Study, Jul/17: "Benzodiazepines and risk of all cause mortality in adults...."

The full title of this American study is "Benzodiazepines and risk of all cause mortality in adults: cohort study".

 

"Conclusions This large population based cohort study suggests either no increase or at most a minor increase in risk of all cause mortality associated with benzodiazepine initiation. If a detrimental effect exists, it is likely to be much smaller than previously stated and to have uncertain clinical relevance. Residual confounding likely explains at least part of the small increase in mortality risk observed in selected analyses."

 

Now, I'd like to see a study on the quality of life of those who initiated benzodiazepine treatment. I'd also like to see the direct connection made between those who take benzos, fall, fracture a hip and then die of pneumonia as a result of being bedridden. Those links are often not made in the literature, and the cause of death might be listed as pneumonia and not as pneumonia-caused-by-a-fracture-caused-by-a-fall-caused-by-benzodiazepines.

 

https://www.ncbi.nlm.nih.gov/pubmed/28684397

A very good point, Lapis!

 

 

Yes, good point Lapis and thank-you for posting these types of studies here on BB. Good to know these things for sure.

Glad to share! I'll keep posting them if people keep reading them. For me, it's really interesting to see what they're studying. I'm still boggled by the lack of action despite the influx of info, but obviously, things move very slowly. Thank goodness we have access to info, and we can just decide things for ourselves now.

The full title of this American study is "Benzodiazepines and risk of all cause mortality in adults: cohort study".

 

"Conclusions This large population based cohort study suggests either no increase or at most a minor increase in risk of all cause mortality associated with benzodiazepine initiation. If a detrimental effect exists, it is likely to be much smaller than previously stated and to have uncertain clinical relevance. Residual confounding likely explains at least part of the small increase in mortality risk observed in selected analyses."

 

Now, I'd like to see a study on the quality of life of those who initiated benzodiazepine treatment. I'd also like to see the direct connection made between those who take benzos, fall, fracture a hip and then die of pneumonia as a result of being bedridden. Those links are often not made in the literature, and the cause of death might be listed as pneumonia and not as pneumonia-caused-by-a-fracture-caused-by-a-fall-caused-by-benzodiazepines.

 

https://www.ncbi.nlm.nih.gov/pubmed/28684397

Many thanks for sharing, Lapis. In my opinion it's a good study. If there is an effect on mortality then this is low and difficult to measure. Especially on the short-term mortality. The effect on long-term mortality is even more difficult to assess. I agree that the authors should have researched the quality of life -- much more relevant!

 

 

 

Hi Fallingstar,

I was thinking further about the quality-of-life issue, and the truth is that it's only retrospect that we seem to understand how diminished our quality of life has been as a result of taking benzodiazepines. If you'd asked any of us how we felt while we were still taking them, we might not have recognized the subtle deterioration of our health and function. And of course, we wouldn't have connected the dots between benzos and quality of life.

 

 

I would like to ask who did this study and whether or not there are any links to pharma. Even if there is low mortality, I think that they're completely missing the point. Lapis, you have a very good point about low quality of life. I hope this doesn't mean doctors can still feel that they can prescribe this pill with abandon because it certainly does NOT bode well for the quality of life issue. 

Hi Terry,

I came across this exchange on Twitter today -- Dr. David Juurlink's account. Please have a look at these tweets, as well as the blurb from Richard Lehman in the BMJ. It made my blood boil, because there are so many errors in the reasoning he uses. Really lame. The fact is that we don't have proper figures on how many people die from falls, fractures and motor vehicle accidents related to benzo use. We also don't have proper figures on how many people might be barely functional (like me), because the meds have so debilitated them that they cannot walk or carry on normally. Death isn't the only measure we should use to decide if people should stay on benzodiazepines long term.

 

https://twitter.com/DavidJuurlink/status/884696060723122176 

 

 

The BMJ 8 July 2017  Vol 358

 

Benign benzos

 

This week, the “bad” habits of us older GPs are being proved reasonable, one by one. We’ve seen that diclofenac really is the best NSAID for arthritis pain (though probably the most dangerous), and that continuous antibiotics (macrolides at least) do reduce exacerbations in asthma and COPD. Now it’s the turn of benzodiazepines. Yes, they do cause dependency, and they should be avoided where there are better alternatives. But this huge US cohort study shows that they do not increase mortality in older people, as has been repeatedly suggested. The few GPs remaining have better things to do with their time than try to wean old ladies off the diazepam they have taken every day for twenty years, in order to meet some arbitrary prescribing target.

