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DSM Changes involving "addiction" and "dependency" explained by Dr. Terry Lynch

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This is Dr. Terry Lynch's letter to the National Assembly for Wales in which he gives a clear explanation for the changes in the DSM that have contributed to this pandemic of pharmaceutical dependency:

 

Dr. Terry Lynch - letter to the Wales Assembly
December 23, 2017

 

An excerpt from the letter: 

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Raising the addiction/drug dependence bar – the medical profession’s response to the benzodiazepine debacle: The public – and the politicians who serve the public – might reasonably expect that the medical profession would have responded to the international benzodiazepine debacle – of addiction/dependence denial and failure to protect the public they serve – by increasing their awareness and vigilance in relation to prescribed drug dependence. The opposite was the case.

 

Produced in the wake of the benzodiazepine debacle, the SSRI antidepressants were not even tested for their addictive/drug dependency potential prior to being licensed for public consumption. Yet drug companies, psychiatrists and GPs alike felt it appropriate to unequivocally assure the public that these new substances were definitely not addictive or dependence-producing. UK psychiatrist David Healy, Professor of Psychiatry, Bangor University, Wales – a former secretary of the British Association for Psychopharmacology – has subsequently identified evidence of drug withdrawal problems within the original SSRI antidepressant drug trials. (5)

 

In 1980, the then current edition of the DSM (the DSM-III) – often referred to as the psychiatrist’s bible, which sets standards of psychiatric understanding and practice internationally – defined drug dependence as the presence of either tolerance (needing more of the drug to get the same effect) or withdrawal symptoms. Consistent with this definition of drug dependence, in 1990, according to the American Psychiatric Association, “The presence of a predictable abstinence syndrome following abrupt discontinuance of benzodiazepines is evidence of the development of physiological dependence”. (6)

 

In a subsequent edition, the DSM-IV (1994), the American Psychiatric Association changed the definition of drug dependence, making it more difficult to define drugs as addictive/dependency creating. They now defined drug dependence as the presence of both tolerance and withdrawal. Rather than become more alert to the important issue of dependence to prescribed drugs as one might expect a responsible profession to do, the American Psychiatric Association both moved the goalposts and heightened the bar. As Charles Medawar subsequently commented, ‘This definition would exclude all but the most exceptional cases of dependence on benzodiazepines’. (7) This definition also results in the gross under-recognition of drug dependence problems with SSRI antidepressants.

 

The World Health Organisation’s view of drug dependence has contrasted with that of the American Psychiatric Association. According to the World Health Organisation, “When the person needs to take repeated doses of the drug to avoid bad feelings caused by withdrawal reactions, the person is dependent on the drug”. (8) 

 

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Another excerpt for historical context: 

 

A long-standing systemic denial and failure. The medical profession has consistently denied/minimised the extent of prescribed drug dependence. In 1998, the then head of Social Audit UK Charles Medawar wrote: “Over the past 200 years, doctors have prescribed an almost uninterrupted succession of addictive drugs, always in the belief that they would not cause dependence or that patients would be mainly responsible if they did. From alcohol and opium to barbiturates and benzodiazepine tranquillisers, all of these drugs have been prescribed as sedatives for mental distress.” (1)

 

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Since that article Dr. Lynch cited was written in 1998, we've gone onto to see the opioid addiction explode, especially here in the US, proof that doctors and the pharmaceutical industry, if left unregulated, will continue down this very destructive path. 

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