Symposium 5 to Clarify Benzodiazepine Use and Misuse

Much mystery surrounds the appropriate use of benzodiazepines, and Symposium 5 “Benzodiazepine Use, Misuse, Addiction and Treatment” will clear the air about the indications, practice guidelines, outcomes, and limitations of prescribing these medications during this session from 10 am to noon today in Continental B on the Lobby Level of the Hilton Chicago.

“We want to present the latest data about long-term efficacy, or lack of efficacy, of benzodiazepines and their use for various types of anxiety and behavioral disorders,” said symposium organizer Gregory Bunt, MD, Clinical Assistant Professor of Psychiatry, New York University School of Medicine, New York, and President of the New York Society of Addiction Medicine.

During the symposium, Dr. Bunt will present an overview of the issues. Christopher Holden, MD, Director of Addiction Services, Department of Psychiatry, Maimonides Medical Center, New York, will discuss efficacy of benzodiazepines prescribed on a long-term basis. Faye Chao, MD, Unit Chief of Inpatient Detoxification and Rehabilitation, Addiction Institute of New York, St. Luke’s and Roosevelt Hospitals, New York, will address clinical challenges in managing benzodiazepine misuse alone or in conjunction with misuse of other prescription opioid drugs. A town-hall style question-and-answer period will follow where addiction medicine specialists and the expert panel can actively engage in conversation about the issues.

“There are no certain answers to a number of questions,” Dr. Bunt said. “It depends on clinical perspective and opinion about whether to prescribe benzodiazepines to patients. Many addiction medicine specialists believe they should limit or not prescribe benzodiazepines to patients with a history of addiction, whether it’s to alcohol or other drugs. Others believe that benzodiazepines can be prescribed selectively and can be therapeutic for certain patients, even if they have a history of an addictive disorder.”

The symposium also will address benzodiazepine use in light of the epidemic of prescription opioid use, he said. Benzodiazepines are often prescribed in addition to opioids, which often leads to serious adverse, or even fatal, events.

“While not considered of epidemic proportion right now in terms of prescription abuse compared to opioids, benzodiazepines are still prescription drugs that can lead to morbidity and mortality, particularly if they are combined with prescription opioids or with alcohol,” Dr. Bunt said. “It’s important for addiction physicians to learn the cutting-edge of the data, both efficacy and the management of misuse, with benzodiazepines because it correlates with the prescription opioid epidemic. There have been celebrities in recent years who evidently took an overdose of medications, and toxicology showed several benzodiazepines in their systems.”

Conversely, it’s important to have a real command of the efficacy of benzodiazepines prescribed on a long-term basis.

“We need to understand the long-term efficacy, or lack of efficacy, for the different disorders, and that is going to be a valuable part of the symposium in presenting an update on the latest data,” Dr. Bunt said. “For some conditions, there may be good efficacy data, and for others, not good data.”

In addition to gaining insight about efficacy or misuse issues from the symposium, he also said he hoped the audience would learn the value of tapering.

“When individuals get into trouble with benzodiazepines, there are strategies for tapering and discontinuing their use,” Dr. Bunt said. “I hope the audience will learn this effective method of tapering down doses in patients who are already being prescribed benzodiazepines.”