The recent report by the U.S. National Center for Health Studies showcases a significant increase in the prescribing of benzodiazepines. Contributions came from data evaluated during 2014-2016, highlighting that these prescriptions were issued in 66 million doctors’ appointments yearly. Translationally, for every 100 adults visiting their doctor, 27 received a benzodiazepine prescription.
- Primary care providers:
- Issued 48% of the prescriptions.
- Psychiatrists: Accounted for 28% of prescriptions.
Prescriptions were higher for women compared to men:
- Women: 34 visits per 100 involved a benzodiazepine prescription.
- Men: 20 visits per 100 involved a benzodiazepine prescription.
- Women aged 65 and above represented the highest rate of doctor visits involving benzodiazepine prescriptions.
These medications, including alprazolam, diazepam, and lorazepam, are indicated for anxiety, pain, and insomnia, among others. However, their association with tolerance, dependency, and adverse long-term effects is well-documented. Ironically, conditions such as panic attacks and insomnia may be exacerbated as repercussions of withdrawal.
- Adverse effects heightened in the elderly population with an increased risk of falls, cognitive impairment, and hospital admissions.
- Overdose fatalities correlated to benzodiazepines rose from 1,000 in 1999 to 11,000 in 2017.
- FDA black-box warning in 2016 about the dangers of co-prescribing benzodiazepines with opiates.
The study’s reception is one of concern, indicating a need for action to address these escalating prescribing practices.
Prescription Patterns and Demographics
The U.S. National Center for Health Studies report exposes critical trends in benzodiazepine prescribing practices, with a stark rise in annual prescriptions and demographic variations that raise concerns.
Annual Prescription Statistics
During the period of 2014-2016, 66 million benzodiazepine prescriptions were issued annually in doctor’s appointments. This equates to 27 out of every 100 adults visiting a doctor receiving a benzodiazepine prescription. Primary care providers were responsible for 48% of these prescriptions, while psychiatrists accounted for 28%.
Gender Disparities in Prescribing
Prescription rates for benzodiazepines show a clear gender disparity. Data reveals 34 doctor visits per 100 women resulted in benzodiazepine prescriptions, compared to 20 visits per 100 men. This notable difference indicates women are prescribed benzodiazepines at a significantly higher rate than men.
Age Variation in Prescription Rates
The frequency of benzodiazepine prescriptions varies with age and is seen to increase among older demographics. Notably, women aged 65 and older had the highest rate of doctor visits resulting in a prescription at 19 per 100 women. This is particularly concerning given the associated risks of benzodiazepine use in the elderly population, such as falls and cognitive impairment.
Clinical Usage and Dependence Issues
Benzodiazepines are prevalently prescribed for certain psychiatric conditions, yet concerns about dependency and adverse long-term effects are escalating.
Benzodiazepines, a class of central nervous system depressants, are frequently prescribed for the management of anxiety, pain, and insomnia. Medicinal statistics indicate that alprazolam, diazepam, and lorazepam feature prominently in physicians’ treatment plans.
Evidence links long-term benzodiazepine use to the development of tolerance and physical dependence, compounding the original conditions they are meant to treat. Reports identify an unsettling trend of increase in withdrawal symptoms resembling anxiety and insomnia, which complicates distinguishing between drug dependency and relapse of the underlying disorder.
Public Health Concerns
The U.S. National Center for Health Studies indicates a sharp increase in benzodiazepine prescriptions, leading to public health concerns, notably the risks in elderly patients and a rise in overdoses as well as fatalities.
Prescription rates of benzodiazepines for elderly patients have significantly increased, a
concerning trend due to the pronounced side effects this demographic faces. Studies associate benzodiazepine use among those aged 65 and over with a heightened risk of falls, cognitive impairment, and hospital admissions.
There has been an alarming escalation in overdoses and deaths related to benzodiazepines across the United States. Data reflect a jump from 1,000 fatalities in 1999 to 11,000 by 2017, prompting the FDA’s issuance of a black-box warning against co-prescribing benzodiazepines and opiates.
Amid escalating concerns over the misuse of benzodiazepines, regulatory authorities have implemented warnings to mitigate health risks associated with these drugs.
The U.S. Food and Drug Administration (FDA), observing a dramatic increase in overdose deaths involving benzodiazepines, issued a black-box warning in 2016. This is the most severe form of warning issued by the FDA, and it explicitly cautioned against the co-prescription of benzodiazepines with opioids. The combination of these medications significantly elevates the risk of severe side effects, including fatal respiratory depression. This regulatory move reflects an urgent response to the concerning trend of rising benzodiazepine use alongside opioids.
Rise of Codeine Misuse in South Africa
In South Africa, many are unaware of their exposure to codeine, commonly found in over-the-counter pain relievers and cough syrups, and available in pure form by prescription for chronic pain. While codeine is generally safe when used as directed, its ease of accessibility and high addiction potential make it prone to misuse. The Office for National Statistics notes a near doubling of codeine-related deaths in the past decade, highlighting its abuse risk.
Codeine misuse involves taking higher than prescribed doses or using it in unintended ways, often driven by addiction. It shares abuse potential with opioids like morphine and heroin, leading to tolerance and increased cravings. Indicators of misuse include consuming higher doses, combining with alcohol or other drugs, seeking multiple doctors, and purchasing from illicit sources.
Reasons for misuse range from chasing euphoric effects to self-medication and peer pressure, exacerbated by easy access and fear of withdrawal symptoms. Risks include respiratory depression, overdose, cognitive impairment, impact on personal and professional life, and dangerous combinations with other substances.
Promoting safe use involves clear dosage instructions, awareness of risks, warning labels, stricter regulatory measures, medicine review programs, pharmacist involvement, and accessible addiction treatment.
When to Get Help?
Consulting a therapist can be beneficial for a range of mental health issues and personal challenges. Therapy, encompassing counseling, psychotherapy, and talk therapy, involves speaking with a qualified expert about mental health problems or other concerns. It is a proactive step towards managing symptoms and improving overall well-being, not a sign of weakness or embarrassment. Therapy can be useful even if you haven’t reached a crisis point or been diagnosed with a mental health disorder. It can help with issues like lack of confidence, relationship problems, or unresolved past issues.
Therapy is effective for various mental health issues, often providing long-lasting benefits beyond what medication alone can offer. It teaches people how to manage symptoms independently, skills that continue to help even after therapy ends. Signs that you might benefit from therapy include feeling overwhelmed, struggling with grief, relationship issues, resorting to substance abuse as a coping mechanism, experiencing symptoms of depression or anxiety, over-relying on opinions of friends, and dealing with personal issues that cause shame or embarrassment.
Therapy offers a confidential, judgment-free space to discuss sensitive issues. It provides relief, helps develop positive coping strategies, and assists in working through trauma. It can also improve relationships and mental well-being. If hesitant about in-person sessions, online therapy is an accessible alternative, offering the benefits of therapy from the comfort of your home.