Since their initial development, multiple benzodiazepine drugs have been developed over the course of several decades. Benzodiazepines are currently used to treat anxiety, seizures, withdrawal states, insomnia, agitation, and are commonly used for procedural sedation. Due to their many uses and addictive properties, benzodiazepines have been widely prescribed and abused since their development several decades ago. This activity reviews the pathophysiology, presentation, and etiology of benzodiazepine toxicity and highlights the role of the interprofessional team in the management of these patients. BZDs are most commonly used for panic disorder and generalized anxiety disorder (GAD) regarding its indications for anxiety.
Treating Benzodiazepine Abuse at Home
- A frail 70 year old with falls prescribed flunitrazepam as a sedative hypnotic for 20 years requires a different management approach from a 25-year-old intravenous drug user buying street alprazolam.
- Benzodiazepines, or “benzos,” are a commonly prescribed class of medications known for their calming and relaxing effects.
- Iatrogenic causes of toxicity can be seen when benzodiazepines are combined with other drugs during procedural sedation, particularly with opiates such as fentanyl.
You may be able to work or drive after you start taking them, depending on how these drugs affect you, the dose you take, how long the drugs last and other factors. The mainstay treatment for acute benzodiazepine toxicity is supportive care, which may include endotracheal intubation to provide definitive airway management. Single-dose or multi-dose activated charcoal, hemodialysis, or whole bowel irrigation play no role in managing benzodiazepine toxicity. Benzodiazepine administration may lead to common adverse effects, including, but not limited to, respiratory depression, respiratory arrest, drowsiness, confusion, headache, syncope, nausea and vomiting, diarrhea, and tremors. Patients on maintenance therapy may eventually reach a period of stability in which withdrawal to a lower dose or abstinence may be considered.
Common uses for benzodiazepines
The ideal use of flumazenil is for an isolated iatrogenic BZD overdose (eg, during conscious sedation) in a BZD-naïve patient. Results showed that, compared to wild-type mice, mice on diazepam experienced longer uninterrupted sleep 42. It also reduces the expression of mRNA transcripts such as CaMKIIa, BDNF, GIF, c-fos, NGFIa which are necessary for regulating synapses and plasticity 42. The suppression of CaMKIIa by diazepam has a long-lasting effect leading to a limited neuronal response to changes in intracellular calcium and decreased response by GABA-A receptors 42.
Adverse Effects
Further studies need to be performed on not just gabapentin, but other medications for MMT patients with BZD dependence should be evaluated since treating them is more complicated. Benzodiazepines taken in toxic doses without other coingestants rarely cause a significant toxidrome. The classic presentation in patients with isolated benzodiazepine overdose will include central nervous system (CNS) depression with normal or near-normal vital signs. Respiratory benzodiazepine withdrawal syndrome compromise is uncommon in isolated benzodiazepine ingestions, but if taken with coingestants such as ethanol or other drugs/medications, respiratory depression can be noted.
Reyvow may not be the right treatment option if you have certain medical conditions or other factors affecting your health. While a standard urine drug screen (UDS) should be ordered, it comes with many limitations. Qualitative immunoassays for benzodiazepines in urine are readily available but do not typically aid in acute management decisions. Most of these screening tests detect only benzodiazepines that are metabolized to oxazepam glucuronide.
Benzodiazepine Addiction and Abuse
Just a week prior, he was charged with receiving stolen property after the Shively Police Department said he was found near a stolen truck with his belongings inside. According to court documents, he injured an officer while he was trying to get away from police. If Reyvow doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist. St. John’s wort is https://ecosoberhouse.com/ an herbal supplement that may be used to treat depression and other conditions.
It is essential to follow the doctor’s instructions for stopping the use of these drugs. While effective, they can come with potentially serious side effects and require some precautions when taking them. Even in this case, the lowest effective dose for the shortest possible period will prove to be the safest in older adults. Dewitt was arrested Feb. 22, but, by Feb. 24, had been released from jail after the Louisville chapter of the Bail Project posted his $5,000 bond. The Bail Project provides bond assistance to those who can’t afford it as a challenge to a system the organization what is alcoholism says criminalizes race and poverty. Troutt’s family filed a lawsuit against The Bail Project, which was later dismissed.
- Abuse, misuse, addiction, physical dependence, and withdrawal reactions greatly increases with use of this drug class.
- If cost is a concern for any medicine, be sure to speak to your physician before prescriptions are written and discuss options with your pharmacist, as well.
- Benzodiazepines are safe when taken as directed and are effective at quickly relieving panic symptoms.
- One view is that many of the short-term effects continue into the long-term and may even worsen, and are not resolved after stopping benzodiazepine usage.
- And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.
- Benzodiazepines are a class of drugs (commonly referred to as “benzos”) prescribed to treat anxiety, panic disorder, seizures, insomnia, and alcohol withdrawal.
Benzodiazepine Withdrawal Management and Addiction Treatment
However, with this ongoing, widespread use comes the dark reality of BZD dependence 6. People who misuse drugs — including tranquilizers called benzodiazepines — often deny their problem by playing down the extent of their drug use or blaming job or family stress. The most important thing that can be done at home is to recognize that there may be a problem and to seek help. Low-risk patients can be managed in general practice and may benefit most from attempting withdrawal. High-risk patients are best managed with initial stabilisation and maintenance therapy in specialist residential or outpatient addiction services.