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Benzodiazepine Abuse

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1. Psychosocial interventions for benzodiazepine harmful use, abuse or dependence. (PubMed)

Psychosocial interventions for benzodiazepine harmful use, abuse or dependence. Benzodiazepines (BZDs) have a sedative and hypnotic effect upon people. Short term use can be beneficial but long term BZD use is common, with several risks in addition to the potential for dependence in both opiate and non-opiate dependent patients.To evaluate the effectiveness of psychosocial interventions for treating BZD harmful use, abuse or dependence compared to pharmacological interventions, no intervention

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2015 Cochrane

2. Psychosocial interventions for benzodiazepine harmful use, abuse or dependence. (PubMed)

Psychosocial interventions for benzodiazepine harmful use, abuse or dependence.

2015 Cochrane

3. Opioid/Benzodiazepine Polydrug Abuse

Opioid/Benzodiazepine Polydrug Abuse Opioid/Benzodiazepine Polydrug Abuse - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Opioid/Benzodiazepine Polydrug Abuse The safety and scientific validity (...) State University Study Details Study Description Go to Brief Summary: Benzodiazepine (BZD)/opioid polysubstance abuse (PSA) dramatically increases risks of overdose, disability and death; however, little is known about phenotypes that could be targeted to decrease this use and these associated risks. The opioid abuse epidemic is generating unprecedented numbers of overdoses (OD) and deaths from prescribed and illegal sources (e.g. fentanyl combined with, or sold as, heroin). Yet, medical

2018 Clinical Trials

4. Deprescribing benzodiazepine receptor agonists

Deprescribing benzodiazepine receptor agonists Vol 64: JANUARY | JANVIER 2018 | Canadian Family Physician | Le Médecin de famille canadien 17 CLINICAL PRACTICE GUIDELINES Abstract Objective To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper and stop antipsychotics; to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes. Methods (...) , alcoholism, cocaine abuse, or Parkinson disease psychosis; to those taking them as an adjunct for the treatment of depression; or if psychosis in patients with dementia has been treated for less than 3 months’ duration. —— Methods —— We used a comprehensive checklist for a successful guideline enterprise to develop the methods for the anti- psychotic deprescribing guideline. 15,16 The Guideline Development Team (GDT) comprised 9 clinicians (4 pharmacists [B.F., L.M., L.R.W., C.R.F.], 2 geriatricians [G.L

2018 CPG Infobase

5. Benzodiazepine overdose

. Definition Benzodiazepine (BZD) overdose occurs when excessive amounts of BZD medications are taken. Commonly known as minor tranquilisers or sleeping pills, BZDs are prescribed for sedative, anxiolytic, hypnotic, and anticonvulsant purposes. BZDs are also widely abused. Acute overdose is characterised by excessive sedation with impaired mental status and diminished postural stability and reflexes. Although BZDs are relatively safe medications, acute overdose may induce respiratory depression resulting (...) Benzodiazepine overdose Benzodiazepine overdose - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Benzodiazepine overdose Last reviewed: February 2019 Last updated: January 2018 Summary Benzodiazepines (BZDs) are the most commonly prescribed medications for anxiety, sedation, and sleep. Overdose can be intentional in suicidal patients, accidental in combination with other CNS depressants such as alcohol and opioids

2018 BMJ Best Practice

6. Pneumonia induced by benzodiazepines

extensively throughout the world, and harm caused by inappropriate use or abuse is an issue . According to the report of the International Narcotics Control Board (INCB) in 2010 [1], the consumption of BZRAs in Japan is significantly higher than that in other Asian countries. In addition, there is a possibility that inappropriate prescription or abuse might be involved. Keywords: benzodiazepine, anxiolytics, hypnotics, pneumonia, infection, immunosuppression, robust association, causality, case-control (...) Pneumonia induced by benzodiazepines Page xvi · MED CHECK - TIP August 2018/ Vol.4 No.11 -The Informed Prescriber C N o 11 M ED HECK A u g u s t 2 0 1 8 What we learned from epidemiological studies on drug-induced pneumonia Japanese Guideline for Hypertension is for disease mongering Editorial What we learned from epidemiological studies on drug-induced pneumonia New Products A new cholesterol lowering agent: lomitapide is highly toxic Reviews Japanese Guideline for Hypertension is for disease

