The epidemic of opioid/opiate misuse with which parts of the world are presently beset follows another epidemic of drug misuse triggered by the overprescription of medications with inherently addictive properties.
In the late 1950’s, benzodiazepines, of which there are a myriad branded and generic variations, became available and were shown to have a variety of clinical benefits, including therapeutically sedative/hypnotic, anxiolytic, anti-convulsant and muscle relaxant effects. In other words, they were used to treat people with sleep disorder, anxiety disorder and seizure disorders, as well as those suffering from muscle spasms. The benzodiazepines divide into those with short, intermediate and long-lasting effects and are frequently referred to colloquially as tranquillisers.
While, from the outset, they were recommended for short-term use only of a few weeks at most or used in surgical anaesthesia, studies found that they were still being prescribed months, if not years, later. In the late 1970’s benzodiazepines came to be the most commonly prescribed of all drugs worldwide.
As patients began to complain of becoming addicted, clinical awareness grew that these drugs carried with them the risk of dependence and addiction for many people. Some individuals reported the return of, or increase in the very symptoms for which they had been taking the drug. Many were experiencing difficulty stopping and even cutting down their dosage. They had begun to develop one of the hallmarks of addiction: an increase in tolerance, whereby more of the drug was constantly needed to achieve the same effect. A discontinuation and withdrawal syndrome were also observed, with a range of unpleasant symptoms commonly experienced. One medical authority lists no less than 33 physical and 21 psychological withdrawal symptoms, while rightly pointing out that not everyone inevitably experiences all these symptoms or in the same way. However, once aware from experience what might accompany withdrawal, patients may find it difficult to sustain motivation and remain committed to the process.
Benzodiazepines inevitably found their way into the illegal drug market where they are often consumed to enhance the effects of other drugs of abuse such as opiates. The internet has made them even more accessible. Some people with what is now termed Substance Use Disorder might turn to them to alleviate the effects of other drugs such as cocaine, amphetamines or alcohol. In fact, benzodiazepines are essential to safe detoxification from alcohol under medical management.
As withdrawal from dependence on benzodiazepines can be particularly difficult, the approach to dose reduction is a carefully graduated one, bolstered by close psychological support and encouragement. It may take quite a bit longer than withdrawal from other substances. An holistic treatment is best with medical management complemented by other therapies that are particularly helpful in alleviating anxiety, such as relaxation, anxiety management, massage, yoga and light exercise. The available and accessible support of others throughout the process is vital.
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