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BENZODIAZEPINES GETS A STRONGER WARNING LABEL 

(Neuroscience Education Institute, 2020). 

The Food and Drug Administration (F.D.A) requires a new warning label on psychiatric drugs known as benzodiazepines that will warn the public and health professionals about the serious risks of abuse and addiction (Kaplan, 2020). Benzodiazepines are prescribed for anxiety, insomnia, seizures, panic disorders, and various other health problems. Certain benzodiazepines are given before medical procedures that will slow brain activity and cause sedation or a calming effect (Kaplan, 2020). 

The F.D.A is an agency within the Michigan Department of Health and Human Services that protect public health by the safety, effectiveness, and security of human and veterinary drugs, vaccines, other biological products for human use, and medical devices (U.S. Food & Drug Adminstration, 2020). 

Benzodiazepines are popular in all ages. According to Kaplan (2020), in 2019, approximately 92 million prescriptions for benzodiazepines were distributed in the United States. Dr. Stephan Hahn, a commissioner at the F.D.A is concerned with the misuse of the drugs, especially when taken with opioid pain relievers, alcohol, or other medications (Kaplan, 2020). It has been found from the National Institute on Drug Abuse reports that more than 30 percent of opioid overdoses involve some form of benzodiazepines (Kaplan, 2020). 

Current labeling on benzodiazepine medications does not provide sufficient warnings about the risks and harms that can come from these medications (Kaplan, 2020). The F.D.A is also warning individuals that they can become physically dependent on them in a matter of days and can experience difficulty when trying to stop them safely. The doctors are called upon to be cautious of prescribing benzodiazepines with opioids and other medications; these combinations can cause respiratory distress or even death (Kaplan, 2020).   

Benzodiazepines - Psychological Issue

When someone is taking benzodiazepines it's for various reasons. But the majority of the time individuals are taking these pills to help with insomnia, anxiety, seizures, muscle relaxation, along treatment for alcohol use disorder. These pills are only recommended for short-term use and if individuals are taking them longer than the recommended time it can cause individuals to become dependent on them. When individuals decide to stop using benzodiazepines they will go through withdrawal which can cause physical and psychological issues for them. These issues include physical weakness, slurred speech, confusion, poor decision-making abilities, poor judgment, blurred vision, lack of motor coordination, dizziness, inability to defend oneself, drowsiness, coma, difficulty breathing, or in some cases death (American Addiction Centers, 2021). Chronically abusing benzodiazepines can also cause anorexia, insomnia, anxiety, tremors, headaches, and memory problems (American Addiction Centers, 2021). 

(Osborn, 2020)

Prevention and Intervention 

"Patient engagement in management is essential as without this any attempts to address harmful use may be hindered by non-adherence or even doctor shopping" (Brett & Murnion, 2015, para 9). If an individual has been using benzodiazepines for more than the recommended time period, they might not be ready to change their ways. If they aren't ready to change or are considering changing their lifestyle, motivational interviewing techniques are important to use with a dependence on benzodiazepines (Brett & Murnion, 2015). If the individual is actually ready for change, there are two approaches to manage the dependence. These two approaches are benzodiazepine withdrawal with the aim of abstinence along with benzodiazepine maintenance therapy (Brett & Murnion, 2015). The approach depends on the risk of harm along with relapse. Low-risk individuals can manage in general practice along with benefitting from attempting to withdrawal from benzodiazepines. High-risk individuals would benefit from initial stabilization and maintenance therapy in residential or outpatient addiction services specializing in benzodiazepine dependence (Brett & Murnion, 2015). When treatment is being offered, it is important to ensure that the client/patient isn't a doctor hoping to access more prescriptions. 

"A meta-analysis of treatment for benzodiazepine discontinuation found that gradual dose reduction combined with psychological treatment was superior to gradual dose reduction alone" (Brett & Murnion, 2015, para 22). Cognitive-behavioral therapy was also found to be beneficial when tapering with the dose of the benzodiazepines. Some other interventions that can help reduce benzodiazepines are relaxation techniques and a letter from the individual general practitioners telling them to reduce or quit the drug altogether. 

Individuals that require maintenance therapy are on a high diazepam equivalent dose, have aberrant drug-related behaviors, along with having a chaotic social setting or an unstable psychiatric diagnosis (Brett & Murnion, 2015). With maintenance therapy, individuals may reach a time of stability where they will go to a lower dose or even consider abstinence. Interventions, substitution, psychotherapist, and pharmacotherapies all help manage benzodiazepine dependence (Brett & Murnion, 2015). 

References 

American Addiction Centers. (2021, January 26). Benzodiazepine Addiction: Symptoms and Signs. https://americanaddictioncenters.org/benzodiazepine/symptoms-and-signs

Brett, J. & Murnion, B. (2015, October). Management of benzodiazepine misuse and dependence. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308

Food and Drug Administration. (2020, September 23). FDA requiring labeling changes for benzodiazepines. FDA. https://www.fda.gov/news-events/press-announcements/fda-requiring-labeling-changes-benzodiazepines

Kaplan, S. ( 2020, September 23). F.D.A requires a stronger warning label for Xanax and similar drugs. The New York Times. https://www.nytimes.com/2020/09/23/health/benzodiazepines-fda-warning.html

Neuroscience Education Institute. (2020, September 25). FDA requiring stronger warning labels for benzodiazepines. https://www.neiglobal.com/Members/MonthInPsychopharmPost/tabid/509/topic/20403/Default.aspx

Osborn, O’K., C. (2020, April 1). How long does withdrawal from benzodiazepines last? Verywell Mind. https://www.verywellmind.com/benzodiazepine-withdrawal-4588452