This is worse when they are mixed with other central nervous system suppressants like alcohol or opioids. Benzo misuse can also lead to lack of restraint of aggressive or impulsive behavior.Īs benzos are sedating medications, they also increase the risk of accidents and falls, especially in the elderly. Benzo overdose, especially when mixed with alcohol or opioids, may lead to slowing of breathing, and potentially death. They both are mostly for short use, have a potential for addiction and are not a cure. In 2017, there were more than 11,000 deaths involving benzos alone or with other drugs, and in 2015, a fifth of those who died of opioid overdose also had benzos in their blood.īenzos to anxiety can be seen like opioids to pain. Actually benzos, especially Xanax, have street value because of the pleasant feeling they induce. That means you may become dependent on these meds and that you have to keep increasing the dose to get the same effect. I do this because I care about you.”Ī major risk of long-term use of benzos is addiction. Now we get to the part about why I and other doctors are not eager to prescribe benzodiazepines for long-term use: We have a Hippocratic oath to “first do not harm.” I sometimes tell patients who insist on getting benzos: “I am not paid differently based on the medication I prescribe, and my life would be much easier not arguing with you about this medication. So why the worry?ĭoctors often are reluctant to prescribe benzodiazepines, and many prefer to talk to their patients about the risks and also about other potential treatments, such as psychotherapy. There is no good evidence for use of benzos in post-traumatic stress disorder. However, for a businessman or woman who flies several times a months, psychotherapy is recommended.īenzos may also be used for situations of short-term stress, such as a stressful job interview.īenzos are also used for other medical conditions, such as treatment of seizures or alcohol withdrawal in the hospital. For example, a person with fear of flying who may fly on a plane once or twice a year may choose to take a benzo before flying. Sometimes, however, phobias can interfere with one’s functioning just sporadically, and the person may not be interested in investing in therapy. The main treatment of phobias, such as excessive fear of animals, places and social interactions, is psychotherapy. During that time, if anxiety is severe and debilitating, benzodiazepines may be prescribed for temporary use.īenzos are also prescribed for occasional situations of high anxiety, such as that caused by phobias. That is because it may take a few weeks for the main pharmacological treatment for anxiety, antidepressants, to kick in. They are mostly used for a short period at the beginning of the treatment. By the 1970s, benzos made it to the list of the most highly prescribed medications.īenzos are mainly used to treat anxiety disorders, such as phobias, panic disorder and generalized anxiety disorder. When benzos were introduced to the market in the 1950s, there was excitement as they were considered safer compared to barbiturates, which had been used to treat anxiety. The benzo family includes diazepam, or Valium clonazepam, or Klonopin lorazepam, or Ativan chlordiazepoxide, or Librium and the one most commonly known to the pop culture, alprazolan, or Xanax, among others.īenzos are often prescribed to treat short-term anxiety. GABA receptors are widely available across the brain, and benzodiazepines work to reduce anxiety by enhancing GABA inhibitory function. GABA is a neurotransmitter, a molecule that helps brain cells, or neurons, communicate with each other. What are benzodiazepines?īenzodiazepines are a class of anti-anxiety medications, or anxiolytics, that increase the activity of the gamma-aminobutyric acid receptors in the brain. The overdose death rate among patients receiving both benzodiazepines and opioids is 10 times higher than those only receiving opioids, and benzo misuse is a serious concern. There has been increasing attention into long-term risks of benzodiazepines, including potential for addiction, overdose and cognitive impairment. I also often receive referrals for patients who are on these medications and reluctant to discontinue them. As an academic psychiatrist who treats people with anxiety and trauma, I often hear questions about a specific class of medications called benzodiazepines.
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