Do Benzos Contribute to the Opioid Epidemic?

benzos and opioids

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We have addressed the problem of doctors writing too many prescriptions for opioid medications. But what about benzos? (emilie zhang/Shutterstock)

We have addressed the problem of doctors writing too many prescriptions for opioid medications. But what about benzos? (emilie zhang/Shutterstock)

In recent articles, we have discussed the trending opioid epidemic at length. We talked about the manner in which prescription drugs may lead to heroin, as well as the ways in which advertising has affected opioid use. What we have not discussed, however, is some of the other drugs commonly involved in this trend. And while it’s easy to point fingers at fentanyl and heroin due to their great involvement in the epidemic, we must also take a closer look at benzos if we wish to truly understand how prescription drugs are hurting our nation’s citizens.

A recent article on The Fix did a great job of outlining this issue. Right off the bat, they make the point that opioid addiction is not always characterized by the sole use of opiate medications. Sure, prescription drug addicts may prefer opioids due to their heavy sedation properties and their ability to activate the brain in unique (if dangerous) ways. But the fact of the matter is that prescription drug addicts will often pop whichever pills they are able to get their hands on—and this often includes benzos.

For the uninitiated, the word benzos refers to benzodiazapines, which are much like opioid medications in that they can be acquired by doctor shopping or by much more clearly illegal means such as a visit to a street pharmacist. And much like normal detox, it can be dangerous for abusers to quit outside of treatment. This may sound like a quibble—all prescription drugs are bad when abused too heavily, and we must therefore be careful. The reason we must be wary of benzos, however, is that they are quickly overtaking the perceived opioid epidemic. That is not to say there is no opioid epidemic—there certainly is. Unfortunately, it appears that yet another drug is on the rise at the very same time.

Understanding the Danger of Benzos

“Take as needed.” Unfortunately, many often ignore this warning. (Burlingham/Shutterstock)

“Take as needed.” Unfortunately, many often ignore this warning. (Burlingham/Shutterstock)

To put it bluntly, benzos are the drugs that are arguably killing even more people than opioids at the moment. From 2001 to 2014, the rate of overdose deaths related to benzos actually rose at a far greater rate than the rate of deaths related to opioid drugs. To be a little more clear, the rate of opioid deaths is defined as the rate of deaths related to both opioid medications and heroin. In other words, the rate at which they have killed such addicts has risen at a faster pace than the rate of overdose deaths related to both opioid prescriptions and heroin combined.

This data is not meant to belittle the opioid epidemic, especially considering the fact that the rise in both rates is largely attributed to the number of prescription drug addicts who are abusing both of these types of drugs at the same time. And a major part of the problem appears to be the fact that many people simply do not understand the healthiest way to detox.

As we mentioned in our article regarding the importance of treatment centers in helping addicts detox properly, withdrawal symptoms can be highly dangerous. Not only can they create danger in and of themselves, but they may also coerce recovering addicts into enacting dangerous behaviors. This is where benzos come in—many detox drugs are in fact benzos. This is fine, as long as they are administered by professionals and only in the proper dosage. Those who take detox upon themselves, however, will often use more than would generally be recommended (assuming they bother taking them at all). Just because a physician has prescribed a drug does not mean that it is being used correctly.

Then, of course, you arrive at the issue that some physicians may simply not care how their patients are using their prescribed medications. The doctor may either not know that the patient in question is using both benzos and opiates, or they may simply not care as long as the frequent visits in pursuit of refills are also refilling their own pocketbooks. Either way, such physicians are dangerous. They are putting their patients in harm’s way by constantly refilling prescriptions that have clearly been abused. And as more of their patients continue to combine dangerous prescription drug cocktails, more and more of them are falling off the face of the earth.

