Health, Culture & Society



Joke Haafkens

Rituals of silence. Long-term tranquilizer use by women in the Netherlands. A social case study.

Amsterdam: Spinhuis, 1997
ISBN 90-5589-062-6




Benzodiazepines are the most widely prescribed drugs for the treatment of anxiety, stress and insomnia in the world. Women take them twice as often as men. Three hundred thousand women in the Netherlands takes these drugs regularly for at least six months. These statistics are surprising because there are many side effects associated with the use of benzodiazepines for more than two months: they lose their effect and may cause memory problems and dependence.

What is it that makes so many women long-term benzodiazepine users? How do women view these drugs? How do they use them and how do prescribing doctors and people in their environment react to their drug use? Joke Haafkens explores this question on the basis of life history interviews with 50 female chronic benzodiazepine users.

From the onset of the women’s drug using careers every one kept quiet about the problems that might be related to benzodiazepine use. This repetitive silence can be seen as the social ritual by which the women, their prescribing doctors and the people in their environment confirm the status quo of bezodiazepine use: Rituals of Silence.

This new perspective on the use of medication is relevant for everyone working in the field of addiction research and treatment and for users themselves.

Joke Haafkens is a social psychologist and assistant professor at the Department of Social Psychiatry at the Erasmus University of Rotterdam and the Department of Women’s Health Studies at the University of Amsterdam.