Addiction: Part I. Benzodiazepines--side effects, abuse risk and alternatives

Area of Science:

• Pharmacology
• Psychiatry
• Addiction Medicine

Background:

• Benzodiazepines are frequently prescribed for anxiety and insomnia.
• While generally safe in overdose, chronic use can lead to dependence.
• Patients with addiction disorders may use benzodiazepines with other substances of abuse.

Purpose of the Study:

• To review the risks associated with chronic benzodiazepine use.
• To explore alternative pharmacologic treatments for patients with substance use disorders.
• To emphasize caution when prescribing benzodiazepines to individuals with a history of substance abuse.

Main Methods:

• Literature review of benzodiazepine pharmacology and addiction.
• Analysis of alternative medication classes for anxiety and insomnia in substance-abusing populations.
• Clinical guidelines review for prescribing psychotropic medications in patients with co-occurring disorders.

Main Results:

• Chronic benzodiazepine use is associated with a significant risk of addiction.
• Alternative treatments like antidepressants, anticonvulsants, buspirone, antihypertensives, and novel neuroleptics show promise.
• Careful consideration is needed when prescribing benzodiazepines to patients with any history of substance abuse.

Conclusions:

• Benzodiazepine dependence is a significant concern in chronic users.
• A range of alternative medications can be considered for patients with addiction disorders.
• Prescribers must exercise caution and consider patient history when managing anxiety and insomnia in individuals with substance use disorders.