How Physicians Inadvertently Promote Misuse of Benzos

Benzodiazepines, a class of prescription drugs known as central nervous system (CNS) depressants, have wrecked a havoc on those using these antianxiety medications. These drugs, along with opioid painkillers and stimulants, are being widely abused by Americans for purposes that are both medicinal and recreational in nature. Some of the disturbing implications of the abuse of benzodiazepines are life-threatening withdrawal symptoms.

However, as a recent research reveals that when it comes to benzos, physicians could be inadvertently contributing to its misuse. Most physicians prescribe benzodiazepines on the “pro re nata” (PRN) or “as needed” basis due to the belief that the user would have the good sense to use medication and only if absolutely necessary. However, people who are prescribed the drug tend to read between the lines and hence there is an increased likelihood of misuse.

While calling for more research on the “prescription practices” of physicians, Dr. Amy Swift, M.D., Mount Sinai Beth, said, “When they are prescribed as standing, people take them in the expected fashion, but when there is a little bit less standardization of what exactly is expected of the patient, then there is more room for misuse.”

Deciphering the markers of abuse

Due to increased misconception, the abuse of benzodiazepines has been consistently on the rise, in terms of both number of people and prescription of doses. In parallel, the number of overdose deaths due to benzodiazepines has also markedly increased. This calls for developing a better understanding of the problem. The markers of misuse of benzodiazepines among patients as detailed by the above-mentioned study are as follows:

Requiring medication earlier than prescribed.
Violating the U.S.-based Internet System for Over-Prescribing Act (I -STOP) program, the host clinic’s program for evaluating the efficacy of the prescription drug monitoring.
Getting into confrontation with the health care authorities.

While a remarkable 71 percent of patients are prescribed benzodiazepines, there were clear markers of misuse due to the following reasons:

6 percent had required medications earlier than prescribed.
6 percent had reported of violations in the I-STOP prescription monitoring program.
28 percent reported of having a confrontation with the health care authorities of the clinic concerned.

Reasons behind the rise in overdose due to benzos

The prescription drug menace has grown more potent in the last couple of years. As stated by the study, many of these overdose incidents also involved drugs like benzodiazepines. The reasons that led to the increased overdose deaths due to benzodiazepines are mentioned below:

Mixing benzos with opioids: Mixing benzodiazepines with opioids can be fatal, as these are two varied classes of drugs. As both the drugs are associated with a high degree of addiction, it is necessary to be careful to avoid polydrug abuse. Since it had been a common practice to use both, people tend to use opioids, such as Vicodin, and a benzo, such as Valium, for treating chronic pain and muscle spasms that could arise because of a chronic injury or back problem. When one mixes opioids with Xanax or Valium, there is an increased risk of witnessing sedation and breathing depression. With the brain no longer receiving oxygen, the other vital body organs also begin to shut down and in certain instances the person could slip into a coma.

Benzos for MDD: The study also contended that the way medications are being prescribed in psychiatric clinics, it flouts the Food and Drug Administration (FDA) guidelines. For example, women between the ages of 50 and 60 who had been diagnosed with a major depressive disorder (MDD) were being prescribed benzos in clear violation of the FDA.

Higher dosages and longer durations: The study also noted that though the average daily dose was 2.8 mg/day of Ativan, in the sample study, for 11 percent of patients it was substantially higher than what was mentioned as pertinent. The dosages were a high 6 mg/day of Ativan or more per day. Also, nearly 60 percent of the patients had been receiving benzodiazepines for five years or longer even though it is clearly stipulated that benzos are meant only for short-term and limited duration.

Questioning the use of benzos

The most common use of a benzo is to cure insomnia and anxiety. As studies have proved, the long-term use of benzos, such as sleeping pills, is responsible for early mortality. Whether it is Xanax or Valium, benzodiazepines are meant only for short-term use. Considering the above-mentioned repercussions, these medications should be taken as per the doctor’s prescription. Moreover, it is vital to consult the doctor in detail regarding when and how to use benzos.

Don’t Ignore These Telltale Signs of Drug Abuse in Teens

Drug abuse has for a long been a problem among teenagers with peer pressure as the key factor driving it. Despite being well documented, parents and caregivers tend to ignore the apparent symptoms of drug abuse in the growing children. The early instances of drug abuse evoke far greater health consequences in this age group than in any other group.

One of the reasons behind the increase in the severity of repercussions of drug abuse is that during adolescence both body and mind are still in the process of development. Apart from the fact that drugs can alter brain chemistry and structure, illicit drug use among teenagers can increase vulnerability to motor crashes and instigate risky sexual behavior. Additionally, drug abuse increases suicidal tendencies, assaults, symptoms of mental health conditions and dropout rate at schools.

Illicit drug use also entails legal and social consequences, such as increase in incidents of violence, criminal activities and neglect, as well as a higher likelihood of abusing drugs in later life. In addition, pregnant teenage girls who continue engaging in drugs are at risk of harming the fetus and themselves in many ways.