 

Here's the study:

 

http://www.bmj.com/content/358/bmj.j2941 

Hi Terry,

I came across this exchange on Twitter today -- Dr. David Juurlink's account. Please have a look at these tweets, as well as the blurb from Richard Lehman in the BMJ. It made my blood boil, because there are so many errors in the reasoning he uses. Really lame. The fact is that we don't have proper figures on how many people die from falls, fractures and motor vehicle accidents related to benzo use. We also don't have proper figures on how many people might be barely functional (like me), because the meds have so debilitated them that they cannot walk or carry on normally. Death isn't the only measure we should use to decide if people should stay on benzodiazepines long term.

 

https://twitter.com/DavidJuurlink/status/884696060723122176 

 

 

The BMJ 8 July 2017  Vol 358

 

Benign benzos

 

This week, the “bad” habits of us older GPs are being proved reasonable, one by one. We’ve seen that diclofenac really is the best NSAID for arthritis pain (though probably the most dangerous), and that continuous antibiotics (macrolides at least) do reduce exacerbations in asthma and COPD. Now it’s the turn of benzodiazepines. Yes, they do cause dependency, and they should be avoided where there are better alternatives. But this huge US cohort study shows that they do not increase mortality in older people, as has been repeatedly suggested. The few GPs remaining have better things to do with their time than try to wean old ladies off the diazepam they have taken every day for twenty years, in order to meet some arbitrary prescribing target.

 

Here's the study:

 

http://www.bmj.com/content/358/bmj.j2941

 

Great points.  His snide remark at the end of the quote is typical and pompous. 

 

I've heard about studies on benzodiazaphines, where a rat was able to tolerate 5000 mg of such and such a Benzo, after which the rat died.  The medical community plays on words and concepts like this, and relative "increased mortality" rates to justify their long term use of benzos for their patients.  Looking back, I now realize that all those times the doctors stated that the benzo I was taking was safe, they were talking about risk to mortality and overdose.  People don't overdose on benzos alone, and the doctors justify their use through this false sense of reasoning.  They know the truth.  Benzos provide them with a quick solution to often complex issues, and they are just concerned about the paycheck at the end of the day.  The quote above makes my point. They want to optimize their time per patient.  When we go to the same prescribing doctor and tell them that we want off, they either tell us just stop, or they tell us to go somewhere else.  It's no longer worth their time.

 

We are too smart and intelligent for these types of justifications, simply because of what we have been through.  There is no greater clinical efficacy than first hand experience with these awful drugs.  Yes, they probably won't kill you like mixing opiates, benzos and alcohol will do.  However, once you get dependent and tolerant to these drugs, the quality of life that this thread mentions is zero. Even if they prove definitively that benzos increase the risk of dementia and Alzheimer's, it's rare that people actually die directly from these maladies.  But the quality of life is zero.  The doector's justifications above fall completely flat, and the study is completely useless and worthless to the patient.

 

Thank you for posting it.

Lapis, thank you!!! I am feeling very badly at the moment and can't seem to concentrate. I'll read up later. THANK YOU for all your wonderful work!!! 

Hi dm123,

When I saw these Tweets this morning, I almost yelled at my computer -- which, of course, would have yielded no response at all, so I'm very glad to have posted it here and received your feedback. Thank you! Excellent points!

 

As an interesting comparison, there was a doctor speaking on CBC Radio this morning about opioids and pain, and in dealing with those things over a long period of time, he said that it's "always about quality of life" when it comes to prescribing medications for pain. For cancer patients or others with excruciating pain, the pain specialist must try to figure out how to improve the person's quality of life.

 

When it comes to benzodiazepines, the same should be true. My quality of life was much diminished while taking these medications, and it went down to zero once my dizziness became relentless. I couldn't function. I couldn't walk or prepare a meal or take a shower. Long term benzodiazepines can -- depending on the person -- lead to weakness, confusion, memory lapses, dizziness, and a whole host of other issues. These things are well known, and there's medical literature to back it up, plus about 33,000 people on BB who would concur.

 

Some people may not ever want to get off their benzodiazepines. But for those of us who do, there should be doctors who are informed and supportive and willing to help. Avoiding the issue, disregarding the existing literature and sticking one's head in the sand is completely irresponsible, and it represents a failure to perform the duties required of a medical doctor.

Lapis, thank you!!! I am feeling very badly at the moment and can't seem to concentrate. I'll read up later. THANK YOU for all your wonderful work!!! 

 

As always, Terry, it's my pleasure to share things here. Please take good care!

Hi Lapis, I'm with you 100%

 

Speaking of those who wish to remain on benzodiazaphines, I'm not sure if you have seen this very recent post

 

http://www.benzobuddies.org/forum/index.php?topic=184584.0

 

I responded there as well.  It's a very interesting thread.

 

Best wishes