Benzodiazepines are the most prescribed psychiatric medications in the world. Xanax and Valium are by far the best known benzodiazepines. In a list of the most prescribed psychiatric medications in the US published by psychcentral.com, in 2013 Xanax (alprazolam) was on the first position with 48,465,000 prescriptions.
Xanax is used to treat anxiety as many other benzodiazepine drugs including lorazepam (Ativan), which occupies the 5-th position on the list of the most prescribed drugs in 2013 published by psychcentral.com, and Valium which occupies the 11-th position.
Xanax has been the most prescribed psychiatric medication since 2005. The benzodiazepines are a controversial class of psychoactive drugs. Of course there are certain types of benzodiazepines that are controversial because of their effect.
The most controversial type of benzodiazepine is flunitrazepam of course. It was also known as the “rape date drug”. Back in the 90s flunitrazepam was in the center of attention as reports of people using Rohypnol (flunitrazepam) as an incapacitating agent to help them perform what is called DFSA (Drug Facilitated Sexual Assault) were largely covered in the media.
But flunitrazepam is not the only benzodiazepine that is controversial. Due to the effects of long term use and side-effects, almost all of the benzodiazepines are controversial. But not all the people suffer from the side-effects and problems associated with long term use of benzodiazepines.
The side-effects include depression and flu-like symptoms and the most common effect of long-term use of benzodiazepines includes dependence.
The new DSM 5 has combined the substance abuse and substance dependence in one disorder called substance use disorder. And the severity is determined by the number of symptoms.
In DSM IV, the term substance abuse refers to the situation when the use of a substance causes a person to have problems with law, interferes with important obligations or lead to hazardous situations such as driving or operating machinery after using the substances.
The term substance dependence refers to situation when withdrawal symptoms or tolerance are developed.
The problem with benzodiazepines is that they give dependence even when used at low therapeutic doses. And considering the high number of prescriptions the incidence of benzodiazepines dependence in particular is pretty high.
According to unreliable sources the number of prescription declined due to the high incidence of benzodiazepine dependence. But after throwing a glance at the numbers offered by psychcentral.com, people might not be that sure anymore.
The most popular benzodiazepine, Xanax was at the top of the list since 2005 and no other drug ever stole that place on the list from this drug. As for lorazepam it actually gained a few position in 2009 when it reached the 3-rd place on that list. In 2013 it returned to its 2005 position.
Compared to other psychiatric medication the number of prescription of the most popular benzodiazepines did not really drop very much.
The signs and symptoms of benzodiazepines dependence includes inability stop benzodiazepines use and inability to cope without benzodiazepines, tolerance to its effects and withdrawal symptoms. The possible withdrawal symptoms include anxiety, sleep disturbance, depression, derealisation and depersonalization.
The people affected most often by benzodiazepines dependence are those who use it for therapeutic purposes and buy them with prescriptions. Benzodiazepine dependence can develop whenever the substance is used for more than four weeks. Sometimes people might have to take the substance for longer periods of time because they have to suppress withdrawal effects.
To prevent any problems with benzodiazepines use the Committee on the Review of Medicines recommended that the patients that should be allowed to use the benzodiazepines should be carefully selected and the treatment should be withdrawn gradually.
People with benzodiazepines dependence will need specialized assistance of a trained mental health specialist.
Benzodiazepines are meant to be prescribed only on a short-term basis though some doctors think they are above that rule. Also the belief that taking a break or a “drug holiday” might help is a pure myth.