Benzodiazepines may seem a straightforward solution to your problems regarding anxiety or sleep disturbances. Yet, these prescription sedative drugs carry significant risks and a high probability of misuse.
A recent study published in Psychiatric Services in Advance showed that more than one in eight American adults used benzodiazepines in the past year. This rate was significantly higher than previous reports, as misuse of the prescription drugs accounted for more than 17 percent of overall use. Misuse, characterized as use deviating from doctors’ directions, was found to be the highest among young adults, aged 18 to 25, as common as prescribed use.
What are benzodiazepines?
Benzodiazepines are a class of sedative medications used to treat conditions such as anxiety and insomnia. Typical examples include alprazolam (Xanax), diazepam (Valium) and lorazepam (Ativan).
These medications apparently work by blocking the excessive activity of nerves in the brain and other areas in the central nervous system.
Benzodiazepines magnify responses to the inhibitory neurotransmitter GABA by opening GABA-activated chloride channels and letting chloride ions to enter the neuron.
This function allows the neuron to become negatively-charged and resistant to arousal, which leads to the array of anti-anxiety, sedative or anti-seizure functions seen with these drugs.
A hidden epidemic
All benzodiazepines are listed as DEA schedule IV controlled substances. As controlled substances, all benzodiazepines have the potential for abuse, addiction, and diversion. Such associated complications from benzodiazepines are fueling a hidden epidemic.
“Medical students, residents and even doctors in practice don’t recognize the addictive potential of benzodiazepines,” said Dr. Anna Lembke, chief of addiction medicine at Stanford University Medical Center, while speaking with NBC News. “There’s been all this awareness on opioids but very little focus on benzodiazepines, and yet people are dying from them.”
Since benzodiazepines exert quick influence against anxiety and sleeplessness, the response from patients is immediate, and doctors are quick to prescribe them. Similarly, patients can quickly develop a tolerance, leading to higher and higher doses, and painful withdrawal symptoms between doses. Long-term use can even lead to severe neurological damage.
Once tolerance has been developed, it is extremely challenging to wean off benzodiazepines. For some patients, quitting opioids may be easier.
Combining benzos and opioids
Benzodiazepines can be particularly dangerous when combined with opioids, which is not an uncommon practice and can increase overdose risks nearly four-fold.
Another recent study published, earlier this year, in the journal Sleep showed a 250 percent increase over the course of 15 years in the number of Americans consuming the dangerous combination of both opioids and benzodiazepines. There was also an 850 percent in patients taking benzodiazepines and so-called drugs Z-drugs that act in an identical manner to that of benzodiazepines.
Lead author of this study, Dr. Nicholas Vozoris, an associate scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital in Toronto, found this combined usage highly concerning associated with serious adverse outcomes including breathing problems and death.
“While the proportions may seem small, these percentages at a population-level correspond to millions of people and the growth of these numbers is alarming,” said Dr. Vozoris.
“The FDA has gone as far as to issue its strongest form of safety warning about this suboptimal prescribing practice and mixing of opioids and benzodiazepines.”
The University of Michigan study revealed that nearly half of the participants misused benzodiazepines to relax and over a quarter did so to resolve sleep disturbances. This only reflects limited access to health care and behavioral health treatments for sleep and anxiety.
Where care providers need to be cautious with initial prescription and closely monitor and evaluate patients, it is just as important to explore alternative options such as Cognitive Behavioral Therapy (CBT) for sleep regulation and managing anxiety. Relaxation training and biofeedback are also helpful approaches.
About the Author:
Sana Ahmed is a journalist and social media savvy content writer with extensive research, print, and on-air interview skills. She has previously worked as staff writer for a renowned rehabilitation institute, a content writer for a marketing agency, an editor for a business magazine and been an on-air news broadcaster.
Sana graduated with a Bachelors in Economics and Management from the London School of Economics and began a career of research and writing right after. Her recent work has largely been focused upon mental health and addiction recovery.
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Published on March 18, 2019
Reviewed by Jacquelyn Ekern, MS, LPC on March 18, 2019
Published on AddictionHope.com