Twelve Things I hate About Benzodiazepines

[lobelsteve]

14 years since publication. I still see a ton of PCPs and Psych Rxing like candy.
FDA and CDC Guidelines recommend against this drug and opiates in combination.
Counseling provided.

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[clubdeac]

It’s no wonder that The Same guys that invented and sold Valium as nonaddictive came up with OxyContin

 

[MitchLevi]

It’s no wonder that The Same guys that invented and sold Valium as nonaddictive came up with OxyContin

Yes!

Most ppl don't know that. Pretty sure it was Arthur Sackler?

 

[GlowInTheDark]

I ruffle both clinician and patient feathers when I refuse to prescribe opioids when someone is already receiving BZs.

Medication refill visits don’t pay enough to accept the headaches.

 

[GoBeers]

i assume psychiatrists are fighting the good fight in regards to benzos right?
a lot of the PCPs in my area are concerned that stimulants are going to be the next big thing

 

[Laryngospasm]

Stimulants and benzos ruin lives just like opioids but are somehow up to this point mostly ignored. I too refuse to prescribe to someone on benzos. Everyone always looks at me like I have two heads.

 

[paindoctor2014]

I’ve just started turning Down the referral if they are on benzos and opioids. I won’t do it and it’s not worth the fight for me. My staff thanks me everyday

 

[Baron Samedi]

i assume psychiatrists are fighting the good fight in regards to benzos right?
a lot of the PCPs in my area are concerned that stimulants are going to be the next big thing

Stimulants and benzos were the reason my psychiatrist spouse took a nonclinical job. It wasn't worth arguing with every other pt about their meds.

 

[DODOCSS]

Stimulants and benzos ruin lives just like opioids but are somehow up to this point mostly ignored. I too refuse to prescribe to someone on benzos. Everyone always looks at me like I have two heads.

benzos or sleepers = no opioids, contraindicated

 

[bedrock]

Stimulants and benzos were the reason my psychiatrist spouse took a nonclinical job. It wasn't worth arguing with every other pt about their meds.

Maybe that’s why Pysch is hot now ?

And maybe that’s why so many patients are willing to pay substantial cash payments for each office visit.

And maybe many psychiatrists make $$$$, and can have all cash patients, because they are close to being a pill mill for benzos and stimulants?

(I’m not insinuating anything about your wife)

 

[clubdeac]

I’m just waiting for the big pendulum swing with stimulants similar to what happened with opioids, it’s insane children are put on these and then many are kept on these throughout their life. They’re addictive like any other controlled substance. It’d be Interesting to do a study looking at the rates of HTN and cvd in chronic stimulant patients compared to the general population. The silent killer

 

[painfree23]

Need a stimulant (cocaine/meth) to get rid of the numbing feeling of opiates (heroin) and the need a benzo (alcohol) to bring you back down when you overshoot the stimulant and you want to go to bed/rest. All these “prescription drugs” are just different versions of other actual hard drugs or alcohol.

 

[Chrish]

I’m just waiting for the big pendulum swing with stimulants similar to what happened with opioids, it’s insane children are put on these and then many are kept on these throughout their life. They’re addictive like any other controlled substance. It’d be Interesting to do a study looking at the rates of HTN and cvd in chronic stimulant patients compared to the general population. The silent killer

Are they? Working in the pharmacy, very few people try to get stimulants early like they do with opioids or benzos. In fact, I would go as far as to say that more people are hooked on gabapentin than Adderall!

And stimulants are few of the control substances that actually are proven to be clinically effective for appropriate indication (unlike opioids for chronic pain or benzos for non-acute anxiety). And their side effect profile is also much safer.

 

[PainBrain78]

I don’t see the same issue with stimulants either. Possibly college kids abusing them to cram last minute. But for your typical ADHD kid a stimulant can be absolutely life altering for the better.

 

[bedrock]

Are they? Working in the pharmacy, very few people try to get stimulants early like they do with opioids or benzos. In fact, I would go as far as to say that more people are hooked on gabapentin than Adderall!

And stimulants are few of the control substances that actually are proven to be clinically effective for appropriate indication (unlike opioids for chronic pain or benzos for non-acute anxiety). And their side effect profile is also much safer.

I’m 100% certain there are more people addicted to adderal than gabapentin.

What level of evidence are the studies for stimulants and adult ADHD? No level one studies that I’m aware of.

 

[gaseous_clay]

what’s the street value of gabapentin?

 

[clubdeac]

I think these guys likely use stimulants themselves to be so pro adderal. I know many people that abuse them. Watch “take your pills”

 

[gaseous_clay]

Are they? Working in the pharmacy, very few people try to get stimulants early like they do with opioids or benzos. In fact, I would go as far as to say that more people are hooked on gabapentin than Adderall!

And stimulants are few of the control substances that actually are proven to be clinically effective for appropriate indication (unlike opioids for chronic pain or benzos for non-acute anxiety). And their side effect profile is also much safer.

Most drugs are clinically effective for the appropriate indication. While working at the pharmacy, how are you able to determine whether the stimulant being prescribed is for the “appropriate” indication vs being utilized off-label? More people are likely to request early refills for opioid and benzo prescriptions due to the more severe withdrawal symptoms compared to stimulants.

 

[Chrish]

I’m 100% certain there are more people addicted to adderal than gabapentin.

What level of evidence are the studies for stimulants and ADHD? No level one studies that I’m aware of.

Plenty of threads on this in psych forum. Overwhelming consensus among psychiatrists is it’s better to treat ADHD (mainly with stimulants) than to not treat it. Here is a brief discussion I found with a quick search.

