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Benzodiazepines: Our Other Prescription Drug Problem

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Re: Benzodiazepines: Our Other Prescription Drug Problem

#11

Post by jnovek »

Serious question: as we make opiods and now bezos increasingly difficult to prescribe, what are the alternatives for people with chronic pain or chronic anxiety?

I have friends and family members with chronic pain and, through them and their communities, have become aware of many people who use opiods on a long-term, occasional basis to manage their pain. A family member of mine who suffers from chronic migraine lives in fear that she won't be able to get an opiod which she uses as a last-ditch rescue treatment before she ends up at the ER (not to mention that she gets treated like a drug seeker when she does end up there).

I don't really see an alternative for acute intense pain; likewise an alternative for acute, intense anxiety. Meanwhile the crackdowns on these drugs also create a chilling effect for physicians. What do we do for people who fall in those categories?

(Edit: not to claim that abuse of these drugs is not a problem... It just seems like the people these drugs are inteded to help are being sidelined in the dialog on the topic.)

Re: Benzodiazepines: Our Other Prescription Drug Problem

#12

Post by OldSchoolJohnny »

jnovek wrote: post #11

Serious question: as we make opiods and now bezos increasingly difficult to prescribe, what are the alternatives for people with chronic pain or chronic anxiety? I have friends and family members with chronic pain and, through them and their communities, have become aware of many people who use opiods on a long-term, occasional basis to manage their pain. A family member of mine who suffers from chronic migraine live…

Cannabis in both cases works well for a great many people.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#13

Post by spamizbad »

jnovek wrote: post #11

Serious question: as we make opiods and now bezos increasingly difficult to prescribe, what are the alternatives for people with chronic pain or chronic anxiety? I have friends and family members with chronic pain and, through them and their communities, have become aware of many people who use opiods on a long-term, occasional basis to manage their pain. A family member of mine who suffers from chronic migraine live…

For benzos: There really is no drug alternative to benzos other than maybe SSRIs but most people perscribed them probably tried SSRIs in the past to no effect. Your other alternative is extensive psychotherapy, which your insurance is unlikely to cover. Perhaps in the future marijuana, MDMA or ketamine might prove useful.

Benzos generally require you to taper off them, as I believe the withdrawal side-effects include seizures. You cannot safely "cold turkey" them.... so I hope they don't get all heavy-handed with them like they are for people who rely on opiods to treat chronic pain.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#14

Post by tnecniv »

piazz wrote: post #7

I was taking 3mg Lorazepam nightly for almost three years. Weening off of it safely took almost an entire year of miserable work, and the final stages I had to do while I had no other significant life responsibilities because of the incredible rebound insomnia and background anxiety you experience withdrawing off benzodiazepines. The only upshot is that when you finally do manage to get yourself off of a drug like th…

> And of course, my Lorazepam was prescribed legally, by a responsible, well regarded psychiatrist, with very little warning regarding how quickly one builds both tolerance and physiological dependence on this chemical.

Sorry to hear that. Mine told me to take at most 1mg no more than once a week for that reason. Seeing what that quantity does to me, I can't imagine dosing at that quantity or frequency (obviously you acquire a tolerance, but still).

Re: Benzodiazepines: Our Other Prescription Drug Problem

#15

Post by jnovek »

OldSchoolJohnny wrote: post #12
jnovek wrote: post #11

Serious question: as we make opiods and now bezos increasingly difficult to prescribe, what are the alternatives for people with chronic pain or chronic anxiety? I have friends and family members with chronic pain and, through them and their communities, have become aware of many people who use opiods on a long-term, occasional basis to manage their pain. A family member of mine who suffers from chronic migraine live…

Cannabis in both cases works well for a great many people.

Cannabis derived treatments do seem promising... someday.

Imagine that marijuana is (at a minimum) federally rescheduled to schedule 2 in the US. How long will it take to research canniboid-based painkillers once drug companies can legally do so? How pong for FDA approval?

It will be a long time until there is an alternative that is taken seriously by anyone other than the most progressive physicians in the realm of cannabis, unfortunately.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#16

Post by jdietrich »

jnovek wrote: post #11

Serious question: as we make opiods and now bezos increasingly difficult to prescribe, what are the alternatives for people with chronic pain or chronic anxiety? I have friends and family members with chronic pain and, through them and their communities, have become aware of many people who use opiods on a long-term, occasional basis to manage their pain. A family member of mine who suffers from chronic migraine live…

Benzodiazepines are a useful option for the short-term management of acute anxiety crises, but there's very little evidence that they're useful in the long-term. Clinical guidance in the UK says that they shouldn't be prescribed for more than two weeks, because the harms rapidly outweigh the benefits. There is good evidence for the efficacy of SSRIs and CBT in the treatment of anxiety disorders.