2018 Med Check - The Informed Prescriber

7. Benzodiazepine use, misuse, and abuse: A review (PubMed)

Benzodiazepine use, misuse, and abuse: A review Benzodiazepine (BZD) abuse has reached epidemic levels and results in poor outcomes, particularly when combined with concomitant central nervous system depressants. BZDs are abused most commonly in combination with opioids and alcohol. Emergency department visits and related deaths have soared in recent years. In the absence of other medications or illicit substances, BZDs are rarely the sole cause of death. Prescription drug abuse has received (...) more attention in recent years, yet much remains unknown about BZD abuse. BZDs have low abuse potential in most of the general population. A subset is at elevated risk of abuse, especially those with a history of a substance use disorder. Education, prevention, and identification are vital in reducing BZD abuse.

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2016 The Mental Health Clinician

8. Benzodiazepine Abuse

Benzodiazepine Abuse Benzodiazepine Abuse Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Benzodiazepine Abuse Benzodiazepine Abuse (...) Aka: Benzodiazepine Abuse , Benzodiazepine Dependence , Tranquilizer , Benzodiazepine Withdrawal , Benzodiazepine Overdose , Benzodiazepine Toxicity , Fake Xanax From Related Chapters II. Class III. Preparations: Medical Uses See s IV. Precautions: Fake Xanax Fake Xanax contains and Etizolam ( analog) Presents as opiod with sedation and respiratory depression ( was also associated) Management 0.4 mg Supportive care Consult poison control References Swadron and Nordt in Herbert (2017) EM:Rap 17(2

2018 FP Notebook

9. Pilot trial of gabapentin for the treatment of benzodiazepine abuse or dependence in methadone maintenance patients. (PubMed)

Pilot trial of gabapentin for the treatment of benzodiazepine abuse or dependence in methadone maintenance patients. Benzodiazepine use disorders are a common clinical problem among methadone maintenance treatment patients and have adverse effects on clinical outcomes.To evaluate gabapentin for the outpatient treatment of benzodiazepine abuse or dependence in methadone maintenance patients.Participants (n = 19) using benzodiazepines at least 4 days per week were enrolled into an 8-week (...) randomized double-blind placebo-controlled outpatient pilot trial. All participants received a manual-guided supportive psychotherapy aimed to promote abstinence. Study medication was titrated over a 2-week period to a maximum dose of gabapentin 1200 mg or placebo three times a day. Benzodiazepine use was assessed using urine toxicology confirmed self-report. Benzodiazepines were not provided as part of study participation; participants were provided guidance to gradually reduce benzodiazepine

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2016 The American journal of drug and alcohol abuse Controlled trial quality: predicted high

10. Benzodiazepines II: Waking Up on Sedatives: Providing Optimal Care When Inheriting Benzodiazepine Prescriptions in Transfer Patients (PubMed)

Benzodiazepines II: Waking Up on Sedatives: Providing Optimal Care When Inheriting Benzodiazepine Prescriptions in Transfer Patients This review discusses risks, benefits, and alternatives in patients already taking benzodiazepines when care transfers to a new clinician. Prescribers have the decision-sometimes mutually agreed-upon and sometimes unilateral-to continue, discontinue, or change treatment. This decision should be made based on evidence-based indications (conditions and timeframes (...) ), comorbidities, potential drug-drug interactions, and evidence of adverse effects, misuse, abuse, dependence, or diversion. We discuss management tools involved in continuation (e.g., monitoring symptoms, laboratory testing, prescribing contracts, state prescription databases, stages of change) and discontinuation (e.g., tapering, psychotherapeutic interventions, education, handouts, reassurance, medications to assist with discontinuation, and alternative treatments).

