| > | | | | higher dosages to obtain the same effect. If the |
| | | | patient is not given the correct dosage or |
| Recent investigations of Heath Ledger’s | | | | management advice, that insidious and |
| cause of death have concentrated on the lethal | | | | often-undiagnosed disorder known as Benzo |
| combination of prescription drugs such as narcotic | | | | Withdrawal Syndrome (BWS) will start its ugly and |
| analgesics and sleeping aids. However, the medical | | | | potentially dangerous descent. |
| community have ignored the underlying | | | | BWS is known by experts in the field for its |
| prescription drug class that often leads to habitual | | | | severity and prolonged nature. It may take years |
| drug dependency with dangerous lethal | | | | to fully withdraw from benzos, even with proper |
| consequences. | | | | care and supervision. Without this knowledge, the |
| The first time I saw Heath Ledger, it was by | | | | unwitting patient can suffer from over 30 |
| accident. My date and later to-be husband, Nick, | | | | symptoms, the most common being unrelenting |
| took me to see The Sixth Sense, finally | | | | insomnia, severe pain and mood changes. People |
| succumbing to peer pressure to guess the big | | | | who have been taking benzos for a relatively |
| surprise ending’. By now, The Sixth Sense | | | | short time can experience withdrawal symptoms |
| was off the major theatre chain circuit and only | | | | even whilst taking the drug. In addition, if you |
| screening in small suburban independent theatres, | | | | have been taking them for a prolonged time, and |
| which led us to experience one of those now rare | | | | then suddenly stop, dire circumstances may |
| events: a double-feature matinee. The first movie | | | | happen. Or, at the very least, more pain, more |
| was 10 Things I Hate About You. | | | | depression and unrelenting insomnia. |
| Well passed teen’ movies, even those | | | | When we now read about Heath Ledger’s |
| with Shakespearian-based scripts, we shyly | | | | complaints, does this sound familiar? Everything |
| admitted to liking 10 Things. Wow, I really like the | | | | points to extreme Benzo Withdrawal, but no-one |
| male lead, what was his name? He’s | | | | is exclaiming its dangers. In fact, most GPs and |
| Australian, you know, replied Nick. And in | | | | even hospital doctors admit they know very little |
| typical Aussie-fashion, I was doubly impressed and | | | | about Benzo Withdrawal. Some even refer their |
| now stupidly filled with national pride. Another | | | | patients to drug rehabilitation centres — an |
| brilliant Australian up-and-comer to join the rapidly | | | | absolute no-no according to benzo counsellors. |
| increasing queue to grace Hollywood screens. | | | | Benzo withdrawal is the exact opposite to alcohol |
| Years later, I would often grab the DVD to fill a | | | | or street drug dependency. You don’t |
| cheerless afternoon and find myself watching and | | | | want to abruptly eliminate the benzo from your |
| rewinding the same scene. Over and over and | | | | body, as they often do in drug rehabilitation. The |
| over again. My secret guilty pleasure. Heath sliding | | | | brain needs the benzo. One must gradually |
| down the pole, microphone in hand, singing | | | | withdraw the artificial benzo until the brain can |
| You’re just too good to be true, | | | | eventually increase its own GABA. Sudden |
| can’t take my eyes off of you
| | | | cessation of benzos can cause severe problems |
| The brass band kicks in. And that charmingly | | | | such as seizures and blackouts. |
| defiant half-run, half-prancing across the school | | | | When in BWS, the counsellors advise against |
| steps. The scene is brilliant. It’s inexplicable. | | | | taking any medication or drugs whatsoever. |
| He simply has that old-fashioned it’ | | | | Paracetamol is probably the only thing the body |
| factor. | | | | can cope with for pain relief. Nothing else. Even |
| I’m not a star-struck fan and was never | | | | codeine is forbidden. Also, one should totally |
| one of those teenagers with movie-star idol | | | | refrain from alcohol, caffeine, and all stimulants. |
| posters plastered all over my bedroom walls, but | | | | There is a strong protocol to be followed and |
| this kid’s got talent. | | | | without this knowledge, the patient is easily put at |
| And then came those scene-stealing roles that | | | | great risk. |
| totally blew us away. The Patriot. | | | | The Ashton Manual, the acknowledged |
| Monster’s Ball. And finally leading-man | | | | benzodiazepine bible’, warns: |
| status and an Academy Award nomination. By | | | | Drug interactions: Benzodiazepines have |
| now, we were just used to having another | | | | additive effects with other drugs with sedative |
| famous Australian up there with the rest of the | | | | actions including other hypnotics, some |
| world’s great talent churning out an endless | | | | antidepressants (e.g. amitriptyline [Elavil], doxepin |
| array of diverse, yet illustrious film roles. | | | | [Adapin, Sinequan]), major tranquillisers or |
| We had no idea. It was not endless. It was not | | | | neuroleptics (e.g. prochlorperazine [Compazine], |
| what we expected. It ended on 22 January 2008. | | | | trifluoperazine [Stelazine]), anticonvulsants (e.g. |
| When people who I’ve never met but | | | | phenobarbital, phenytoin [Dilantin], carbamazepine |
| greatly admire die, I’m sad. But I’ve | | | | [Atretol, Tegretol]), sedative antihistamines (e.g. |
| never cried before. I have never before felt that | | | | diphenhydramine [Benadryl], promethazine |
| heart wrenching overwhelming shock that lasted | | | | [Phenergan]), opiates (heroin, morphine, |
| for days after I heard the news. This time it was | | | | meperidine), and, importantly, alcohol. Patients |