Opioids are a more difficult problem. Some patients do need opioids, but we're not sure which. There is some evidence to suggest that opioids may worsen the long-term prognosis for many chronic pain patients. We need more research and better availability of psychosocial interventions and physiotherapy.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#17

Post by maxander »

lmpostor wrote: post #9
maxander wrote: post #6

What is the thesis here? Benzodiazepines are commonly prescribed and have the potential for abuse; these things are both true; I hadn't heard the rate of prescription was rising, but I'd believe it. There doesn't seem to be any evidence presented for a trend or rise in benzodiazepine abuse, or evidence of general harm from the use of the drugs. It highlights parallels between the existence of this prescription drug c…

>A study published in 2016 in the American Journal of Public Health finds that from 1996 to 2013, the number of adults in the United States filling a prescription for benzodiazepines increased 67 percent, from 8.1 million to 13.5 million. The death rate for overdoses involving benzodiazepines also increased in this time period, from 0.58 per 100,000 adults to 3.07. In the first link in the article >the quantity of be…

That's all prescribed doses, though. So, yes, the use of benzodiazepines is going up, which obviously carries with it the associated rise in side effects and drug-related deaths. It's not reasonably comparable to the narcotics epidemic, where illegal use is driving mortality rates.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#18

Post by qubex »

According to my psychiatrist (whom I turned to when I realised that I had an addiction problem I had to deal with) were it not for some highly unusual metabolic pathways my sixteen-year benzodiazepine habit would have had a chance to end my life multiple times (as it is I just ended up in ER once after inadvertently combining a hefty dose of Valium in the morning with a few celebratory margaritas at midday).

Said pathways have also given me the privilege of being able to quit cold turkey (in the se se that I suffered no crippling withdrawal symptoms or rebound effects, but man is it difficult to break the habit).

I count myself amongst the very lucky.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#19

Post by copperx »

spamizbad wrote: post #13
jnovek wrote: post #11

Serious question: as we make opiods and now bezos increasingly difficult to prescribe, what are the alternatives for people with chronic pain or chronic anxiety? I have friends and family members with chronic pain and, through them and their communities, have become aware of many people who use opiods on a long-term, occasional basis to manage their pain. A family member of mine who suffers from chronic migraine live…

For benzos: There really is no drug alternative to benzos other than maybe SSRIs but most people perscribed them probably tried SSRIs in the past to no effect. Your other alternative is extensive psychotherapy, which your insurance is unlikely to cover. Perhaps in the future marijuana, MDMA or ketamine might prove useful. Benzos generally require you to taper off them, as I believe the withdrawal side-effects include…

The other long-term side effect of benzos is that they have shown to speed up dementia in older people. This may be motivation enough to quit for some people.

Re: Benzodiazepines: Our Other Prescription Drug Problem

#20

Post by cc-d »

tnecniv wrote: post #10
UpshotKnothole wrote: post #2

A friend of mine got hooked on heroin and ended up on methadone maintence. He’s since managed to get off that and is clean, but he had horror stories of people on methadone abusing benzodiazepines like crazy. Apparently mixing methadone and high doses of drugs like Xanax produce effects similar to heroin, but benzos are really hard to get off. He talked about a woman who couldn’t get her Xanax fix, and she started ha…

Benzo withdrawal can, in some cases be even riskier than opiate withdrawal. You also build a tolerance to them very quickly, which makes addiction even worse.

Not in some cases, almost all.

GABAergenics in general are pretty much the sole class of popular recreational drug which have a very real possibility of lethal withdrawals.

In the case of alcohol, it often takes years for addicts to reach a point where withdrawal becomes lethal. In the case of short acting benzodiazepines/barbiturates, this point can be reached in less than a month.

Of course, benzodiazepines are in schedule IV, which means they are viewed as being rather benign with no/low potential for abuse. In the eyes of the federal government, alprazolam (xanax) is far less dangerous than marijuana/the traditional psychedelics.

Just another data point demonstrating the utter absurdity of US drug legislation and regulation.

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