'The one that got away': escalation from prescribed to street use of temazepam
Peter is the youngest of nine siblings. His mother is alcoholic; his father is unknown. He was taken into care at the age of 2 and brought up in a series of children's homes. He was said to be a quiet and sensitive child who was always terrified of violence. When he was about 13, following an incident with one of the teachers at a boarding school, Peter 'discovered' he was gay.
In his 20s, Peter was involved, as a passenger on a motor cycle, in a road traffic accident. He sustained serious injuries including fractures of his arm and collar bone and compound fractures in his leg. He spent several months in an orthopaedic ward and suffered complications including infection, non-healing of the leg fractures, bone-grafting, insertion of pins and plates, etc.
In hospital, he experienced 'dreadful panic attacks and fears'. He received no psychological treatment or counselling of any kind but was prescribed temazepam and dihydrocodeine. At first, the dosage of temazepam was 20mg nocte for sleep, but was increased to 60mg in hospital. After discharge, he continued to receive temazepam from his general practitioner because of panics and insomnia and the dosage was increased over a period of years until he was taking 80mg temazepam each night and 40-80mg during the day. He felt he had to take the temazepam, otherwise he got panicky and frightened, suffered pains in the stomach and was unable to sleep. After taking temazepam, he stated that he felt 'all nice and calm for a time, but then the panics and fear return'.
At the age of 30, Peter was removed from his GP's practice when it was discovered that he had altered a prescription for temazepam. He was taken on by another GP but later attended a series of GPs, obtaining ever larger prescriptions of temazepam and dihydrocodeine from each, often presenting with stories that his last prescription had been lost or stolen. He also attempted to obtain supplies of temazepam from the hospital pharmacy, the orthopaedic clinic and the casualty department, sometimes wearing a white tunic and name badge, giving the impression he was a nurse.
When he could no longer satisfy his need from prescriptions, Peter took to obtaining temazepam on the street, taking large and irregular doses by mouth. His behaviour became chaotic and he was twice sent to prison for credit card frauds. In prison, he was terrified and made bizarre claims about his health: that he was on renal dialysis. that he was HIV-positive, that he expected to have his leg amputated through disease. He was able to obtain temazepam in prison from other prisoners.
After discharge, and now aged 34, Peter agreed to enter a detoxification centre and apparently made a real effort to stop the temazepam. Initially, he made good progress. The temazepam was replaced with decreasing doses of diazepam and following his admission he continued for some months to attend the centre weekly as an outpatient. Withdrawal symptoms consisted of increasing anxiety, panics and stomach pains. He took no other drugs, as confirmed by weekly urine tests, and very little alcohol. He had never injected any drugs. Unfortunately, when down to only 4mg diazepam daily, he 'broke his contract' and obtained some temazepam on the street. This resulted in immediate discharge from the detoxification centre and no further medical supervision.
When last heard of, Peter, aged 35, was again buying temazepam illicitly and was involved in a court case for obtaining money on false pretences.
