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Brazil's Pill-Popping Problem

While much of the West has seen the danger in abusing psychoactive drugs such as Valium, sales of these drugs in Brazil are skyrocketing, and doctors warn that it's out of control.

Brazpill
Brazpill
Cláudia Collucci and Monique Oliveira

SAO PAULO — In many European countries, sales of sedatives in the benzodiazepine family such as Rivotril, Valium and Lexotan have fallen by as much as 30% over the past decade. But in Brazil, sales of the pyschoactive drugs have been consistently on the rise, new data shows.

Between 2009 and 2013, in fact, sales of these drugs jumped from 12 million boxes to 17 million boxes, a surge of 42%, according to figures obtained from the consulting firm IMS Health.

These drugs are prescribed for anxiety and panic, and tend to work faster for such symptoms than anti-depressants. But patients often become dependent and suffer severe side effects such as memory lapses and drowsiness. While British physicians are being trained to “wean” dependent patients off them by gradually reducing doses, psychiatrists in Brazil say that most patients use the drugs without supervision, often exceeding both recommended doses and duration of use.

“They should be used temporarily, over two or three months,” warns Antônio Geraldo da Silva, president of the Brazilian Association of Psychiatry. “But some people have been taking them for years. The situation is a lot worse than what people think.”

He says the boom in consumption can be explained by the absence of adequate control of their sales and by the fact that many non-psychiatrists prescribe these psychoactive drugs. “Psychiatrists prescribe these drugs a lot less than other health professionals,” Silva explains. “There’s also a lot of self-medication. Anybody can make a fake prescription. There’s no control whatsoever.”

Ronaldo Laranjeira, psychiatrist and professor at the Federal University of São Paulo, says that doctors in developed countries are careful to prescribe fewer and fewer of these drugs because there is actually no evidence that patients benefit from using them over a long period of time. “The recommended period of time is always the shortest possible. It’s the exact opposite to what happens in Brazil.”

Among those who use these drugs inappropriately are people who have trouble sleeping, Laranjeira explains. “They stay awake 20 hours a day and prefer turning to pharmacology instead of changing their lifestyles.”

Maria Inês Vasconcelos, a labor attorney and author of the book Panic Syndrome and Work, says that the use of the drugs is “widespread” among executives. “I’ve had more that 30 cases that were extremely severe and in which people were incapacitated,” she says.

Their use is also common in the art world. According to V.M., a 35-year-old artistic director who prefers to remain anonymous, people in her line of work use Rivotril a lot. “It’s a way of dealing with stress. Sometimes I’m so agitated that I can’t sleep. That’s when I started taking medications. It makes you switch off instantly,” she explains. “I even reached the point when I had to take one in the middle of the day. But now I’ve managed to control my consumption.”

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