| somehow more personal. As soon as I read the | | | | taking benzodiazepines should be warned of these |
| detailed list of the first report of his deathbed | | | | interactions. If sedative drugs are taken in |
| scene, I intuitively knew how he died. | | | | overdose, benzodiazepines may add to the risk of |
| Ten days later the final medical examiner’s | | | | fatality. |
| report confirmed my suspicions. | | | | The real problem is that there are extremely few |
| Hollywood is Xanax-city’. Feeling down, | | | | experts in treating BWS; they will not include your |
| pop a Xanax. Feeling stressed, pop a Xanax. Need | | | | local doctor, hospital, or drug clinic. However, there |
| to perform at your very best, pop a Xanax. A-list | | | | are good BWS specialists that can be extremely |
| stars feel the pressure to provide A-grade | | | | helpful, but they are usually found in specially |
| performances when working on multi-million dollar | | | | funded tranquilliser recovery clinics. |
| films. There’s too much money at stake. | | | | One must ask, why don’t doctors know |
| The intense stress, both internal and external, is | | | | about this? The problem is they simply |
| immeasurable. The studios are risking billions, | | | | don’t. Is it their fault or the pharmaceutical |
| paying the stars millions, and the actors are | | | | companies that profit from these addictions? |
| unnaturally subjected to more pressure than we | | | | There is little or no dissemination of information |
| mere mortals can imagine. | | | | within the community, the medical fraternity or |
| Heath Ledger, himself, admitted that after the | | | | from the pharmaceutical companies about |
| worldwide release of A Knight’s Tale with | | | | benzodiazepines. And, according to BWS |
| its instant paparazzi-bulb-flashing stardom, his | | | | counselors working in the field, there is insufficient |
| stress levels increased ten-fold. | | | | research or empirical studies on the effects of |
| Xanax is the trade name of the generic | | | | benzos and BWS management to assist them |
| anti-anxiety/tranquilliser prescription drug, | | | | with their intensive workloads. |
| alprazolam, listed in Ledger’s toxicity | | | | Why? Who is at fault? Who is responsible for |
| report. The other anti-anxiety drug was diazepam, | | | | remedying the situation? Why are the people who |
| or more commonly known as Valium. These | | | | write the scripts uninformed about the |
| drugs are from a class of commonly prescribed | | | | after-effects and potential dangers associated |
| tranquillisers known as benzodiazepines or simply | | | | with benzodiazepines? |
| referred to as benzos. | | | | Can our beloved Heath Ledger’s death be |
| According to the latest National Health Study, | | | | at least one catalyst that will draw this |
| approximately 10 million scripts of benzos are | | | | devastating travesty to the public’s |
| written annually in Australia alone with its meagre | | | | attention to demand more information? |
| population of 20 million compared to 300 million in | | | | I hope so. |
| the US. | | | | © Ann Marosy, 4 March 2008. References |
| Many doctors will write a script for benzos faster | | | | 1. Professor C Heather Ashton DM, FRCP, |
| than a speeding bullet. But the real danger is that | | | | The Ashton Manual, 2002. Available from |
| too many of them do not know the long-term | | | | 2. Dr Reg Peart, Select Committee on |
| effects these drugs have on your system, how | | | | Health Minutes of Evidence, House of Commons, |
| to give their patients the correct advice when | | | | UK. June 1999. This submission by Dr R F |
| administering or monitoring the dosages, and | | | | Peart, National Co-ordinator of Victims of |
| — more frighteningly - how to manage | | | | Tranquillisers concerns the nature, causes and |
| their patients’ benzo withdrawal program. | | | | consequences of 40 years of Benzodiazepine |
| Firstly, this is how benzos affect your body | | | | dependency, arguably the biggest medically |
| — or more importantly — your | | | | induced health problem of the 20th Century. |
| brain. Benzodiazepines increase, or rather, enhance | | | | Available from |
| your brain’s main neurotransmitter, | | | | 3. Mayo Clinic Staff. How You Feel Pain. |
| commonly known as GABA. Eventually, and this | | | | 2007. The Mayo Clinic. Available from |
| can be as quickly as 3 to 4 weeks if taking a daily | | | | 4. Benzodiazepines. 2007. Reconnexion |
| dose, your brain will stop producing its own GABA | | | | (formerly TRANX — Tranquilliser Recovery |
| and rely totally on the artificial benzo. | | | | and New Existence), Melbourne, Australia. Available |
| GABA is the most important neurotransmitter | | | | from |
| because it affects just about everything else. | | | | 1. Charles S. Hirsch, M.D., Chief Medical Examiner. |
| Primarily it enhances the brain’s other | | | | The City of New York’s Medical Examiner |
| neurotransmitters such as Serotonin and | | | | Report — Heath Ledger Cause f Death. |
| Dopamine. All of the brain’s | | | | Department of Health & Mental Hygiene, Office of |
| neurotransmitters have important functions such | | | | Chief Medical Examiner. 6 February 2008. |
| as, voluntary movement of the muscles, | | | | 6. Sheila Marikar and Richard Esposito. |
| wakefulness, sleep, memory function, sensory | | | | DEA Investigating Ledger Overdose, Feb. 6, 2008. |
| transmission - especially pain, and much, much | | | | ABC News (USA). |
| more. | | | | 7. Amy Westfieldt & Stephanie Nano. |
| The problem is that from this point on your brain | | | | Accidental Overdose Killed Heath Ledger. 7 |
| needs more benzo as tolerance starts the | | | | February 2008. Associated Press. |
| downward spiral, and the brain needs higher and | | | | |