Evaluation of the prevalence of Benzodiazepines in Australia - Essay Example

EVALUATION OF THE PREVALENCE OF BENZODIAZEPINES IN AUSTRALIA, AND ITS POTENTIAL HARM AND BENEFITS Name: Institution: Unit Code: Tutor: Date: Prevalence, Harm and Benefits of Benzodiazepines Introduction Benzodiazepines are a type of psychoactive drugs also known as “benzos” or tranquilizers. These types of drugs are some of the most commonly prescribed medicines in Australia and America due to the wide range of chemical properties that help in mitigation of certain conditions (Starcevic, 2015). The medication acts mainly on the central nervous system, affecting neurotransmitters such as the gamma-amino butyric acid (GABA). The result of this is a reduced level of anxiety, increased muscle relaxation, anti convulsion, reduced insomnia and aid in withdrawal of drugs and alcohol, among several other effects. Benzodiazepines are classified mainly according to the time-span of their effects on the body. They are grouped into short acting (or ultra-short acting), intermediate (or short acting) and long acting effects. In the recent decades, a growing concern has increased over the abuse of pharmaceutical drugs in Australia, particularly benzodiazepines (Victoria, 2006). Therefore, the study will examine the benefits and harmful effects of the drug. This may be a useful step in identifying the underlying problems so that practical and appropriate action can be taken to reduce abuse of benzodiazepines. Prevalence of Benzodiazepines in Australia Benzodiazepines are widely used in Australia. This includes the legal use (through a doctor’s prescription) or through non-medical purposes such as for intoxication and recreation (Jones, Lubman and Bruno, 2013). About 5 million prescriptions of benzodiazepines receive a subsidy annually courtesy of the Pharmaceutical Benefits Scheme. This leads to an increased rate of about 5 percent of all prescribed drugs in Australia (Jones et al, 2013). In Australia, it is unlawful to use such drugs without the prescription of a licensed doctor. There are several other ways in which the drug can be obtained. This includes forging of prescriptions, theft and pharmaceutical related fraud. This is one of the reasons why the illegal drug use is prevalent in Australia (Loxley, 2007). Their inherent safety when used in short terms makes them a popular choice for their prevalence. The increased rate of use in Australia between the year 2013 and 2015 has been attributed to their generic production which makes them affordable. Risk factors associated with the prevalent abuse of the drug range widely. Risk factors such as an unstable family structure while growing up, unemployment, incarceration and prior use of the drug that led to addiction. Increased risk of recreational drugs and benzodiazepine misuse was linked to release from prison and being unemployed for a period of more than 6 months (Nicholas, Lee and Roche, 2014). A study carried out by the center for population health in Australia indicated that risks of overdose were associated with benzodiazepine use with the presence of a mental disorder (Winter, Stoove, Degendardt, Hellard, Spellman and Jenkinson, 2015). Prevalence of benzodiazepine use in Australia is associated with increased age. A recent study of benzodiazepine use in patients ranging between 65 and 69 years if age indicated about 16 percent of elderly patients had a benzodiazepine prescription. Increase in age increased the prevalence of benzodiazepine use, with over twenty percent of patients aged 85 years and over receiving at least one prescription of the drug. Prevalence also varied widely among genders in the elderly patients, with the female elderly reporting 19.6 percent and 10.8 percent in male patients (Windle, Elliot, Moore and Duszynski, 2015). This has been due to the limited costs of alternative methods of treatment of anxiety. In addition, the alternative costs available are costly, as compared to benzodiazepines which are highly affordable in Australia. Potential Benefits Associated with Benzodiazepines Benzodiazepines are used mainly for treating anxiety in patients. The most commonly diagnosed anxiety disorder is referred to as General anxiety disorder (GAD). Patients with GAD exhibit symptoms such as restlessness, fatigue, irritability, tinnitus (Jufas Affiliation, 2015), difficulty in concentrating and insomnia or sleep disturbances. Excessive neurological activity has been linked to increased anxiety levels, thus benzodiazepines work to reduce nerve activity thus providing a user with relaxation effects. Similar conditions that increase levels of stress such as panic attacks can be treated by administration of benzodiazepines. Common benzodiazepine drugs include clonazepam, lorazepam, diazepam and alprazolam. These drugs are high in efficiency when used as directed by a doctor. The success rate will be reduces when the drug is used continuously after the achieved effect. Benzodiazepines can be used as general anaesthesia before a patient undergoes a minor operation. They are also used as sedatives before surgical or diagnostic procedures. Compared to opiates, these drugs are generally safer and pose a lower risk of overdose (Pomerantz, 2007). Due to the effect it has on the central nervous system, particularly the GABA-A receptor, benzodiazepines such as xanax, alprox, solanax, thiadipona, restyl, limpidon