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2018 Journal of clinical medicine

11. Emergency department visits involving benzodiazepines and non-benzodiazepine receptor agonists. (PubMed)

Emergency department visits involving benzodiazepines and non-benzodiazepine receptor agonists. Sedative-hypnotic medications (e.g., Benzodiazepines [BZDs] and non-benzodiazepine receptor agonists [nBZRAs]) are associated with adverse events, especially in the elderly, that may require emergency department (ED) treatment. This study assessed outcomes from ED visits attributed to BZDs and/or nBZRAs, and variations in these associations by age group.Data came from the 2004-2011 waves of the Drug (...) Abuse Warning Network (DAWN). Visits were categorized as involving: (1) BZDs-only, (2) nBZRAs-only, (3) combination of BZDs and nBZRAs, or (4) any other sedative-hypnotic medication. DAWN also recorded the disposition (i.e., outcome) of the visit. Analyses focused on outcomes indicating a serious disposition defined as hospitalization, patient transfer or death. Using logistic regression, the association of BZD and nBZRA use with visit disposition was assessed after applying sample weights so

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2017 American Journal of Emergency Medicine

12. Benzodiazepine and z-drug withdrawal

Benzodiazepine and z-drug withdrawal Benzodiazepine and z-drug withdrawal - NICE CKS Share Benzodiazepine and z-drug withdrawal: Summary Benzodiazepines are gamma-aminobutyric acid (GABA) receptor agonists which have hypnotic, anxiolytic, anticonvulsant, and muscle relaxant properties. Benzodiazepines can be grouped into hypnotics and anxiolytics: Hypnotics are used for short term treatment of insomnia and include nitrazepam, loprazolam, lormetazolam, and temazepam. Anxiolytics are effective (...) in alleviating anxiety states and include diazepam, oxazepam, lorazepam, alprazolam, and chlordiazepoxide. Z-drugs are non-benzodiazepine hypnotics, developed to overcome some of the adverse effects of benzodiazepines (such as next-day sedation, dependence, and withdrawal). Like benzodiazepines, they are also GABA receptor agonists. The two z-drugs available in the UK are zolpidem, and zopiclone. Despite warnings regarding the long-term use of benzodiazepines and z-drugs, millions of prescriptions are still

2019 NICE Clinical Knowledge Summaries

13. CRACKCast E186 – Substance Abuse

provoke countertransference. Shownotes – Key Concepts Substance abuse can affect people from all socioeconomic groups and all ages. For the majority of patients with toxin-induced violent behavior, intramuscular butyrophenones (such as, haloperidol) are safe and rapidly effective sedating agents. With suspected sympathomimetic (eg, cocaine and amphetamines) intoxication, benzodiazepines (such as, lorazepam) should be used. Presentation to an ED with a complication of substance abuse may be a “teaching (...) -anxiety or anti-insomnia drugs The drugs of misuse or abuse most commonly involved in deaths are cocaine, opioids, antidepressants, benzodiazepines, stimulants, and club drugs. A major barrier to appropriate recognition and treatment of substance abuse is the lack of a precise definition. The American Psychiatric Association defines it as a maladaptive pattern of drug use associated with some manifest harm to the user or others. Physicians have a difficult time recognizing such abuse, particularly

2018 CandiEM

14. Narcotics, Benzodiazepines, Stimulants, and Gabapentin: Policies, Initiatives, and Practices Across Canada, 2014

, as well as place a significant burden on our health, social services, and public safety systems.” 1 The purpose of this Environmental Scan is to provide an overview of policies, practices, and initiatives which the publicly funded drug programs, colleges of physicians and surgeons, and colleges of pharmacy are implementing across Canada to address the misuse, abuse, and diversion of prescription narcotics (opioids), benzodiazepines, stimulants, and gabapentin. This information may assist drug policy (...) . This report outlines many of the leading initiatives across Canada that aim to minimize opportunities for misuse, abuse, and diversion while ensuring access to adequate treatment options. Objective The purpose of this report is to outline the policies, initiatives, and practices in place across Canada to address the abuse, misuse, or diversion of prescription narcotics, benzodiazepines, stimulants, and gabapentin. Methodology This Environmental Scan is not intended to provide a comprehensive review

