Seven out of eight emergency department (ED) visits attributed to adverse events from benzodiazepines involve self-harm or nonmedical use of these drugs, and more than 80% involve concurrent use of alcohol, illicit drugs, or other substances, new research shows.
Although benzodiazepines are typically not problematic in terms of acute overdoses when used alone, patients often don’t take them as prescribed or use them with other substances in a self-harm attempt, author Daniel S. Budnitz, MD, MPH, director of the Medication Safety Program, Centers for Disease Control and Prevention (CDC), told Medscape Medical News.
“Clinicians need to be aware of what other substances patients might be taking when they’re being prescribed a benzodiazepine,” Budnitz added.
The study was published online February 19 in the American Journal of Preventive Medicine.Benzodiazepines Implicated in High Rate of ED Visits Across US – Medscape – Feb 25, 2020 – https://www.medscape.com/viewarticle/925686#vp_1
“I took the medication only as prescribed,” Bobbi said. After her benzodiazepine was stopped abruptly, she suffered multiple disabling neurological symptoms, including seizures, cognitive and visual impairment, difficulty walking, and hand contractures, leaving her unable to work. Bobbi is one of many patients my advocacy organization helped report their harm to the FDA. Our goal was to raise awareness of the adverse effects of benzodiazepines and advocate for stronger warning labels.
Thus, I was pleasantly surprised last September to see the FDA’s drug safety communication announcing an update to the boxed warning for benzodiazepines “to address the serious risks of abuse, addiction, physical dependence, and withdrawal reactions.” Curious, I filed a FOIA request for the FDA’s 175-page report on benzodiazepines. Many of the document’s conclusions raise the same concerns benzodiazepine safety advocates have had for decades.updated benzodiazepine boxed warning: What you need to know — https://www.kevinmd.com/blog/2021/03/the-updated-benzodiazepine-boxed-warning-what-you-need-to-know.html
I downloaded the FDA report for future reference.
The report should be fun weekend reading.
Between 1996 and 2013, the number of adults who filled a benzodiazepine prescription increased by 67 percent, from 8.1 million to 13.5 million. Unlike opioid prescribing, which peaked in 2012 and has decreased nearly 20 percent since then, benzodiazepine prescribing continues to rise. The risk of overdose death goes up nearly fourfold when benzodiazepines are combined with opioids, yet rates of co-prescribing benzodiazepines and opioids nearly doubled between 2001 and 2013. Overdose deaths involving benzodiazepines increased more than sevenfold between 1999 and 2015.
Anna Lembke, M.D., is associate professor of psychiatry and behavioral sciences at the Stanford University School of Medicine, chief of the Stanford Addiction Medicine Dual Diagnosis Clinic, and author of “Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop” (Johns Hopkins University Press, 2016).
You can read the full article here.
Prescription benzodiazepines continue to be commonly prescribed drugs for treatment of mood and anxiety disorders. In 2015, more than 32 million people over the age of 12 reported use of benzodiazepines in the previous year. Of these, nearly 20% used benzodiazepines in a pattern of misuse (Figure 1).1 Benzodiazepines also ranked second among misused/abused drug related visits to the ED by patients aged 65 and older in 2011.2 The rates of long term benzodiazepine use have steadily increased over time. A retrospective study showed an age-related increase in the percentage of benzodiazepine use with higher rates of any benzodiazepine use in women at any age.3 Most of the patients with long term benzodiazepine use received their prescriptions from prescribers who were not psychiatrists.4 Benzodiazepine dependence can be seen within just 3-6 weeks of regular use at therapeutic doses.3