This manual was not only translated for patients, who are at a loss due to insufficient information regarding benzodiazepine dependency and withdrawal, but it also serves as an important message / information for doctors, pharmacists, drug companies and the Ministry of Health.

Withdrawal symptoms can be more severe than medical service workers are inclined to think and it is impossible to place a definite time on the course of duration. Doctors often say “It is safe to take these drugs long term”, “It’s okay to take them over the course of a lifetime”, “Clinical doses pose no problem”, and so forth.

The number of people who trust their doctor’s advice and continue taking the drugs only to fall into a deep state of drug dependence has reached overflowing proportions here in Japan.

Further, when many of these people go to doctors for help, they are often told “Withdrawal symptoms all disappear within about 4 weeks”, “Those symptoms are due to your original complaint” and other such comments effectively shutting down all avenues of escape. The reality is that many of these drug dependent people are desperately exchanging information over the internet.

From the 1990s, there was already information available, even in a variety of “Japanese” medical books and journals, clearly stating that it is necessary to give patients proper informed consent with regards to dependency on clinical doses and withdrawal together with the need for doctors to monitor patients for the forming of dependency.

Further, following the year 2000, Japan’s exceptionally high prescribing rates have stood out markedly when compared to other countries, which has been indicated in a number of research journals.

This was also indicated by the International Narcotics Control Board (a United Nations organization) in their 2010 Annual Report which suggested “inappropriate prescribing” as a possible contributing factor.

Despite these national and international warnings, the all too familiar trend of easily dishing out long term prescriptions continues at medical practices on a large scale in Japan, and there is no end to the number of people suffering from iatrogenic (doctor induced) dependency. This is, without doubt, a significant social problem.

What I would like to say to health service workers is that patients don’t know that they have fallen into a state of dependency. That is to say, in Japan today, there are large amounts of drug dependent people walking around from day to day not even realizing what’s wrong with them. They are not able to understand what is actually causing all the irregular physical and psychological problems or why they behave strangely at times.

To make matters worse, as outlined above, even if for example they did know what was wrong, there’s no information or anywhere to turn to for help with many people feeling at a complete loss.

The public release of The Ashton Manual in Japanese serves as a significant and multipronged message with the hope that, at some time, there will be no further cases of people suffering from involuntary drug dependency.

Finally, I would like to extend my deepest gratitude to Prof. Ashton for granting permission to carry out the translation and for her significant detailed advice along the way.

Translators: Ryo Tanaka, Wayne Douglas

Editorial Supervisors: Dr. Hirokuni Beppu, Prof. Reisaku Tanaka

Date of Translation: August 19, 2012