Benzodiazepine Drugs Background and Usage Trends
Benzodiazepines, also known as "benzos", are a class of psychoactive drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. Some common benzodiazepines include diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan). Initially developed in the 1950s, benzodiazepines quickly became widely prescribed for conditions like anxiety, insomnia, alcohol withdrawal, and muscle spasms due to their calming and sedative effects.
According to new research from the Centers for Disease Control and Prevention (CDC), the rate of Benzodiazepine Drugs prescriptions in the United States has been rising sharply in recent decades. In 1997, approximately 8.1 million Americans were prescribed a benzodiazepine, representing a rate of 3.8 prescriptions per 100 persons. However, by 2015 this had ballooned to approximately 13.5 million Americans receiving a benzodiazepine prescription, equating to a rate of 5.6 per 100 persons - a 47% increase. Women are nearly twice as likely as men to be prescribed a benzodiazepine, and older adults aged 65 and up account for nearly a third of all benzodiazepine prescriptions despite facing higher risks of adverse effects.
Risks of Long-Term Benzodiazepine Drugs
While benzodiazepines can be safe and effective for short-term use, regular long-term consumption poses serious health risks. One major concern is the high potential for physical and psychological dependence to develop with ongoing benzodiazepine therapy. Weaning off benzodiazepines after prolonged usage can cause severe and sometimes life-threatening withdrawal symptoms. There is also evidence that continuous benzodiazepine exposure may worsen the underlying conditions they are prescribed for rather than improve them.
Long-term and high-dose benzodiazepine use has been associated with various cognitive impairments related to memory, learning, and psychomotor skills. It may increase the rate of car accidents and falls in older adults by impairing coordination, concentration, and reaction time. Benzodiazepines can also worsen symptoms in those with dementia by exacerbating confusion and disorientation. When combined with other sedating substances like opioids and alcohol, benzodiazepines greatly multiply the risk of fatal overdose due to compounded respiratory depression.
Rising Healthcare Costs of Benzodiazepine Misuse
The ever-increasing utilization of benzodiazepines in the US has corresponded with higher healthcare spending on substance abuse treatment programs related to benzodiazepine misuse and dependence. A growing percentage of people are obtaining benzodiazepines through methods other than prescription from a doctor, including buying diverted or counterfeit pills on the illicit market or receiving overlapping prescriptions from multiple physicians.
Each year, more Americans end up in emergency rooms or inpatient facilities due to adverse reactions involving benzodiazepines mixed with other psychoactive substances. The costs of detox, rehabilitation, and ongoing medication-assisted treatment programs required to safely manage benzodiazepine withdrawal and prevent relapse place substantial burdens on state Medicaid budgets and private insurance companies. There is also a tangible economic toll from lost work productivity for individuals needing lengthy leaves of absence or who become permanently disabled due to benzodiazepine misuse issues like overdose or traffic accidents.
Efforts to Promote Safe Benzodiazepine Prescribing
In response to escalating concerns over high-risk benzodiazepine use patterns in America, medical organizations are working to revise guidelines and improve physician education. In 2018, the CDC published a draftset of voluntary prescribing recommendations that advised limiting benzodiazepine therapy to the shortest effective duration of 2-4 weeks for conditions like anxiety and insomnia. Doctors are also urged to avoid coprescribing benzodiazepines with opioids whenever possible due to the enhanced overdose risk.
At the state level, several legislatures have taken action mandating the establishment of prescription drug monitoring programs (PDMPs) integrated with electronic health records. By giving providers up-to-date information on a patient's controlled substance prescription history across multiple practitioners, PDMPs aim to curb "doctor shopping" and duplicative prescribing associated with benzodiazepine misuse and diversion. Professional medical associations likewise emphasize the importance of fully informing patients about proper benzodiazepine usage and risks of physical dependence before starting long-term regimens.
With ongoing advocacy and multi-pronged strategies, it is hoped that healthcare providers and policymakers can work together to promote safer, evidence-based benzodiazepine prescribing standards that protect public health while still meeting clinical treatment needs. By curbing unwarranted high-risk usage and prioritizing short-term, intermittent therapy wherever possible, lives may be saved from preventable overdose down the road. However, reducing benzodiazepine consumption levels on a population-wide basis remains a complex challenge that will require sustained commitment and resources over time.
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