Pharmacy Times 2014 -- on "Legitimate Indications" and "Overprescription"

This Jan. 2014 article was written by a professor at University of Connecticut School of Pharmacy and appeared in Pharmacy Times:

 

http://www.pharmacytimes.com/publications/issue/2014/January2014/Benzodiazepines-Recognizing-Their-Legitimate-Indications

 

It does not address the issues faced by BB members, but I think you'll find it interesting nevertheless, and I'm curious to hear others' thoughts. To me, it's so disappointing because it leaves so much out. It's directed at pharmacists, who I feel could play a crucial role in educating patients.

 

This second article addresses the issue of overprescription in the U.S., but again, it leaves a lot out. To be fair, these are short articles that try to cover what -- to many of us -- is an important topic in a few paragraphs. A lot more needs to be said.

 

http://www.pharmacytimes.com/news/Opioids-Benzodiazepines-Overprescribed-Across-the-United-States

 

 

Over the holidays I met a kid studying to be a pharmacist. (His sister wants to be a pharma rep !! ) The kid is working as an assistant in one of the big chains and I asked him if there are restrictions or warnings on the dispensing of benzos.

 

He never heard of them. 

Just read the article - very distressing.

I'm sure he'll hear lots about them very soon. And then he'll be selling lots of them once he graduates!

 

Really, I think pharmacists could play an important role when it comes to benzos. They could educate people, they could help with taper support, etc. If they see an ongoing, long-term prescription, they could have a chat with someone to give them some crucial, possibly life-saving info. I hope the almighty dollar doesn't rule the day everywhere, but it likely does.

This is a very discouraging article to read. The only thing I can think of that is a positive is that people won't be doing a c/t because otherwise they'd have to pay out of pocket for the drug. But Ms. Wick doesn't go into the dangers of taking benzos long term. Many of the same side effects of the drugs mentioned that were considered dangerous are the very ones that so many of us go through in benzo w/d.

 

I do think pharmacists could play a tremendous role in assisting patients with understanding benzo usage and the dangers of prolonged use, but I also wonder if they tend to defer to the physicians' decision for keeping the patient on a benzo drug in the first place and figure that, as most of the world seems to think, as a whole benzo use is a positive thing for society in general and that patients are benefiting. In other words, let sleeping dogs lie and don't ruffle any feathers, keep the status quo as is. As for the rest of us, we'll continue to suffer excruciating pain and misery in silence.

 

This has nothing to do with short-term use, however. I think benzo drugs are very valuable when used for a few days only, at the very most, during a triage situation.

 

 

Well-said, Terry38! I'm sure there are issues with challenging the doctor's prescription, but then I also think that there's a responsibility to educate. I'm sure there's a fine line in there and a good way to go about it. Education shouldn't be seen as problematic. I'd love to hear the insider's view from a pharmacist, just to better understand what their role is when it comes to an issue like this.

 

On the positive side, I posted an article awhile ago that was in a Canadian pharmacy journal. It showed how helpful the pharmacist's involvement was in reducing the use of benzos by some elderly patients. I'm not sure how often that happens, but it was heartening to see it.

I spoke with a pharmacist by phone one time, and she didn't understand what I was talking about when I mentioned benzo w/d. However, I'm sure there are many pharmacists out there who are very knowledgeable about them. And I agree that it would help tremendously to hear solid, reliable information from a pharmacist, the one who is actually handling all types of drugs on a daily basis. I hope that someday soon there's going to be a snowball effect, and finally the correct information will come out into the open. I keep reading on BB about people who have been given erroneous information from their doctors. It's really sad.

 

 

Yes, Terry, me too. Pharmacists study medication, so they should be well-versed in side effects, withdrawal effects and interactions. I heard of a case where a a pharmacist was charged because he failed to warn someone of a major drug interaction and the woman died as a result. Apparently, there's a warning system in the computer program that the pharmacist ignored. I'm not sure how often that happens, but it's a scary thought.

 

http://www.cbc.ca/news/canada/british-columbia/pharmacists-failure-to-check-drug-risks-leads-to-horrible-death-1.2787185

 

Anyway, when it comes to benzos, I'd love to see a warning system! Danger! Danger! Truthfully, I think there are systemic reasons for the benzo epidemic, and the solution is going to be a multi-faceted one that addresses all of the different parts of the system that appear to be encouraging and supporting long-term benzo use despite the dangers that we've all come to know too well. Patients, doctors, pharmacists, drug companies, the media, public health departments, etc., can all play a role in changing things for the better.

Thank you for the article, Lapis!! This troubles me deeply. Although the pharmacist was at fault for not warning the patient about the drug interactions, I'm appalled that Dr. Le Roux passed all the blame onto the pharmacist by saying that it was the pharmacist's duty to warn the patient about interactions when he was the one prescribing the two drugs in the first place. I believe it's the doctor's duty, equally, to understand drug interactions and to give pertinent information to the patient or realize that it's not a good idea to be prescribing a deadly drug combination. Hopefully now he'll be more careful when dispensing drugs to other patients.

 

I wish that medical offices employed pharmacists in-house so that they could confer with doctors immediately after a prescription is written up. The two could interact and learn from each other on a daily basis.

 

This is what also scares me: There are so many new drugs on the market now, and I was reading something about the FDA approving 41 new drugs in 2014, an 18-year high. Unless doctors begin taking extensive classes on drugs, they'll be even more inept at understanding all the interactions, leading to more deaths.

 

As for benzo drugs, they need a warning system, as you mentioned!!

 

The story I shared really represents a failure on the part of those entrusted to care for an ill person. It's awful. I hope it's an isolated case, but we do hear of deaths caused by medications.

 

What I find so strange is that there are so many warnings about herbal products and lack of testing, etc., etc., but drugs cause deaths all the time! It's nonsensical.

 

It seems we have to study something before we take anything at all. Doctors and pharmacists should be there to provide information and appropriate support, but it doesn't always work that way. I'm glad we have access to online info. Where would we be without it?

Yes, I agree. I don't know where we'd be without the Internet. It's hard to imagine that I used to live in a time when there was no Internet and little news!

I'm sure we're dating ourselves, but wow, things have changed! Granted, there's a lot of crap online, and our bullshit meters have to be in good working order so that we can spot that crap. But we're lucky to be able to do what we're doing here -- share info, share experiences, learn, etc. When it comes to figuring out what's true and what's not regarding our health, it's a minefield!

This is a very discouraging article to read. The only thing I can think of that is a positive is that people won't be doing a c/t because otherwise they'd have to pay out of pocket for the drug. But Ms. Wick doesn't go into the dangers of taking benzos long term. Many of the same side effects of the drugs mentioned that were considered dangerous are the very ones that so many of us go through in benzo w/d.

 

I do think pharmacists could play a tremendous role in assisting patients with understanding benzo usage and the dangers of prolonged use, but I also wonder if they tend to defer to the physicians' decision for keeping the patient on a benzo drug in the first place and figure that, as most of the world seems to think, as a whole benzo use is a positive thing for society in general and that patients are benefiting. In other words, let sleeping dogs lie and don't ruffle any feathers, keep the status quo as is. As for the rest of us, we'll continue to suffer excruciating pain and misery in silence.

 

This has nothing to do with short-term use, however. I think benzo drugs are very valuable when used for a few days only, at the very most, during a triage situation.

 

That was the pat answer my pharmacist told me. Bets

Bets, it seems that if the pharmacist defers to the physician and the physician leaves it up to the pharmacist to explain side effects, we'll be going round in circles forever!