By Claire Warrender

GENERAL PRACTITIONERS across Fife are being urged to ask patients whether they use drugs or alcohol before prescribing certain tranquillisers.

The warning from one of the region’s top doctors yesterday follows the deaths of four men across the kingdom in the space of a week.

All four are believed to have died after taking a lethal cocktail of heroin, alcohol and benzodiazepines.

Benzos, as the drugs are known, is a group of sedatives, such as valium, used to treat a number of conditions including anxiety and insomnia.

The effects are heightened if used alongside other drugs with a sedative effect—including alcohol and heroin—which increases the risk of death.

Dr Alex Baldacchino, consultant psychiatrist with NHS Fife and senior lecturer in addictions at Dundee University, said people using heroin did not have to take an overdose to die.

“It is very well known because of recent statistics that if you take heroin, alcohol and benzodiazepines it can push you to the edge of death,” he said.

“Many of the people who die have not taken a lethal dose of heroin but the fact they have also taken alcohol and benzodiazepines has made a lethal concoction.”

Dr Baldacchino said research suggested that specific cocktail of drugs was a purely Scottish phenomenon not seen elsewhere in the UK. “It’s been the case for around 20 years or so, so it’s not something that’s new but it’s a pattern that is making people more vulnerable,” he said.

“It’s one of the issues we are looking at but we don’t have any results as yet to say whether the people dying through taking a cocktail of drugs have the same type of risk factors as the people dying of overdoses.

“What we are seeing is alcohol does play a major part.”

The doctor said efforts were being made to inform services involved with drug and alcohol users of the need to keep users informed of the potentially lethal cocktail.

However, he added it was just as important to ensure GPs also knew the risks. “People who have the authority to prescribe need to be aware when prescribing benzodiazepines that the patient is not also taking illicit drugs or drinking alcohol to excess.”

Dr Baldacchino was the co-author of a ground-breaking report published in March which revealed 54 people in Fife, almost all of them men, died as a result of drugs between 2005 and 2007.

Some 89 per cent of those who died were intravenous drug users and most of the deaths were due to a cocktail of heroin, benzodiazepines and alcohol.

Agencies working with the region’s drug users pledged to improve services in the wake of the report in a bid to cut the toll of deaths.

The study found most of the people who died due to drugs did so within 10 miles of their own homes in Fife’s more socially-deprived areas. Many were also physically or mentally unwell. The average age of victims was 31—older than previously thought—and many had experienced significant stressful life events.

Most died in the company of friends or relatives, leading to the recommendation that families of drugs users should be made aware of the signs of an overdose.

Those who died last week were a 25-year-old Levenmouth man, a 22-year-old from Dunfermline and a 43-year-old and a 24-year-old who died separately in Glenrothes. It brings the number of deaths since January to 18, three more than in the same period last year.