsiness, headache, conttion, fatigue, rashes, tremors, incontinence, vertigo, blurred vision, -nausea, change in libido, confusion, blood changes and depfession. Some feel the regular user may evolve into a depressed personality with extended use.
Paradoxical reactions include anxiety, hallucinations, insomnia rage, increased muscle spasticity and hyperexcitability. Since respiratory functions are not affected by the drug, suicides rarely find success with Valium alone. Withdrawal from heavy use should be attempted only under medical supervision.
Valium is regulated under Schedule IV of the Controlled Substances Act, with prescriptions refillable up to five times within six months.