For stressed-out patients, yet more and tougher warnings about ‘benzos’

benzos-300x180Signs abound that the coronavirus pandemic has really stressed out Americans. Dentists say they are seeing a surge in patients needing care for jaw-clenching and teeth grinding. Doctors report treating increased numbers of patients who have shed abnormal amounts of hair due to fear and anxiety about getting sick with Covid-19, losing a job as part of the disease’s economic shocks, or losing friends or loved ones to illness.

But there also is an increasingly worrisome way to deal with the mental health challenges of the coronavirus: prescription drugs, specifically the class of medications known as benzodiazepines. “Benzos,” as they commonly are known, are widely “prescribed for anxiety, insomnia, seizures, panic disorders and other health problems,” the New York Times reported.

“They are also often given before certain medical procedures. They slow brain activity, causing sedation or calming effects. The drugs are enormously popular. In 2019, according to the agency, roughly 92 million prescriptions for benzodiazepines — such as the highly prescribed Xanax, Klonopin and Ativan — were dispensed in the United States.”

Doctors and addiction experts have warned for some time now about the huge risks that patients can be exposed to by taking benzos. The federal Food and Drug Administration has cranked up its alarms about the meds, ordering new, more emphatic language to the existing “black label” warnings on benzo boxes, which already carried some of regulators’ toughest descriptions about the drugs. FDA chief Dr. Stephen Hahn explained in a statement his regulators’ latest steps with the powerful prescriptions:

While benzodiazepines are important therapies for many Americans, they are also commonly abused and misused, often together with opioid pain relievers and other medicines, alcohol and illicit drugs,” Hahn said. “We are taking measures and requiring new labeling information to help health care professionals and patients better understand that while benzodiazepines have many treatment benefits, they also carry with them an increased risk of abuse, misuse, addiction and dependence.”

According to the FDA:

“Physical dependence can occur when benzodiazepines are taken steadily for several days to weeks. Patients who have been taking a benzodiazepine for weeks or months can have withdrawal signs and symptoms when the medicine is discontinued abruptly or continued in lower doses to avoid withdrawal. Stopping benzodiazepines abruptly or reducing the dosage too quickly can result in acute withdrawal reactions, including seizures, which can be life-threatening. Prior to stopping benzodiazepines, patients should talk to their health care provider to develop a plan for slowly tapering the medication. In addition to requiring an update to the Boxed Warning, the FDA is requiring other changes to the Warnings and Precautions, Drug Abuse and Dependence and Patient Counseling Information sections of the prescribing information for all benzodiazepine products. The agency is also requiring revisions to the existing patient Medication Guides for these medicines to help educate patients and caregivers about these risks.”

The FDA’s increased warnings and concern about benzos is occurring even as news organizations have reported that the opioid crisis has worsened during the pandemic, particularly as patients suffer loneliness, isolation, stress, and worry — all while they may be cut off from drug treatment and psychological support programs.

Benzos, abused in tandem with opioids, heighten the risks of overdoses and increase the lethality of legal and illicit, as well as prescription and synthetic pain medications. Experts have warned since early on in the pandemic about the excessive availability and likelihood of abuse of benzos, particularly as Americans sought help in dealing with the uncertainty and fear of infection and death by the novel coronavirus.

Data lags on drug abuse.  But both the Washington Post and Wall Street Journal have reported that experts nationwide believe that opioid abuse and drug overdoses are soaring, and “this follows a likely record number of deadly overdoses in the U.S. last year, with more than 72,000 people killed, according to federal projections,” the Wall Street Journal most recently found.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damages that can be inflicted on them by dangerous drugs. Law enforcement and public health authorities have dealt this year with overpowering issues connected to the coronavirus alone, much less how the illness has worsened long-standing nightmares like the opioid crisis and the menace of benzo abuse.

As the nation’s struggles with Covid-19 trudge on — not helped by a shambolic federal response — the unease about coronavirus infection and death, combined with fear about joblessness and other pandemic-related economic shocks, as well as with harsh political divides and partisanship added in, and, well, Americans will need more mental health support than ever. We need to not only get expert therapeutic assistance but also the special bolstering that our colleagues, friends, and families can provide. We need to learn more about the power of communities, including those of a religious nature, as well as mental health care — especially when psychological therapies that don’t turn in a snap to risky prescription medications for patients.

We’ve got a lot of work to do to ensure that we’re in far better place in the days ahead than we have been before in more normal times — with slashing the opioid crisis, reducing benzos abuse, and with providing everyone in the country with appropriate and needed mental health care. Health care must be a right not a privilege, and this nation must provide mental health care to the many who need it.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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