2015 Canadian Agency for Drugs and Technologies in Health - Environmental Scanning

15. Combination Benzodiazepine-Opioid Use

;125(4):115-30. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057040 PubMed: PM23933900 16. Jones JD, Mogali S, Comer SD. Polydrug abuse: a review of opioid and benzodiazepine combination use. Drug Alcohol Depend. 2012 Sep 1;125(1-2):8-18. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351 PubMed: PM22857878 17. CADTH. Combination benzodiazepine-opioid use: a review of the evidence on safety [Internet]. Ottawa: Canadian Agency for Drugs and Technologies in Health (...) ; 2011 Sep 16. [cited 2015 Mar 25]. (Rapid response report: summary with critical appraisal). Available from: http://www.cadth.ca/media/pdf/htis/sept-2011/RC0299_Benzodiazepines_final.pdf Additional References 18. Ogbu UC, Lotfipour S, Chakravarthy B. Polysubstance abuse: alcohol, opioids and benzodiazepines require coordinated engagement by society, patients, and physicians. West J Emerg Med. 2015 Jan;16(1):76-9. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307731 PubMed: PM25671013

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

16. Discontinuation Strategies for Patients with Long-Term Benzodiazepine Use

in daily clinical practice. Eur Psychiatry. 2012 May;27(4):301-7. PubMed: PM21334859 7. Kawasaki SS, Jacapraro JS, Rastegar DA. Safety and effectiveness of a fixed-dose phenobarbital protocol for inpatient benzodiazepine detoxification. J Subst Abuse Treat. 2012 Oct;43(3):331-4. PubMed: PM22285834 8. de Gier NA, Gorgels WJ, Lucassen PL, Oude Voshaar R, Mulder J, Zitman F. Discontinuation of long-term benzodiazepine use: 10-year follow-up. Fam Pract [Internet]. 2011 Jun [cited 2015 Jan 21];28(3):253-9 (...) -4A0C-937F- FBBE4ADA153F/301831/Bit_v22n2_e.pdf See: Effectiveness of withdrawal interventions, page 7 13. Effective interventions to manage symptoms of benzodiazepine withdrawal in seniors [Internet]. Ottawa: Canadian Centre on Substance Abuse; 2014 Nov. [cited 2015 Jan 21]. (Rapid review). Available from: http://www.ccsa.ca/Resource%20Library/CCSA- Benzodiazepine-Withdrawal-Seniors-Rapid-Review-2014-en.pdf 14. Oulis P, Konstantakopoulos G. Efficacy and safety of pregabalin in the treatment

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

17. Abuse-Deterrent Formulations of Opioids: Effectiveness and Value

-shopping rates for brand ER oxycodone relative to changes for comparator opioid analgesics and benzodiazepines pre- and post-reformulation of brand ER oxycodone: (pre-/post-period rate/ pre-to post % change): ©Institute for Clinical and Economic Review, 2017 Page 124 Evidence Report—Abuse-deterrent Formulations of Opioids: Effectiveness and Value Return to Table of Contents Fair prescriptions from IMS LRx longitudinal data 6-month calendar intervals before and after the introduction of reformulated (...) Abuse-Deterrent Formulations of Opioids: Effectiveness and Value ©Institute for Clinical and Economic Review, 2017 Abuse-Deterrent Formulations of Opioids: Effectiveness and Value Evidence Report June 28, 2017 Prepared for: ©Institute for Clinical and Economic Review, 2017 Page i Evidence Report—Abuse-deterrent Formulations of Opioids: Effectiveness and Value ICER Staff/Consultants Reiner Banken, MD, MSc Senior Fellow Institute for Clinical and Economic Review Foluso Agboola, MBBS, MPH Research

