Benzo Update 02.25.18

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.

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ADHD Prescriptions Skyrocket Among Young Women

The percentage of women who filled a prescription for an ADHD medication rose from 0.9% in 2003 to 4.0% in 2015 ― an increase of 344%, the researchers report.

ADHD prescriptions increased for all subgroups of female patients aged 15 years to 44 years (analyzed in 5-year increments), and in all geographic regions of the country. The largest increase in ADHD prescriptions occurred among women aged 25 to 29 years (700% increase), followed by women aged 30 to 34 (560% increase).

WHY???  Read the Medscape article (and comments) here and the MMWR report at this link.

 

 

Benzodiazepine Withdrawal Syndrome: Presentations and Emergency Department Management – emDOCs.net – Emergency Medicine Education

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

Source: emDOCs.net – Emergency Medicine EducationBenzodiazepine Withdrawal Syndrome: Presentations and Emergency Department Management – emDOCs.net – Emergency Medicine Education

Trends in Prescription Opioids Detected in Fatally Injured Drivers in 6 US States: 1995–2015 | AJPH | Ahead of Print

Results. The prevalence of prescription opioids detected in fatally injured drivers increased from 1.0% (95% confidence interval [CI] = 0.5, 1.4) in 1995 to 7.2% (95% CI = 5.7, 8.8) in 2015 (Z = −9.04; P < .001). Prescription opioid prevalence was higher in female than in male drivers (4.4% vs 2.9%; P < .001). Of the drivers testing positive for prescription opioids, 30.0% had elevated blood alcohol concentrations (≥ 0.01 g/dL), and 66.9% tested positive for other drugs.

Source: Trends in Prescription Opioids Detected in Fatally Injured Drivers in 6 US States: 1995–2015 | AJPH | Ahead of Print

Houston…we have a problem.

FDA Adds New Warnings to All Testosterone Product Labels

Testosterone and other AAS, which have a schedule III classification by the Controlled Substances Act, may be abused by adults and adolescents, including athletes and body builders.

“Abuse of testosterone, usually at doses higher than those typically prescribed and usually in conjunction with other AAS, is associated with serious safety risks affecting the heart, brain, liver, mental health, and endocrine system,” the FDA notes.

Reported serious adverse outcomes include myocardial infarction, heart failure, stroke, depression, hostility, aggression, liver toxicity, and male infertility. People abusing high doses of testosterone have also reported withdrawal symptoms, such as depression, fatigue, irritability, loss of appetite, decreased libido, and insomnia, the agency says.

Source: FDA Adds New Warnings to All Testosterone Product Labels

Source: Safety Alerts for Human Medical Products > Testosterone and Other Anabolic Androgenic Steroids (AAS): FDA Statement – Risks Associated With Abuse and Dependence

It is interesting you no longer see those Low-T commercials on television any more.  Really?  Just another clever marketing campaign to create a disease that doesn’t exist along with a convenient drug based solution.  What side effects?

Read this book.  Now.

Source: Bill Moyers Journal . Profile . Melody Petersen | PBS