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.


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