2017 California Technology Assessment Forum

18. Benzodiazepine and Z-Drug Safety

for that patient. This designated prescriber should also be responsible for prescribing other medications with abuse potential, specifically central nervous system (CNS) stimulants and4 narcotics; otherwise the prescriber of benzodiazepines should closely coordinate care with those who are prescribing other controlled substance medications. • For patients who are prescribed chronic benzodiazepines for anxiety at a dose exceeding the maximum dose listed in Appendix 1, consultation with a psychiatrist (...) Benzodiazepine and Z-Drug Safety © 2014 Kaiser Foundation Health Plan of Washington. All rights reserved. 1 Benzodiazepine and Z-Drug Safety Guideline Expectations for KFHPWA Providers 2 Background 2 Prescribing 3 Management of Patients on Chronic Benzodiazepines or Z-Drugs 6 Tapering and Discontinuation 9 Treatment of Withdrawal Symptoms 12 Referral Criteria 13 Evidence Summary 14 References 17 Guideline Development Process and Team 18 Appendix 1 Table A. Long-acting benzodiazepine comparison

2014 Kaiser Permanente Clinical Guidelines

19. Benzodiazepines are Prescribed More Frequently to Patients Already at Risk for Benzodiazepine-Related Adverse Events in Primary Care. (PubMed)

-recipients, benzodiazepine recipients were more likely to have diagnoses of depression (OR, 2.7; 95 % CI, 2.6-2.9), substance abuse (OR, 2.2; 95 % CI, 1.9-2.5), tobacco use (OR, 1.7; 95 % CI, 1.5-1.8), osteoporosis (OR, 1.6; 95 % CI, 1.5-1.7), chronic obstructive pulmonary disease (OR, 1.6; 95 % CI, 1.5-1.7), alcohol abuse (OR, 1.5; 95 % CI, 1.3-1.7), sleep apnea (OR, 1.5; 95 % CI, 1.3-1.6), and asthma (OR, 1.5; 95 % CI, 1.4-1.5). Compared to low-dose benzodiazepine recipients, high-dose benzodiazepine (...) recipients were even more likely to have certain medical diagnoses: substance abuse (OR, 7.5; 95 % CI, 5.5-10.1), alcohol abuse (OR, 3.2; 95 % CI, 2.2-4.5), tobacco use (OR, 2.7; 95 % CI, 2.1-3.5), and chronic obstructive pulmonary disease (OR, 1.5; 95 % CI, 1.2-1.9). Benzodiazepine recipients had more primary care visits per 100 patients (408 vs. 323), specialist outpatient visits (815 vs. 578), emergency department visits (47 vs. 29), and hospitalizations (26 vs. 15; p < .001 for all comparisons

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2016 Journal of General Internal Medicine

20. Preoperative Exposure to Benzodiazepines or Sedative/hypnotics Increases the Risk of Greater Filled Opioid Prescriptions After Surgery. (PubMed)

, an important resource. In addition, we now provide much more detailed preoperative counseling regarding the use and abuse of opioid medication in patients with exposure to benzodiazepines, sedatives, and those with a smoking history and mood disorders.Level of Evidence Level II, therapeutic study. (...) Preoperative Exposure to Benzodiazepines or Sedative/hypnotics Increases the Risk of Greater Filled Opioid Prescriptions After Surgery. The effect of the preoperative exposure to controlled substances such as benzodiazepines and sedative/hypnotics on prolonged opioid consumption after hand surgery is not known.(1) Is preoperative exposure to benzodiazepines and sedative/hypnotics associated with greater numbers of filled postoperative opioid prescriptions after hand surgery? (2) Is a positive

2019 Clinical Orthopaedics and Related Research

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