Study, May 2016: "Sustained Use of Benzodiazepines and Escalation..."

The full title of this study is "Sustained Use of Benzodiazepines and Escalation to High Doses in a Canadian Population". The introduction makes reference to "antibenzodiazepine campaigns" that have been "conducted worldwide", and I'd love to see examples of what they're referring to. I haven't seen any actual "campaigns" here in Canada, but of course, I think they're absolutely necessary.

 

The study finds that some proportion of those taking benzodiazepines do escalate their doses, and clonazepam seems to be the drug they're most often taking. The abstract doesn't give any explanation, but as usual with an abstract, it's short on detail.

 

http://www.ncbi.nlm.nih.gov/pubmed/27133727

 

 

Yes, pity we're not able to read all the full articles.  This similar article on the sidebar caught my eye, published 2003.

 

https://www.ncbi.nlm.nih.gov/pubmed/12851438

 

CONCLUSION:

 

The results of this study did not support the hypothesis that long-term use of benzodiazepines frequently results in notable dose escalation.

What astounds me is that the studies continue to roll in, but there's little action to change anything. Escalation or no escalation, benzos still carry many risks with them. Time to take action and decrease the numbers of prescriptions handed out.

J Clin Psychiatry. 2005;66 Suppl 2:9-13.

Meta-analyses of peer-reviewed studies were conducted and found that

cognitive dysfunction did in fact occur in patients treated long term with

benzodiazepines ... after benzodiazepines were withdrawn, patients did not

return to levels of functioning that matched benzodiazepine-free controls.

J Clin Psychiatry. 2005;66 Suppl 2:9-13.

Meta-analyses of peer-reviewed studies were conducted and found that

cognitive dysfunction did in fact occur in patients treated long term with

benzodiazepines ... after benzodiazepines were withdrawn, patients did not

return to levels of functioning that matched benzodiazepine-free controls.

 

Yes, but I doubt they followed the patients for very long. It may take time for people to return to higher levels of function, as we've seen by the Success Stories on BB. I'd like to see some long-term studies that really follow people. For now, we have BB stories to show us that people CAN get better.

Antibenzo campaigns are, surprisingly enough, being driven more by law enforcement agencies and state departments of health than by anything at the federal level. In fact, the feds are mostly distracted by the opioid epidemic and are not focused on benzos.

 

One might say, "Well, at least someone is doing something," but there are negative effects. Overall benzo prescriptions in the US are declining as states start arresting doctors for overprescribing (my own doc was one arrestee). The problem is that this is making many doctors afraid to prescribe benzos, even as part of a supervised Ashton-style taper.

 

Consequently, many of us are going to heroic efforts to hook up with Ashton-supportive docs, and those docs are at increasing risk of sanction from regulators. It's a very screwed-up situation.

That's a really unfortunate situation. There's a lot of information available about how to taper appropriately from these medications, and the fact that prescribing doctors don't take the time to inform themselves and that they're not expected to do so, is beyond comprehension. Why are there no standards of behaviour or codes of ethics when it comes to this? And where are the pharmacists in all of this? They could play a huge, helpful, educational role if they took the time to understand and read some of the literature. Listening to patients might be a good place to start too.

 

So disappointing. Lives hang in the balance.