and paxor can be used to treat or lessen the severity of a certain number of conditions such as severe muscle spasms and seizures. Benzodiazepines have been successful in treating withdrawal symptoms from other drugs and alcohol use. Common symptoms of withdrawal include shakes, confusion, anxiety, seizures and hallucinations. Since the early 1960 these classes of drugs have assisted patients to overcome other drug addiction withdrawal symptoms through controlled doses. Common benzodiazepine drugs include diazepam (commonly known as valium), chlordiazepam (librium) and lorazepam (atvian). Common but mild side effects of using these drugs include memory impairment, temporary drowsiness, confusion, aggression and irritability (Reactions Weekly, 2015). These symptoms are most common during the first few days of administration of the drug but reduce over time. Potential Harms Associated with Benzodiazepines Despite the wide range of benefits that benzodiazepines offer, the drug has been associated with dependence on the user. This is mostly so when the drug is used for an extended period. It is also the case for users that do not have any symptoms of anxiety, insomnia or other condition that may warrant a doctor to prescribe the drug. Thus, those users who self medicate use them as recreational or withdrawal drugs are more likely to become addicted to benzodiazepines. When misused as intoxicants or for recreational purposes, they may cause a wide range of physical and visual impairments. Thus they can cause a driver to increase the risk of causing accidents (Ogden, Morris, Fred, Boorman, Stough and King, 2013). In the study carried out to investigate psychological dependence in patients suffering from panic disorder, a total of 60% of the examined population showed signs of dependence after a prolonged use (Fujii, Uchida, Suzuki and Mimura, 2015). However, for remitted patients the proportion was much lower. The main risk factor was the prolonged use of this drug, which was mostly common in patients with severe anxiety and panic disorders. These results were mostly attributed to the lack of extensive knowledge on the risks of dependence of benzodiazepines in psychiatrists and patients. The administration of benzodiazepines together with other forms of anti-depressants is common among the elderly patients than younger adults (Nielsen, Lintzeris, Bruno, Campbell and Larance, 2015). In the recent study on aging patients using benzodiazepines for an extended period exhibited a direct association with increased motor-vehicle accidents (Wilchesky, Patenaude and Suissa, 2015). This risk was increased significantly when benzodiazepines were used alongside with other anti-depressants, a phenomenon referred to as polypharmacy. This was especially common in the older adults under study, aged between 64 and 87 years old. The use of benzodiazepines has also been associated with increased crime rate among the users. In a study to investigate the proportion of drug users in a detainment center, an estimated proportion of 15 percent of users were found to have used benzodiazepines alongside other drugs such as heroine and amphetamines within the last 7 days (Australian Institute of Criminology, 2009). Normally, drug use among female offenders has been a source of concern and the research concluded that women were at higher risk of dependency on the drugs than their male counterparts. Crime rates will increase due to the psychological dependency associated with it, which may cause the user to engage in illegal activities that ensure the continued usage, such as theft. The risk of developing mental health conditions was also increased with the use of benzodiazepines (Victoria, 2006). The research attributed this occurrence to social disadvantage which is prevalent among families subject to high risks. The research thus suggests a timely intervention by the community to reduce these risks. Benzodiazepines along with opioids are some of the most frequently prescribed and abused classes of drugs (Jones, Mogali and Comer, 2012; Galarneau, 2015). The chemical feature involves the fusion of a benzene and diazepine ring, thus activating the GABA receptor which subsequently leads to muscle relaxing and anxiety reduction properties. Due to their short term effects, they are commonly used for purposes initially not intended for them, such as for intoxication and recreation. They often regarded as weak reinforcements of other highly reactive drugs such as heroine. Some of the benzodiazepine drugs such as chlordiazepoxides have been known to produce several short-term side effects such as confusion, constipation, drowsiness, altered sex drive, minor menstrual irregularities, lack of muscle co-ordination fluid retention leading to swelling, skin rash and yellow eyes and skin. Conclusive research is yet to be made on whether the use of benzodiazepines while pregnant could be dangerous. Diazepam, a type of benzodiazepine is known to be safer for pregnant women especially after the first trimester (Nulman, Terrana, Lutwak and Pearlson, 2015). Possible side effects of benzodiazepines use during pregnancy include abortion, intrauterine growth retardation, mutagenesis, carcinogenesis and malformation. Mothers are required to also be cautious of using benzodiazepines while breastfeeding as the drug is absorbed into breast milk. Part of