Tuesday, 2 October 2012

On quick fixes...

The papers are apparently full of sleeping tablets. That is to say, the NHS is spending rather a lot of money on benzodiazepines and the so-called Z drugs (with 15.3 million prescriptions last year), commonly prescribed for insomnia and anxiety. Furthermore, an additional £40million was spent on over the counter sleeping rememdies. Benzos and Z drugs are what health-care professionals would call "dirty drugs". They come at a price...side effects and, in particular, tolerance and withdrawal which add up to addiction.

Physical tolerance means that the body requires more and more of the drug to get the same effect. Withdrawal means that stopping the drug causes side effects, which are relieved by the drug. It may also lead to 'rebound' symptoms of whatever the drug was being taken for in the first place. It is for these reasons that guidelines state that sleeping tablets should only be used on a short term basis.

We have now embarked on the usual cycle of blame. Patients blame doctors for ruining their lives with addiction. Health-care professionals blame patients for self-treating without medical advice. Warnings about what not getting enough sleep can cause (early death) are now balanced by warnings about the long term effects of sleeping tablets (Alzheimer's). I would say that there isn't a clear direction of causality with these effects. Both Alzheimer's and early death could be caused by some underlying factor which also causes sleep deprivation. The brain and the immune system are involved with sleep and neither is fully understood. But all this has no doubt led to increased anxiety over sleep: waking up in the night is now a disaster which makes us so stressed out that we can't get back to sleep.

Working in healthcare I have seen an increase in the use of "lifestyle" drugs. Increasingly we want a quick answer to an annoying problem. I am not denying that depression, anxiety, insomnia and obesity (to name a few) are not real diseases. However, I think we often seek a rapid solution to something that needs addressing in the long term. Stress and anxiety contribute to many illnesses, and once again I would argue that they could well stem from individualism. The need for a quick fix can be traced to the nihilism and hedonism which now underly our culture. Thus both the problem and the equally problematic solution come from the same place. A lack of community, and the difficulty of forming true friendships mean no-one to talk about our problems with. We distract ourselves with alcohol, food, sex, exercise, television, whatever. Of course we lie awake at night worrying about our jobs, our children, our spouses or lack thereof, money, keeping up with the Joneses...because we are unable to rest. We have nowhere to rest. Without God, without heaven and hell, we have nothing to work for in the long term either. We need the solution now. If I cannot manage to renounce biscuits  (and sitting here I have just absent-mindedly eaten an entire packet) for the sake of eternity, how I am going to be able to renounce them for the benefit of my waistline in this life. Of course I want a tablet. If I have no-one in whom I can truly rest then of course I am going to lie awake worrying about my problems. If there is a magic pill to solve my problems, great! And if I have no room or no need for a God who suffered out of love for me and who is with me in my sufferings then I am definitely going to want to eliminate all suffering from my life as fast as possible.

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