News that controversial Canadian psychologist Jordan Peterson has been struggling with the negative effects of a common anti-anxiety medication came as no surprise to Dennis Amott. The Vancouver resident has dealt with the same thing.
Similar to Dr. Peterson, Mr. Amott developed a physical dependency to benzodiazepines soon after he was prescribed them. Instead of getting better on the drugs, he said, his health worsened over time.
“They stopped working, and then all hell began to break loose,” he said.
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Earlier this month, Dr. Peterson’s daughter Mikhaila Peterson posted a video on YouTube, stating that the University of Toronto psychology professor was in Russia seeking medical detox from a benzodiazepine, which he took for years as prescribed for anxiety. She said he has been in “unbearable discomfort from the drug.”
His is the latest high-profile case to raise questions about the risks involved in taking benzodiazepines, a class of depressant drugs that includes Valium, Ativan, Klonopin and Xanax. In recent years, actress Lena Dunham has publicly discussed recovering from a dependency to Klonopin, which she took for anxiety and post-traumatic stress disorder, while singer Justin Bieber has opened up about his past misuse of Xanax.
Benzodiazepines, typically prescribed for anxiety, insomnia and seizure disorders, have been used for many decades, and are considered a relatively safe replacement for barbiturates, since they have a lower potential for fatal overdoses, said Silvia Alessi-Severini, an associate professor in the College of Pharmacy at the University of Manitoba. But it is well-known that individuals can develop a tolerance to the drugs, and that these medications are prone to abuse, she said.
“It’s very hard for patients who have been using them for a relatively long time to get off,” she said, explaining they may experience withdrawal syndrome, which can involve agitation, tremors, cravings, restlessness and movement disorders.
According to Health Canada, short-term effects can include memory loss, drowsiness and loss of coordination, while long-term effects can also include physical dependence, problems learning or concentrating, and substance use disorder.
Because of these potential adverse effects, clinical practice guidelines recommend limiting the use of benzodiazepines for a short period, ranging from two weeks to two months, depending on the diagnosis, Dr. Alessi-Severini said. Some psychiatrists suggest longer-term use of these medications can be beneficial for certain patients with anxiety disorders, she added.
Nevertheless, she said, clinicians need to recognize there are risks to using the drugs.
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Mr. Amott said his doctor prescribed him clonazepam more than 10 years ago, not because he had anxiety or insomnia, but because he experienced mild recurring headaches. The medication seemed to rid him of his headaches for a while, but over time, he developed new, more painful headaches that lasted all day. Since his doctor told him he could safely take clonazepam for the rest of his life, if he wanted to, he stayed on the medication for five years.
Despite slowly and successfully tapering off the drug five years ago, under professional guidance of another doctor, Mr. Amott said his health problems are worse than ever. These issues, he said, include a constant headache, memory loss, and sensory and motor symptoms, such as muscle aches, tingling throughout his body, heart palpitations, leg cramps and tinnitus. (Many of these symptoms are not included in Health Canada’s list of side effects and risks of benzodiazepines.)
In Dr. Peterson’s case, Ms. Peterson said her father experienced a rare “paradoxical reaction,” where he had the opposite reaction to the drug’s intended effect. She said he also developed a movement disorder called akathisia, characterized by restlessness and an incontrollable urge to move, which made him suicidal.
Dr. Alessi-Severini said a paradoxical reaction is very rare, occurring in certain individuals who may be more susceptible, such as those who have experienced brain trauma or an underlying neurological condition.
It can be difficult to tease apart whether an individual’s symptoms arise from their withdrawal of the medication, from the condition it was intended to treat, or from another underlying or co-morbid disorder, she said. Moreover, individuals can react differently.
“Unfortunately, with almost all drugs, there are rare reactions that some individuals, for some reason, can experience,” she said.
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For those who develop a dependency to benzodiazepines, doctors generally reduce the doses slowly over time until they stop using the drug, she said. (One should not stop using the medication suddenly, nor should getting off the drugs be done without professional guidance.)
To put the harms of these drugs into perspective, alcohol far surpasses benzodiazepines in terms of the impact on and costs to society, said Sarah Konefal, research and policy analyst at the Canadian Centre on Substance Use and Addiction.
There is no evidence that the use of prescription sedatives, including benzodiazepines, are on the rise in Canada, Dr. Konefal said, explaining the number of prescriptions has, in fact, declined over the past five years.
However, benzodiazepines are involved in an increasing proportion of opioid overdose-related deaths, she said. Since benzodiazepines have the same effects on the brain as other central nervous system-suppressants, such as alcohol and opioids, use of these other substances while on the drug is not recommended, she said.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
