The Benzodiazepines Crisis

ISBN : 9780197517277

John Peppin; Joseph V. Pergolizzi, Jr.; Robert B. Raffa; Steven L. Wright
288 Pages
156 x 235 mm
Pub date
Jan 2021
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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.


Reid Finlayson, Lynn Webster, Bernie Silvernail, and Carrie Silvernail
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

About the author: 

John Peppin, Clinical Adjunct Professor, Marion University, College of Osteopathic Medicine, Joseph V. Pergolizzi, Chief Operating Office, NEMA Research, Robert B. Raffa, Adjunct Professor, University of Arizona College of Pharmacy, Steven L. Wright, Medical Director, Mountain Medical Care John F. Peppin, DO, FACP, is board certified in Internal Medicine and pain medicine. Elected Fellow of the American College of Physicians, Kentucky Colonel in 2009, and PainWeek 2011 Clinician of the Year. He currently is a consultant in the areas of pain, palliative and internal medicine and Clinical Adjunct Faculty for Marian University, College of Osteopathic Medicine. He has published over 70 articles in the fields of pain management, palliative care, internal medicine and bioethics and edited books and given numerous lectures, papers and posters at national and international conferences. Dr. Peppin has been a principle investigator for over 80 clinical trials, as well as having other; research projects and grants in his career including in conjunction with the NIH. Joseph V. Pergolizzi, Jr., MD, is Chief Operating Office of NEMA Research, chairman of the Abstract and Poster Selection Committee for PAINWeek, and a member of the CHANGE PAIN Board. Dr. Pergolizzi's research interests focus on acute and chronic pain in adults with a particular focus on pain in the elderly. Dr. Pergolizzi has held various adjunct and/or part-time academic positions and faculty over the past decade. He is the author of more than 100 peer-reviewed articles, abstracts, platform presentations and book chapters in his areas of interest and expertise. Robert B. Raffa, PhD, is Adjunct Professor at the University of Arizona College of Pharmacy and Professor Emeritus at Temple University School of Pharmacy. He is a cofounder of CaRafe Drug Innovation and the CSO of Neumentum Inc, both companies directed to the discovery and development of non-opioid analgesics. He has published more than 300; papers in peer-reviewed journals, and co-authored or edited several books on pharmacology and thermodynamics and is a Co-Editor of Journal of Clinical Pharmacy and Therapeutics. He is a past president of the Mid-Atlantic Pharmacology Society of ASPET and is the recipient of research and teaching awards. Steven Wright, MD, is a residency-trained family physician with a 37-year clinical career. Board-certified in addiction medicine and experienced in medical pain management, he is involved in a variety of roles including medical director of Mountain Medical Care. His clinical interests include the neurophysiology and treatment of pain and addiction, non-opioid analgesia, opioids, benzodiazepines, cannabis, best practices, and systems of care. He is the medical consultant for The Schreiber Research Group and the Alliance for Benzodiazepine Best Practices.

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