Benzodiazepines (May)

Date of Issue: 05/01/2016 | Volume: 4 | Number: 4

Issue Links:Learning Objectives | Editorial Information

Using benzodiazepines to treat patients who also substance use disorders presents challenges. In this issue, we help you learn how the terms dependence, tolerance, and addiction are applied to your patient's benzodiazepine use, and what you can do to ensure this doesn't become an issue while treating co-occurring disorders. We also look at options for non-benzo medications that can treat anxiety.

In This Issue

Article

Medication Treatment of Anxiety Disorders in Substance Abusers

Topics: Addiction | Anxiety Disorder | Benzodiazepines | Psychopharmacology Tips

While benzodiazepines are effective anti-anxiety workhorses for many patients, most guidelines tell us to avoid prescribing them to substance abusers. The concern is that the benzo high will remind patients of their substances of choice, and that benzo withdrawal symptoms will lead to old substance abuse habits.

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Expert Q&A

Benzodiazepines: Dependence, Tolerance, and Addiction

Topics: Addiction | Anxiety Disorder | Benzodiazepines | Psychopharmacology Tips

One good way to think of benzodiazepines is that they are literally, physiologically anyway, alcohol in a pill. Especially the fast-onset/fast-offset benzodiazepines like alprazolam (Xanax) have a very similar pharmacologic profile to alcohol. This discussion with Dr. Alex Stalcum covers strategies of using benzodiazepines as anxiety treatments for substance-abusing patients.

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Research Update

Synthetic THC and Antihypertensive Provide Little Benefit for Cannabis Dependence

Topics: Addiction | Substance Abuse

Second only to alcohol, marijuana is the most common reason people enter substance abuse treatment. And unlike alcohol dependence, there are virtually no effective medications available for those addicted to it. It’s not from a lack of trying. A recent review of 14 drug studies for cannabis dependence revealed little benefit from antidepressants, anticonvulsants, or anxiolytics.

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Research Update

When Physicians Become Addicted: How Well Do Treatment Programs Work?

Topics: Addiction | Practice Tools and Tips | Research Updates

When physicians are diagnosed with opioid or other drug dependence, they are required to receive treatment from special physician health programs (PHP) if they want to keep their medical licenses. Unlike treatment programs for the general population, PHPs do not use opiate agonists, such as methadone or buprenorphine.

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