Developed decades ago to treat a legitimate medical need, benzodiazepines promisingly displaced less-effective and less-safe drugs, though prescribing has since exceeded their intended use and outpaced the available data. The current situation is characterized by excessive prescribing and extended utilization beyond good therapeutic practice. Evidence indicates that prolonged use of benzodiazepines causes a wide range of adverse reactions, and withdrawal can be particularly challenging. Misused, abused, diverted, and counterfeited, benzodiazepines have serious potential for substance use disorder, and are among the leading causes of drug-related overdose deaths. The Benzodiazepines Crisis sounds the alarm against the overuse of benzodiazepines, presenting an updated, evidence-based overview of this class of drugs and their negative consequences. Bringing together years of research, clinical expertise, and scientific evidence, this book aims to address a perceived lag between evidence and action in order to call for rational and dramatically reduced usage of benzodiazepines.
Forewords
Reid Finlayson, Lynn Webster, Bernie Silvernail, and Carrie Silvernail
Preface
John F. Peppin, Joseph V. Pergolizzi, Jr., Robert B. Raffa, and Steven Wright
1. Introduction: Anxiety, Insomnia, and Benzodiazepines
Michael M. Miller John Peppin
2. The Evolution of Benzodiazepines and the 'Z' Drugs
Jamie L. Hansen and Timothy J. Atkinson
3. Uses, Efficacy, and Adverse Effects of Benzodiazepines
Brian Merrill and Jeffrey Guina
4. Problems with Benzodiazepine Use in the Elderly
Jan Kitzen
5. Benzodiazepine Receptors in the Brain
Michael H. Ossipov
6. Benzodiazepine Receptors in the Periphery
Robert B. Raffa
7. Benzodiazepine Withdrawal: Neurobiologic Aspects
George F. Koob
8. Benzodiazepine Withdrawal: Clinical Aspects
Steven Wright
9. Benzodiazepines and Pain
John F. Peppin and Steven Wright
10. Benzodiazepines Abuse
John J. Coleman
11. History of the Regulatory Control of Benzodiazepines
John J. Coleman
12. Guidelines and Guidances
Jo Ann LeQuang
13. The Benzodiazepine Legacy Patient
Jeffrey Guina and Brian Merrill
14. Perspective
John Peppin
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