The Benzodiazepines Crisis

"Benzodiazepines were developed to treat legitimate medical needs. However, unbridled success and prescribing beyond their intended duration of use and the available data has led to excessive prescribing, extended utilization beyond good therapeutic practice, and unintended adverse effects and substance use disorder. This book is the first to bring to light and discuss the largely unrecognized and enigmatic problem of an exceedingly prolonged withdrawal syndrome from benzodiazepines that can persist for months or years in susceptible patients, and the medical need for better evidence-based prescribing of benzodiazepines, and a call for the recognition and better treatment of the prolonged withdrawal syndrome"--

Developed decades ago to treat a legitimate medical need, benzodiazepines promisingly displaced less-effective and less-safe drugs, though prescribing has since exceeded their intended use and outpaced the available data. The current situation is characterized by excessive prescribing and extended utilization beyond good therapeutic practice. Evidence indicates that prolonged use of benzodiazepines causes a wide range of adverse reactions, and withdrawal can be particularly challenging. Misused, abused, diverted, and counterfeited, benzodiazepines have serious potential for substance use disorder, and are among the leading causes of drug-related overdose deaths. The Benzodiazepines Crisis sounds the alarm against the overuse of benzodiazepines, presenting an updated, evidence-based overview of this class of drugs and their negative consequences. Bringing together years of research, clinical expertise, and scientific evidence, this book aims to address a perceived lag between evidence and action in order to call for rational and dramatically reduced usage of benzodiazepines.

FROM THE BACK COVER: Are you--or is someone you care about--taking tranquilizers or sleeping pills? You could be at risk of addiction without even knowing it. Benzos are the most commonly prescribed tranquilizers and sleeping pills, in use by millions of people. Doctors prescribe these drugs routinely without ever warning patients that regular use may cause a dangerous dependency. For many people, Benzos are much harder to quit than heroin, cocaine, crack and other illegal substances, even when taken under a physician's supervision. Benzo Withdrawal may last for months, even years. Get the facts about the drugs in your medicine cabinet--facts the pharmaceutical companies, and even the FDA, don't want you to know. The Benzo Book recounts the author's experience as an unwitting addict, with full details about minimizing withdrawal symptoms, and exposes the sociological, medical and economic factors which cause this widespread--yet largely unknown--problem.

Brain on Fire meets High Achiever in this “page-turner memoir chronicling a woman’s accidental descent into prescription benzodiazepine dependence—and the life-threatening impacts of long-term use—that chills to the bone” (Nylon). As Melissa Bond raises her infant daughter and a special-needs one-year-old son, she suffers from unbearable insomnia, sleeping an hour or less each night. She loses her job as a journalist (a casualty of the 2008 recession), and her relationship with her husband grows distant. Her doctor casually prescribes benzodiazepines—a family of drugs that includes Xanax, Valium, Klonopin, Ativan—and increases her dosage regularly. Following her doctor’s orders, Melissa takes the pills night after night until her body begins to shut down. Only when she collapses while holding her daughter does Melissa learn that her doctor—like so many others—has over-prescribed the medication and quitting cold turkey could lead to psychosis or fatal seizures. Benzodiazepine addiction is not well studied, and few experts know how to help Melissa as she begins the months-long process of tapering off the pills without suffering debilitating, potentially deadly consequences. Each page thrums with the heartbeat of Melissa’s struggle—how many hours has she slept? How many weeks old are her babies? How many milligrams has she taken? Her propulsive writing crescendos to a fever pitch as she fights for her health and her ability to care for her children. “Propulsive, poetic” (Shelf Awareness), and immersive, this “vivid chronicle of suffering” (Kirkus Reviews) and redemption shines a light on the prescription benzodiazepine epidemic as it reaches a crisis point in this country.

Advanced Perioperative Crisis Management is a high-yield, clinically-relevant resource for understanding the epidemiology, pathophysiology, assessment, and management of a wide variety of perioperative emergencies. Three introductory chapters review a critical thinking approach to the unstable or pulseless patient, crisis resource management principles to improve team performance and the importance of cognitive aids in adhering to guidelines during perioperative crises. The remaining sections cover six major areas of patient instability: cardiac, pulmonary, neurologic, metabolic/endocrine, and toxin-related disorders, and shock states, as well as specific emergencies for obstetrical and pediatric patients. Each chapter opens with a clinical case, followed by a discussion of the relevant evidence. Case-based learning discussion questions, which can be used for self-assessment or in the classroom, round out each chapter. Advanced Perioperative Crisis Management is an ideal resource for trainees, clinicians, and nurses who work in the perioperative arena, from the operating room to the postoperative surgical ward.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

The disturbing connection between well-meaning physicians and the prescription drug epidemic. Three out of four people addicted to heroin probably started on a prescription opioid, according to the director of the Centers for Disease Control and Prevention. In the United States alone, 16,000 people die each year as a result of prescription opioid overdose. But perhaps the most frightening aspect of the prescription drug epidemic is that it’s built on well-meaning doctors treating patients with real problems. In Drug Dealer, MD, Dr. Anna Lembke uncovers the unseen forces driving opioid addiction nationwide. Combining case studies from her own practice with vital statistics drawn from public policy, cultural anthropology, and neuroscience, she explores the complex relationship between doctors and patients, the science of addiction, and the barriers to successfully addressing drug dependence and addiction. Even when addiction is recognized by doctors and their patients, she argues, many doctors don’t know how to treat it, connections to treatment are lacking, and insurance companies won’t pay for rehab. Full of extensive interviews—with health care providers, pharmacists, social workers, hospital administrators, insurance company executives, journalists, economists, advocates, and patients and their families—Drug Dealer, MD, is for anyone whose life has been touched in some way by addiction to prescription drugs. Dr. Lembke gives voice to the millions of Americans struggling with prescription drugs while singling out the real culprits behind the rise in opioid addiction: cultural narratives that promote pills as quick fixes, pharmaceutical corporations in cahoots with organized medicine, and a new medical bureaucracy focused on the bottom line that favors pills, procedures, and patient satisfaction over wellness. Dr. Lembke concludes that the prescription drug epidemic is a symptom of a faltering health care system, the solution for which lies in rethinking how health care is delivered.