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In the United States, an increasing number of people are taking anti-anxiety medications like Valium and Xanax, not only to relieve anxiety or depression, but also to relieve chronic pain, according to researchers.
These drugs belong to a family of drugs called benzodiazepines, which also include drugs such as Ativan and Klonopin.
Benzodizepines are mainly used to relieve anxiety, but also to treat problems such as insomnia, seizures, panic attacks, nausea, alcohol withdrawal and muscle laxity .
Although benzodiazepine overdoses and injuries have increased in recent years, researchers do not have a complete picture of prescribing trends.
Benzodiazepines have strangely similar side effects to opioids, including the risk of addiction and difficulty breathing. There is also little evidence that they work as a good alternative to pain
For this study, researchers examined data from 386,457 outpatient visits from 2003 to 2015 and found that the proportion involving a benzodiazepine prescription doubled from 3.8% to 7.4%.
Prescriptions against anxiety and depression remained the most common use of these drugs, rising from about 27% to 34%.
The largest increase, however, is for prescriptions for back pain or other forms of chronic pain, which increased from 3.6% to 8.5% during the study period.
"Benzodiazepines are almost never a good alternative to opioids for treating pain," said Dr. Sumit Agarwal, co-author of the study, primary care physician at Brigham Hospital and Women & # 39; Boston Hospital.
"When introduced, benzodiazepines were a significant advance over their predecessor, barbiturates, and these drugs have very real benefits, especially when they are prescribed for short-term and intermittent use," he said. said Agarwal.
However, benzodiazepines have strangely similar side effects to opioids, including the potential for addiction and difficulty breathing, added Agarwal.
"They are involved in falls and fractures, road accidents, overdoses and deaths," said Agarwal. "These risks are even more pronounced when they are badociated with other drugs that alter the central nervous system."
During the study period, researchers reported in the JAMA Network Open that the proportion of benzodiazepine prescriptions for people also taking opioids had quadrupled from 0.5 to 2%.
During the same period, the proportion of benzodiazepine prescriptions among people taking other drugs sedated doubled from 0.7 to 1.5%.
The use of benzodiazepines by psychiatrists remained stable at around 30% of visits during the study period. The increased use of these drugs came rather from primary care physicians and other providers.
Primary care physicians accounted for about half of the visits involving benzodiazepine prescriptions in the study. Primary care visits involving these drugs increased from 3.6 to 7.5% during the study period.
The study was not designed to evaluate the reasons for the increased use of benzodiazepines, nor to determine to what extent increased use could affect the health of patients.
One of the limitations of the study is that researchers lacked data on the exact reason for benzodiazepine prescriptions and badumed that the main complaints listed in patients' medical records regarding their visits were the problem that the drugs were intended to treat .
"It is possible that primary care physicians are increasingly prescribing benzodiazepines as a safer and more effective alternative to opioids, but there is little evidence to support it," said Marissa Seamans, researcher at the Johns Hopkins Bloomberg School of Public Health in Baltimore. t involved in the study.
"Patients need to be informed and weigh the risks and benefits of using benzodiazepines, especially if they take other drugs that affect the central nervous system," Seamans said by e-mail .
"For conditions other than anxiety such as chronic non-cancer pain, non-pharmacological and non-opioid badgesics should be sought first."
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