How Death Rates Compare

Death rates due to prescription drug overdose are frighteningly on the rise. (abd/Shutterstock)

Death rates due to prescription drug overdose are frighteningly on the rise. (abd/Shutterstock)

While the death rate for benzos is growing at a faster rate than it is for opiates, the actual overdose deaths are much lower. In 2014, there were 29,000 combined deaths from prescription opiates and heroin. Conversely, there were less than 8,000 overdose deaths strictly related to benzodiazepines. And despite the fact that this is still close to 8,000 too many, some will see it as a low number when compared to the overdose deaths we see from heroin and opioid medications.

Even so, The Fix points out that we have good reason to worry about these numbers. The first point they make is that, since many withdrawal and overdose reversal medications are benzos, it is worrisome that so many addicts are abusing opioids and benzos at the same time. In doing so, they are increasing their tolerance and making it more difficult to gauge the proper amount of medication. Too much could be dangerous, but too little might be ineffective if their tolerance is exceedingly high. This is especially worrisome in the case of drugs such as Narcan. Those who have abused large numbers of benzos will be less susceptible to its respiratory benefits, and it will be harder to save them. In other words, rising rates of benzodiazepine abuse could actually be inflating the number of opioid-related overdose deaths.

This matter makes detoxification much more difficult from a medical standpoint. If too much of a drug is given, the result could be bad. Not necessarily deadly, but at the very least painful and discomforting. Not only that, but it will take much longer to detox when both of these types of drugs have been abused concomitantly. When the detox process is too long and the withdrawal symptoms are too uncomfortable, there is a greater risk that patients will simply give up on the process altogether and go back to their using habits. If they can get through it, they should stand a decent chance at remaining sober. The problem is simply that getting through it will not be easy.

The final point made by The Fix—and it’s a point with which we concur based on our own experiences—is that patients in general have a much rougher go of it when they are trying to quit more than one substance at the same time. It isn’t just a matter of withdrawal symptoms, it’s a matter of habit. Addicts concoct routines, rituals they follow so that using always gives them the same high. When they have abused more than one substance, there are more components of their routine that must be discarded if they wish to stay sober. This will be uncomfortable from a psychological standpoint, and such patients can be much harder to treat as a result.

Fighting Addiction at Amethyst

Therapy is a major step toward overcoming our dependence on addictive drugs. (Image Point Fr/Shutterstock)

Therapy is a major step toward overcoming our dependence on addictive drugs. (Image Point Fr/Shutterstock)

The Fix may outline some troubling concerns regarding the rate of benzos, but they do note a possible solution for the treatment of patients who have abused both benzos and opiates. Aside from their solutions regarding pain management and a national database for prescriptions, they say that those who actually require benzos or opiates for issues such as anxiety or pain should be given non-addictive alternatives in addition to cognitive behavioral therapy. At Amethyst, we’ve already been providing such options for quite some time.

Patients who suffer from mood disorders or chronic pain are not new to us. There are many who become addicted to medications that were prescribed to them under just circumstances. Physicians are not always to be blamed in this case, as it is not always immediately clear that the patient is an addict. Furthermore, many go to multiple doctors pharmacies for refills so that they can continue their use. But once the problem has been identified, a solution must be found that will allow the patient to continue treating the problem for which the medication was initially prescribed.

Our method of fighting addiction in these cases is very similar to what has been outlined by The Fix. Top priority is ensuring that the patient’s ailments can be treated using non-addictive medications. There are many more available alternatives today than there once were, so treating a patient’s pain or anxiety without heavy reliance on opiates and benzos is not too difficult. Our approach to therapy is also highly based on cognitive behavioral therapy, which has become something of a gold standard in addiction treatment. We even offer the occasional alternate treatment method, such as equine therapy, for those who feel they might enjoy something a bit different from time to time.

No matter what substance or combination of substances has been ailing you, Amethyst has the means to help. We make sure that our programs are strongly personalized so that each patient receives the specific level of care that he or she requires in order to combat their addiction and remain sober. For more information on our treatment approach, contact us today.

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