Absence of evidence is not evidence of absence

Nurturing and caring for a teenager is no easy task. The bumpy journey of growth that includes a number of transitional phases, ranging from hitting puberty to adolescence, yearning for dependence to realizing independence, “I love you” to “I hate you,” to confronting life without a safety net to making sense of it all, can mislead parents, guardians and caregivers, especially when their children are on drugs.

Even in the absence of any evidence, it is important that parents who feel that something is wrong with their children trust their hunch and take significant remedial actions, such as talking to their children or seeking professional help.

One of the most practical tools to address the problem of drug abuse among teenagers is communication. Usually, drug-using teenagers develop traits that assist them in concealing their growing addiction-related practices.

They also spend their time incommunicado. When a teenager displays odd behavioral patterns, such as not being themselves after a social event, being vague about the details of the movie watched, getting home beyond curfew, avoiding interaction or getting close to their parents, it is best to investigate to safeguard their health and life.

Some of the below-mentioned warning signs specified by the National Institute on Drug Abuse (NIDA) can assist parents in keeping a check on their adolescent children:

A change in peer group
Carelessness with grooming
Poor academic performance
Increased absenteeism
Loss of interest in favorite activities
Changes in eating or sleeping habits
Deteriorating relationships with family members and friends

Although the 2016 Monitoring the Future (MTF) survey of drug use among American teenagers suggests decline in the past year use of illicit drugs, except marijuana, alcohol and drug use amidst teenagers is a major public concern. In addition, there is substantial evidence that drug use in early years increases the likelihood of a teenager developing substance use disorder and the symptoms of mental health conditions in their adulthood. However, early intervention is known to reduce and treat these conditions more successfully compared to those who let the abuse linger or get treated late.

Pull the plug on drugs

The earliest warning signs of drug abuse among teenagers are changes in their behavior and mannerism. Usually, addressing a teenager’s drug abuse habits can be an unpleasant ordeal, which is at times riddled with extreme opposition from the patient.

Therefore, it is important that parents communicate with their adolescent children about the life-threatening consequences of drug abuse. They should also discuss about the ways that can assist in overcoming the challenge of drug abuse. They can guide their children in the right direction through their love and care.

Multipronged Approach Most Effective for Heroin Addiction Treatment

The personal and public cost of heroin addiction is staggering. According to statistics from the American Society of Addiction Medicine, more than 586,000 Americans were addicted to heroin in 2014, with an additional 1.9 million suffering from general opioid addiction. The Centers for Disease Control and Prevention notes that drug overdose is the most common cause of accidental death in the United States, and estimates that the systemic cost of addiction is more than $400 billion annually. The good news, however, is that heroin addiction treatment with a combination of pharmacological and behavioral methods is often effective.

Pharmacological Treatments

A range of medications can be used to assuage the physical and psychological side effects caused by heroin withdrawal. During the initial detoxification stage, people discontinuing opioid usage experience severe nausea, vomiting, pain, and diarrhea. Doctors typically prescribe medications that help ease this transition by affecting the brain’s opioid receptors without activating the pleasurable feelings associated with heroin. Common options including methadone, which has been used for this purpose since the 1960s; buprenorphine, which was FDA-approved in 2002 and includes naloxone, which induces withdrawal symptoms if the person attempts to use the medication to get high; and naltrexone, which reduces physical dependence to the drug.

Many people who are addicted to heroin have coexisting mental health disorders that must also be addressed. For example, effective addiction treatment will also take steps to treat underlying depression, anxiety, and other issues that may have either been present before addiction or caused by pervasive drug abuse.

Behavioral Therapies

Although subverting the drug’s effect on the brain and body is a key component of heroin addiction treatment, behavioral therapy helps prevent relapse. Therapy can be provided in either an outpatient or residential setting. One effective approach, called contingency management, allows patients to earn vouchers for positive drug tests that can be used to purchase items that encourage healthy living. Another approach, cognitive-behavioral therapy, helps the person modify his or her expectations and behaviors, as well as explore and reduce stressors that may have contributed to initial opiate use.

Principles of Effective Treatment

It’s important for those entering heroin addiction treatment to be aware of the ways in which the drug affects the body and brain and the steps that must be taken to break these connections. Addiction alters the brain’s structure and function, which explains why relapse is so common among those addicted to opioids. No single type of treatment is appropriate for everyone, so it may take several false starts to find the appropriate settings and services that help an individual return to a functional, productive lifestyle. Treatment should take into account a person’s medical, psychological, social, vocational, and legal problems in addition to the addiction.

Most people need at least three months in intensive treatment to successfully discontinue drug use. It’s important to plan for the eventuality of leaving a treatment setting, including integrated social and vocational supports that prevent a person from returning to destructive routines, friends, and activities.