When will ADHD medication shortage end?

This is a joke right? Educate us, what makes you say this?

forums.studentdoctor.net

As for point regarding Gabapentin, it’s abused far more frequently than stimulants by MANY patients in my personal experience. I have at least dozen patients at my pharmacy with the note on their profile “watch early gabapentin refill”. Got dozens for Oxy/ Ambien/ Xanax as well.

I can’t think of a single one for the stimulants in all these years.

 

[Chrish]

I think these guys likely use stimulants themselves to be so pro adderal. I know many people that abuse them. Watch “take your pills”

That’s a very silly thing to say. I am not on Adderall (or any prescription medication for that matter). In fact, I am bit of a skeptic myself when it comes to overdiagnosis of this condition.

Do you believe ADHD is real?

Discuss..

forums.studentdoctor.net

 

[Chrish]

Most drugs are clinically effective for the appropriate indication. While working at the pharmacy, how are you able to determine whether the stimulant being prescribed is for the “appropriate” indication vs being utilized off-label? More people are likely to request early refills for opioid and benzo prescriptions due to the more severe withdrawal symptoms compared to stimulants.

See post above. Overwhelming number of psychiatrists agree that patients with ADHD benefit from the stimulant treatment. While overwhelming also agree that benzos shouldn’t be used for chronic anxiety.

Just like most pain physicians disagree with opioid use for chronic pain in vast majority of patients.

 

[Chrish]

what’s the street value of gabapentin?

Not high because it being a non-control in majority of states, it’s pretty easy to obtain via real/ forgery prescriptions. Patients can use multiple prescribers/ poly-pharmacy as it doesn’t show up in PDMP.

 

[clubdeac]

Not high because it being a non-control in majority of states, it’s pretty easy to obtain via real/ forgery prescriptions. Patients can use multiple prescribers/ poly-pharmacy as it doesn’t show up in PDMP.

Are you a psychiatrist? Psych PA? General public interested in psych?

 

[gaseous_clay]

See post above. Overwhelming number of psychiatrists agree that patients with ADHD benefit from the stimulant treatment. While overwhelming also agree that benzos shouldn’t be used for chronic anxiety.

Just like most pain physicians disagree with opioid use for chronic pain in vast majority of patients.

I’m not arguing that patients with ADHD don’t respond to stimulants nor am I stating that benzos should be used for chronic anxiety or opioids should be used for chronic pain. I’m stating that early refill requests may be due to the intensity of the withdrawal response, which is different for each category of drug. Unlike benzos, no one dies from stimulant withdrawals. Furthermore, your ‘data’ is anecdotal.

 

[VA Hopeful Dr]

I’m 100% certain there are more people addicted to adderal than gabapentin.

What level of evidence are the studies for stimulants and ADHD? No level one studies that I’m aware of.

In kids, huge amounts of high quality evidence.

In adults who started treatment as kids, decent but not overwhelming evidence .

In adults with no childhood symptoms, basically zero good evidence.

 

[bedrock]

In kids, huge amounts of high quality evidence.

In adults who started treatment as kids, decent but not overwhelming evidence .

In adults with no childhood symptoms, basically zero good evidence.

Thank you.

I should have specified that I’m referring to adults.

I’m rather skeptical about all the adults who decide once they reach college age or in particular grad school age, that suddenly they are ADHD, when in reality they just want a cheat code over their fellow grad students.

I also feel that ADHD is dramatically over diagnosed in kids.
But I agree and accept that stimulants are appropriate and helpful for kids, who truly have ADHD.

 

[VA Hopeful Dr]

Thank you.

I should have specified that I’m referring to adults.

I’m rather skeptical about all the adults who decide once they reach college age or in particular grad school age, that suddenly they are ADHD, when in reality they just want a cheat code over their fellow grad students.

I also feel that ADHD is dramatically over diagnosed in kids.
But I agree and accept that stimulants are appropriate and helpful for kids, who truly have ADHD.

The theory is that mild ADHD can be hidden if kids are smart enough, but it becomes more clear if the kids are challenged enough. Not sure I agree with that but I'm no psychiatrist so I'll leave that up to them.

ADHD in kids is both under and over diagnosed. Under in that there are kids with legitimate ADHD who don't get diagnosed - either parents don't get them evaluated or their ADHD behavior is blamed on them not being able to behave. Over in kids whose parents insist they have ADHD because they don't make all As in school or have to be reminded to finish their homework.

 

[epidural man]

I never had symptoms of ADHA until I started posting on SDN. It eventually ruined me. Now I have to constantly be checking twitter, than facebook, than SDN, than instagram, then apple news, then Key and Peele videos, than Ryan Long videos, than back to twitter, than my stocks...ya know...it just goes on and on.

 

[cowboydoc]

Thank you.

I should have specified that I’m referring to adults.

I’m rather skeptical about all the adults who decide once they reach college age or in particular grad school age, that suddenly they are ADHD, when in reality they just want a cheat code over their fellow grad students.

I also feel that ADHD is dramatically over diagnosed in kids.
But I agree and accept that stimulants are appropriate and helpful for kids, who truly have ADHD.

Not to mention, the "adult onset" ADHD flies in the face of the evidence that the condition is caused by delayed development of the frontal lobe.

 

[Chrish]

Tired of this

Here’s the med list for my consult today: Diazepam 10 mg daily Xanax 0.5 mg qid Hydrocodone 7.5 mg qid Ambien 10 mg at hs So sick of dealing with this

forums.studentdoctor.net

 

[po_boy]

"My PCP is sick and tired of you pain doctors not prescribing pain meds to patients on benzos..."