the continued use of benzodiazepines is the increased tolerance. This means that after a certain period of time, a user will increase their dose in order to experience the required effects. This leads to increased risk in overdose of the drug Greenblatt, 2015). Symptoms of benzodiazepines overdose include mental confusion, hypotension, impaired muscle co-ordination and reflexes, dizziness, weakness in the muscles, somnolence coma and death (more common when used with other recreational drugs). The study suggests the implementation of a withdrawal program that involves a reduced dosage over time. Conclusion The use of benzodiazepine has been known to bring about several health benefits. Discovered in the late 1950s, the drug has become increasingly popular over the decades. It has aided treating conditions such as anxiety, insomnia, drug withdrawal symptoms, panic attacks among several others. In addition, it has been used as general anesthesia, as a sedative for surgical procedures and inducing amnesia. Increased use of this drug n Australia has led to increased risks of dependence, tolerance and overdose. The growing concern over the misuse of this drug hassled to an extensive research and study of the positive and negative side effects (Umbricht, 2015). It has also led to an empirical examination of the risk factors associated with its use as well as the most vulnerable population. This research has been necessary in order to evaluate the potential and practical actions that the community, the government and the individual can take to avoid the aforementioned harmful effects. The suggested preventive measures include increased awareness of the effects of benzodiazepines, alternative sources of medication and formation of withdrawal programs. Reference Benzodiazepines/buprenorphine: Various Toxicities: Case Report. (2015). Reactions Weekly, 1544, 1, 51. Coghlan, S., Australian Institute of Criminology. Gannoni, A., Goldsmid, S., Patterson, E., & Willis, M. J. (2015). Drug use monitoring in Australia: 2013-14 report on drug use among police detainees. Canberra: Australian Institute of Criminology. Fournier, J.-P., Wilchesky, M., Patenaude, V., & Suissa, S. (2015). Concurrent Use of Benzodiazepines and Antidepressants and the Risk of Motor Vehicle Accident in Older Drivers: A Nested Case-Control Study. Neurology and Therapy, 4, 1, 39-51. Fujii, K., Uchida, H., Suzuki, T., & Mimura, M. (January 01, 2015). Dependence on benzodiazepines in patients with panic disorder: a cross-sectional study. Psychiatry and Clinical Neurosciences, 69, 2, 93-9. Galarneau, D. W., & Conrad, E. J. (2015). Benzodiazepine Intoxication and Withdrawal. Hospital Medicine Clinics, 11.) Greenblatt, D. J. (January 01, 2015). A soft benzodiazepine. Clinical Pharmacology in Drug Development, 4, 2, 81-82. Jones, J.D., Mogali, S., & Comer, S (2012). Polydrug Abuse: A review of Opioid and Benzodiazepine Combination Use. National Library of Health, 125, 1, 8-18. Jones, K., Bruno, R., & Lubman, D., (2013). Benzodiazepines: their Role in Aggression and Why GPs Should Prescribe With Caution. Australian Family Physician, 40, 11, 862-865. Jufas Affiliation, University of Sidney & Kolling Deafness Research Center, (2015). The use of Benzodiazepines for Tinnitus: A Sstematic Review. Journal of Iarynology and Otology, 132, 3, 14-22. Loxley, W., & Australian Institute of Criminology. (2007). Benzodiazepine use and harms among police detainees in Australia. Canberra, A.C.T: Australian Institute of Criminology Nicholas, R., Lee, N., & Roche, A., (2014), Pharmaceutical Drug Misuse in Australia: complex Problems, Balanced Responses. National Center for Education and Training on addiction. Flinders University, Adelaide. Nielsen, S., Lintzeris, N., Bruno, R., Campbell, G., Larance, B., Hall, W., Hoban, B., Degenhardt, L. (2015). Benzodiazepine use among chronic pain patients prescribed opioids: associations with pain, physical and mental health, and health service utilization. Pain Medicine (malden, Mass.), 16, 2, 356-66. Nulman, I., Terrana, P. N., Lutwak, M., & Pearlston, M. (2015). Psychotropic Medications in Pregnancy. Pomerantz, J., (2007). Risk versus Benefit of Benzodiadepines. Psychiatric Times. Starcevic, V. (2015). The popularity of benzodiazepines, their advantages, and inadequate pharmacological alternatives. Jama Psychiatry, 72, 6, 623-4. Swinburne University of Technology. Faculty of Health, Arts and Design., Ogden, E., Morris, C., Frederiksen, T., Boorman, M., Stough, C., & King, R. (2013). Responsibility for non-fatal collision: the abuse of benzodiazepines. International Council on Alcohol, Drugs and Traffic Safety. Umbricht, A., & Velez, M. L. (2015). Benzodiazepine Abuse and Addiction. SpringerLink. Victoria. (2006). Inquiry into misuse/abuse of benzodiazepines and other forms of pharmaceutical drugs: interim report. Melbourne, Vic, Drugs and Crime Prevention Committee. Windle, A., Elliot, E., Moore, V., & Duszynski, K. (2015). Benzodiazepine Prescribing in Australia: Recent Findings from a General Practice Database. National Medicine Symposium Winter, R. J., Stoové, M., Degenhardt, L., Hellard, M. E., Spelman, T., Jenkinson, R., McCarthy, D. R., Kinner, S. A. (2015). Incidence and predictors of non-fatal drug overdose after release from prison among people who inject drugs in Queensland, Australia. Drug and Alcohol Dependence, 153, 43-9. Read More

