Benzodiazepines

History

Benzodiazepine development began in the 1950’s following work carried out by the Polish chemist Dr. Leo Sternbach who at the time was working for the Swiss pharmaceutical company Hoffmann-La Roche.

In 1957, Sternbach tested a chemical initially thought to be pharmaceutically inactive.  Surprisingly, it was found to be active against the effects of the poison strychnine while also possessing sedative and hypnotic (sleep-inducing) properties.  This drug –chlordiazepoxide (Librium) went on to become the first benzodiazepine drug and was launched in 1960. By 1963, Hoffmann-La Roche had also developed and marketed the second member of the benzodiazepine drug class, diazepam which went on to achieve rapid success partly due to it being more potent than chlordiazepoxide.  Compared to their previously popular predecessors (the barbiturate drugs), diazepam and other benzodiazepines offered an improved safety profile which also contributed to their popularity. 

It was only after the launch of a third Hoffmann-La Roche benzodiazepine, nitrazepam (Mogadon) that different pharmaceutical companies began to develop and launch their own products.  That said, of the 17 different benzodiazepines launched in the UK between 1960 and 1983, 6 of those were developed by Hoffmann-La Roche.

The 1960s and 1970s saw a rapid increase in overall benzodiazepine use –peaking in the United States during 1975 with 10% of all prescriptions issued containing a benzodiazepine.  This was followed by a 6-year decline in sales until 1981 at which point a steady increase began.

Significant numbers of dependency cases involving benzodiazepines by themselves or in combination with other drugs such as opioids and alcohol were being reported as early as the 1970s, though a lack of consensus amongst medical professionals on the subject meant that no significant action was taken at the time to regulate supply more tightly and reduce the harm caused by such use. 

During the 1980s, a significantly-harmful form of benzodiazepine abuse emerged in the UK involving temazepam. At the time, it was available in a capsule filled with liquid drug, commonly known as ‘jellies’ or ‘jelly’.  Many users began to extract this liquid and inject it intravenously.  Unlike the overall problem of benzodiazepine abuse, this problem was quickly addressed by reformulating temazepam into a completely solid form.

Given the years during which benzodiazepines were more extensively supplied, combined with medical improvements increasing life expectancy, a growing and significant proportion of people with a benzodiazepine dependency can be found amongst the elderly.