Article: Benzos: The Other Epidemic

Interesting. We are finally getting some respect.

 

https://www.statnews.com/2018/02/22/benzodiazepines-drug-epidemic/

 

Sadly, this short article puts it mostly in the category of illegally obtained drugs instead of legal prescriptions. 

although the list of 25 most commonly prescribed meds for 2016 is heartbreaking.... Xanax is #2.

 

If you really want to be depressed, read the comments at the end of the article.  Most of them talk about how they have to have their benzos, opioids, etc to function and only one I've found so far talks about the trouble getting off them.

Interesting article, but then it goes on a tangent about a man taking something called Clonazolam. Is that even something that is legally manufactured at all? Some good parts in the article, but then talking about an ex-heroin user overdosing on a substance that is not even legally made, let alone prescribed sort of detracts from the story. The overdose story makes Xanax look like a mild sedative.

 

Sadly, this short article puts it mostly in the category of illegally obtained drugs instead of legal prescriptions.

 

Which is why instead of celebrating an article like this, we should be criticizing it.

 

Articles like this only exacerbate the ignorance and misinformation surrounding benzos. At least as far as the iatrogenic dependence issue goes.

 

If you really want to be depressed, read the comments at the end of the article.  Most of them talk about how they have to have their benzos, opioids, etc to function and only one I've found so far talks about the trouble getting off them.

 

This is another reason why articles like this do more harm than good. All of these people who take benzos read this article and think to themselves "That will never happen to me. I will never have a problem with these drugs since I don't have an addictive personality and I take them exactly as prescribed".

Talk about mixed messages in the article:

 

Benzodiazepines work well to ease anxiety or insomnia when used intermittently and for less than a month at a time.

 

People use them intermittently and still get in trouble. Also, taking them for less than a month at a time also creates this repeated pattern of use that can cause dependence as well.

 

When taken daily for an extended period of time, they stop working and can make anxiety and insomnia worse

 

The whole myth of benzodiazepines that have stopped "working" needs to be addressed. That sort of language may encourage someone to do an ill-informed cold turkey attempt (Oh, no, this has stopped working! Why am I taking these pills if they no longer work? I am going to stop tomorrow. And then, chaos ensues.

 

There are safer treatments than benzodiazepines for anxiety and insomnia. These include behavioral interventions and long-term medications like selective serotonin reuptake inhibitors.

 

What exactly is a behavioral intervention? Also, recommending SSRI's is also iffy, because they can cause a host of of horrible problems when stopped. You can do better than recommending behavioral interventions or SSRI's, doctor.

 

Part of this public health crisis can be solved by physicians adopting wiser prescribing practices.

 

It calls for wiser prescribing practices. What are those, exactly?

 

But the public can help, too. If you are struggling with anxiety or insomnia and go to see your doctor, be wary of accepting a prescription for a benzodiazepine — including Ambien, a close cousin of benzodiazepines that is also addictive and potentially deadly.

 

And now she finally recommends that it's best to avoid them completely

 

If you take a benzodiazepine every day, ask your doctor about helping you taper off of it. It’s important to go slowly, because abruptly stopping a benzodiazepine can precipitate life-threatening withdrawal.

 

Fair enough. A nice warning. However, a patient doesn't have to take benzodiazepines every day in order for dependency to develop. A very common misconception.

 

Apparently, the author cannot make up her own mind on benzodiazepines. She seems to simultaneously defend them and also vilify them. So, how are the patients supposed to know what to do, if a doctor writes articles that are cryptic,  wavering and confusing?

Thanks for your very sharp point-by-point analysis!

It brings into relief how very confused (if in some way well meaning) that author is. 

 

To her point that patients should [paraphrasing] "step up to the plate" by declining a doctor's RX of "benzodiazepines."  I'm not sure how many people are even aware that x,y and z drugs are  "benzodiazepines."  They generally seem to know individual benzos by brand names - Xanax, Ativan, Klonopin - but don't realize these are all in the benzo  class.  I've seen this with the few people I've talked to about withdrawal from Ativan and how it's tied to a whole "class" of these drugs. They've never heard the word "benzodiazepines" but know the brand names of the individual drugs.  So it's not clear how well equipped a patient in the doctor's office would be to "know" s/he is being offered a benzo.  This might seem nitpick, but I think the author assumes a lot.

 

It also seems a little unrealistic to expect the person (patient) who is going to the doctor - probably in a vulnerable state and with the expectation that the doctor is the expert - to have the wherewithal (in terms of knowledge or emotionally) to decline a prescription recommended by the doctor.  I know how many of us in this community took what the doctor prescribed trusting s/he knew what they were doing.  And how many of us today wish we had known what we know today about these terrible drugs so we might have been in a position to say "no thank you" before accepting our first prescription.

 

Anyway, thank you for posting the article and for the right-on-the-button critique!