Benzodiazepine Prescriptions Spike Among Primary Care Doctors
According to a new study, the number of outpatients being prescribed benzodiazepine during medical visits has doubled from 2003 to 2015. Data from the study revealed almost half of the prescriptions were prescribed by primary care physicians.
Benzodiazepine is a class of drugs used in the following medications:
Benzodiazepines are commonly prescribed to treat anxiety, insomnia, and seizures. The study was published in JAMA Network Open and revealed back pain and other types of chronic pain had the biggest increase in benzodiazepine prescriptions.
Although doctors say that benzodiazepines are best for short-term use, the study found that long-term use has also increased by 50% from 2005 to 2015. Using benzodiazepines for an extended period of time can result in physical dependence, addiction, and death from overdose.
Dr. Sumit Agarwal is a primary care physician and researcher at Brigham and Women's Hospital in Boston, and one of the authors of the study. He says, “I don't think people realize that benzodiazepines share many of the same characteristics of opioids. They are addictive. They cause you to have slower breathing; they cause you to be altered in terms of mental status. And then, eventually, [they] can cause overdose and deaths."
Speaking about the death toll in the wake of rising prescriptions, Agarwal says, “That's somewhere around 10,000 to 12,000 deaths at the hands of benzodiazepines. This rise is happening quietly, outside of the public eye."
The U.S. Centers for Disease Control and Prevention recently released a report that showed overdose deaths caused by benzodiazepine among women between the ages of 30 and 64 increased by 830% between 1996 and 2017.
According to Agarwal, "women are more likely to be prescribed these medications,” and are also more likely to come in to the clinic to be treated for anxiety and depression.” Agarwal says benzodiazepines tend to be the medications doctors prescribe to treat these conditions.
Talking about the findings from the study, Anna Lembke, an associate professor of psychiatry and medical director of addiction medicine at Stanford University School of Medicine, said “The study highlights that we have a very serious problem with benzodiazepines.”
Lembke points out that primary care physicians, not psychiatrists, are the cause of the substantial increase in benzodiazepine prescriptions. Lembke said, “I think the big message here is that primary care doctors are really left with the burden of dealing, not only with chronic pain and opioid prescription, but also benzodiazepine prescription. The incredible burden of care on primary care physicians, who are given little time, or resources, that's partly what got us into the opioid epidemic in the first place.”
The study also revealed the co-prescribing of benzodiazepines with opioids has increased, something Dr. Joanna Starrels, associate professor at the department of medicine at the Albert Einstein College of Medicine, warns that co-prescribing these two kinds of medications can be dangerous. "They both slow down the central nervous system in complementary ways [that] increase the risk of overdose deaths," says Starrels. "It is dangerous — and generally advised not to prescribe together.”
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