Hacker News Reader

Comment by martinald | Hacker News Reader

"Benzodiazepine" isn't a drug, it's a class of drugs. Really sloppy editing.

Indeed, and the range is rather large as well for what they cover. Most people have taken a Valium (diazepam) at some point in their life for example.

I don't know about the UK, which would have been relevant since that's where the author of the piece is from (maybe you do?), but in Sweden it's certainly not true that most people have ever had a Valium (or rather one of the brands that are marketed here). Many may not even know what they are, and if they do, they think of them as something a very ill person or a junkie might take.

Swedish physicians are quite restrictive with prescribing benzodiazepines in general - unless you have some serious issues you're not going to get them. This is in contrast to my (very possibly flawed) image of benzodiazepine use in the United States. Going by pop culture and brief discussions with a few Americans, that country pops heavy duty benzos such as Xanax like candy, with their doctors' blessings. I don't have any insight into which approach is more guided by rationality and the well-being of patients, so I'm not making any judgements.

My point is that the Swedish journalist might have made a much bigger deal of their role in this mess than an American or possibly a Brit would.

There was a time in the US where people were widely prescribed benzodiazepines for general use but doctors are generally more reluctant to prescribe them now because their long-term affects are now now well known.

Benzos work very, very well in the short term however they are usually counterproductive in the long term.

They are still used in acute medical settings. For things like drug withdraw in a medical facility and for medical procedures such as colonoscopies. They are a component in twilight anesthesia. For example, I was prescribed a benzodiazepine in an emergency room to get me to sleep because I was staying overnight in that ER however they are very rarely prescribed for insomnia at home (anymore).[1]

I'm sure Sweden uses them in acute medical settings as well because they are very effective in that role.

[1] Nonbenzodiazepine medicines known as "Z drugs" are now the widely prescribed insomnia medicines despite their downfalls and risk of dependence.

>There was a time in the US where people were widely prescribed benzodiazepines for general use but doctors are generally more reluctant to prescribe them now because their long-term affects are now now well known.

I see, so perhaps my notions are just outdated then. Thanks for setting me straight. I still believe it's possible though that the average American may be more familiar and comfortable with the thought of using benzodiazepines than the average Swede.

>I'm sure Sweden uses them in acute medical settings as well because they are very effective in that role.

That's certainly true, I know from personal experience that you are right about that.

>the average American may be more familiar and comfortable with the thought of using benzodiazepines than the average Swede.

Of course, America went through a culture of benzo use whereas Sweden did not.

Yes, that remark might have been a bit redundant.

I am from the UK and have been prescribed a few benzos over the years for different things. They are prescribed although not as often as in America by the sounds of things. I think Valium is the most prescribed but only for short term use in the cases of anxiety and related issues.

I would guess most people reading this wouldn't care. And I would also guess that you can guess why. It isn't even close to being a central piece of the story.

You beat me to it, I just paused reading to come moan about that before continuing.

But not only that, having read a lot about benzos and have previously been prescribed a few different ones for insomnia, their effects are to quote Wikipedia "sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant"

Unless mixed with another drug - but I'm guessing he wasn't drinking in there - I don't see how their effects would be relevant.

Edit: 'When a new doctor took Bergwall off the heavy doses of benzodiazepine, his confessions abruptly stopped. "He sobered up and thought, 'What the hell have I done?' " Hill says.' But he didn't tell anyone until a journalist visited? Really feels like the author of the article heard "psychiatric" and "drugs" and jumped on the assumption that they were the cause. Interesting none the less.

It wasn't like he was a stable guy taking it for insomnia. He had long history of personality disorder, including multiple personalities, and drug abuse.

"This, incidentally, is what Bergwall says was his daily intake, with extra top-ups when requested: six 5 mg. Valium, four 1 mg. Xanax, one 10 mg. prefill Valium, 1.5 mg. Halcion, two Rohypnol, six Treo comp, six Panocod."

http://www.gq.com/story/thomas-quick-serial-killer-august-20...

Ok, I'll also quote Wikipedia

"The long-term effects of benzodiazepine use can include cognitive impairment as well as affective and behavioural problems. Feelings of turmoil, difficulty in thinking constructively, loss of sex-drive, agoraphobia and social phobia, increasing anxiety and depression, loss of interest in leisure pursuits and interests, and an inability to experience or express feelings can also occur. Not everyone, however, experiences problems with long-term use.[10][78] Additionally an altered perception of self, environment and relationships may occur.[77]"

I have taken similar drugs for insomnia and I don't think they would outright cause delusional confessions. I do think that they could relax a person enough to continue with a plan that they might not have been as likely to execute otherwise.

Anecdotal: I was having reservations about a relationship and wasn't sure if I was willing to stay involved. In a relaxed state from pain medications related to a standard medical procedure, I finally said that I wanted out. I wouldn't have said it (at that moment) if I hadn't been sedated to the point of an above average sense of wellbeing. After the effects diminished, I realized that I was not as ready to live with the outcome and wished I had taken more time to think it over.

If Quick was already on the edge of making a false confession for the purpose of gaining attention or fame, this scenario would make sense. Whether that was the situation, I have no idea.

Reply on news.ycombinator.com