Prevalence also varied widely among genders in the elderly patients, with the female elderly reporting 19.6 percent and 10.8 percent in male patients (Windle, Elliot, Moore and Duszynski, 2015). This has been due to the limited costs of alternative methods of treatment of anxiety. In addition, the alternative costs available are costly, as compared to benzodiazepines which are highly affordable in Australia. Potential Benefits Associated with Benzodiazepines Benzodiazepines are used mainly for treating anxiety in patients.

The most commonly diagnosed anxiety disorder is referred to as General anxiety disorder (GAD). Patients with GAD exhibit symptoms such as restlessness, fatigue, irritability, tinnitus (Jufas Affiliation, 2015), difficulty in concentrating and insomnia or sleep disturbances. Excessive neurological activity has been linked to increased anxiety levels, thus benzodiazepines work to reduce nerve activity thus providing a user with relaxation effects. Similar conditions that increase levels of stress such as panic attacks can be treated by administration of benzodiazepines.

Common benzodiazepine drugs include clonazepam, lorazepam, diazepam and alprazolam. These drugs are high in efficiency when used as directed by a doctor. The success rate will be reduces when the drug is used continuously after the achieved effect. Benzodiazepines can be used as general anaesthesia before a patient undergoes a minor operation. They are also used as sedatives before surgical or diagnostic procedures. Compared to opiates, these drugs are generally safer and pose a lower risk of overdose (Pomerantz, 2007).

Due to the effect it has on the central nervous system, particularly the GABA-A receptor, benzodiazepines such as xanax, alprox, solanax, thiadipona, restyl, limpidon and paxor can be used to treat or lessen the severity of a certain number of conditions such as severe muscle spasms and seizures. Benzodiazepines have been successful in treating withdrawal symptoms from other drugs and alcohol use. Common symptoms of withdrawal include shakes, confusion, anxiety, seizures and hallucinations.

Since the early 1960 these classes of drugs have assisted patients to overcome other drug addiction withdrawal symptoms through controlled doses. Common benzodiazepine drugs include diazepam (commonly known as valium), chlordiazepam (librium) and lorazepam (atvian). Common but mild side effects of using these drugs include memory impairment, temporary drowsiness, confusion, aggression and irritability (Reactions Weekly, 2015). These symptoms are most common during the first few days of administration of the drug but reduce over time.

Potential Harms Associated with Benzodiazepines Despite the wide range of benefits that benzodiazepines offer, the drug has been associated with dependence on the user. This is mostly so when the drug is used for an extended period. It is also the case for users that do not have any symptoms of anxiety, insomnia or other condition that may warrant a doctor to prescribe the drug. Thus, those users who self medicate use them as recreational or withdrawal drugs are more likely to become addicted to benzodiazepines.

When misused as intoxicants or for recreational purposes, they may cause a wide range of physical and visual impairments. Thus they can cause a driver to increase the risk of causing accidents (Ogden, Morris, Fred, Boorman, Stough and King, 2013). In the study carried out to investigate psychological dependence in patients suffering from panic disorder, a total of 60% of the examined population showed signs of dependence after a prolonged use (Fujii, Uchida, Suzuki and Mimura, 2015). However, for remitted patients the proportion was much lower.

The main risk factor was the prolonged use of this drug, which was mostly common in patients with severe anxiety and panic disorders. These results were mostly attributed to the lack of extensive knowledge on the risks of dependence of benzodiazepines in psychiatrists and patients.

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