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Benzodiazepines: Frequently Asked Questions

What are benzodiazepines?

Benzodiazepines are one of the most commonly prescribed drugs in the United States. They are sedative hypnotic drugs which relieve anxiety with less harmful side effects than the barbiturates. The benzodiazepine class of drugs include: Diazepam (Valium), Oxazepam(Serax), Chlordiazepoxide(Librium), Chlorazepate(Tranxene), Temazepam(Restoril), Alprazolam (Xanax), Triazolam (Halcion), Lorazepam(Ativan) and Prazepam (Centrax).

What drugs are included as "benzodiazepines and barbiturates"?

Benzodiazepines include drugs like clonazepam (Klonopin), lorazepam (Ativan), alprazolam (Xanax), temazepam (Restoril) and diazepam. Barbiturates include drugs like Phenobarbital and mephobarbital (Mebaral). For NYS Medicaid, prescriptions for a brand-name drug with an "A-rated"generic equivalent will still require prior authorization.

Are benzodiazepines affected by antacids use?

As a general rule it is best to separate antacid use and any other medications by at least 1 hour. When antacids are only taken occasionally, this seldom presents a serious problem. Since there are so many good medications to reduce stomach acid, some of them over-the-counter, it is unusual to require frequent antacid use during the day and night.
As a general rule it is best to separate antacid use and any other medications by at least 1 hour. When antacids are only taken occasionally, this seldom presents a serious problem. Since there are so many good medications to reduce stomach acid, some of them over-the-counter, it is unusual to require frequent antacid use during the day and night. ...

Are benzodiazepines used for mental illness?

Benzodiazepines may be useful, in low doses, for patients with schizophrenia who are beginning to show signs of relapse and may help to avoid the necessity of major increases in neuroleptic medication. They may also be useful in treating mania.

What are benzodiazepines and how are they used?

For anxiety, urine marking, noise phobias, fear induced aggression, generalized fear, waking at night, and some panic disorders, anti-anxiety drugs such as the benzodiazepines (e.g. diazepam, oxazepam, alprazolam) might be used. Because of their short onset of action and relatively short duration, these drugs are primarily used for specific predictable situations that might produce temporary anxiety, and less frequently for long term or on-going problems. ...

What is the clinical use of benzodiazepines?

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Are any of the benzodiazepines going to be covered by any of the plans?

Such drugs are considered excluded from the Medicare Part D benefit. For those individuals who have both Medicare Part D and Medicaid, Medicaid will cover the benefit for benzodiazepines, barbiturates, and certain over-the-counter medications.

Do benzodiazepines have legitimate medical uses?

Benzodiazepines are used to treat phobias, panic attacks, obsessive-compulsive disorder, and other anxiety disorders (see p. 208).

Can I stop the benzodiazepines straight away?

A It is dangerous to come off the benzodiazepines suddenly (cold turkey). There can be the risk of having a withdrawal fit. Usually people are so overwhelmed by withdrawal symptoms they start taking benzodiazepines again, consequently feeling a failure and with an unnecessarily bad experience of withdrawal. Some people say that they haven’t got the patience to cut down slowly. If this is the case, it is safest to go into a residential Drug Withdrawal Unit to come off, where medical supervision is available.

What is safe and appropriate use of the benzodiazepines?

A The benzodiazepines are safe to use occasionally or intermittently; or every day for no more than a few weeks at a time. The benzodiazepines are useful drugs for a number of medical procedures and as an anaesthetic. The drugs can also be useful for severe anxiety while the person seeks longer term assistance, or short term in a crisis. (Use of the benzodiazepines in a crisis can be controversial because of the effects of the drugs on emotions and memory. ...

Are faxed prescriptions acceptable for dispensing benzodiazepines?

The issue of faxed prescriptions was discussed with the National Association of Pharmacy Regulatory Authorities (NAPRA) a few years ago. At that time, NAPRA presented a document establishing conditions under which prescriptions, including those for narcotics and controlled drugs, could be transmitted using facsimile technology. This document is available on NAPRA's website. ...
The issue of faxed prescriptions was discussed with the National Association of Pharmacy Regulatory Authorities (NAPRA) a few years ago. At that time, NAPRA presented a document establishing conditions under which prescriptions, including those for narcotics and controlled drugs, could be transmitted using facsimile technology. This document is available on NAPRA’s website. ...

Can I ever use benzodiazepines again without becoming dependent?

A If you use benzodiazepines according to the “safe use” principles, that is, intermittently or for no more than a few weeks, there is no reason you should become dependent on them.

Question: Should I use phenobarbitol to come off of benzodiazepines?

Don't use the pheno. Barbiturates are cross tolerant with benzodiazepines but they don't work exactly the same. Phenobarbitol works on barbiturate receptors which directly gate or open the chloride ion channel whereas benzodiazepines increase the opening frequency. They have a different mechanism of action at the GABAa receptor than the benzodiazepines and Z drugs and thus you may only end up complicating matters by using pheno.

Is it necessary to obtain approval from Health Canada prior to destroying Targeted Substances such as benzodiazepines?

Prior approval from Health Canada is not required to destroy Targeted Substances such as benzodiazepines. However, records including the name, strength per unit, and quantity of the Targeted Substance destroyed must be kept for three years. The destruction must render the product unusable, and it must be witnessed by another health care professional. ...

Why should you come off Benzodiazepines (Valium, Xanax, Rohypnol, etc.)? What are the withdrawal symptoms?

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Can pharmacists continue to mail out benzodiazepines to patients who are residing outside of the country?

As of September 1, 2000, pharmacists are not permitted to mail a Targeted Substance to another country. This activity is considered an exportation and only Licensed Dealers can export a Targeted Substance, after they have received an export permit from the Office of Controlled Substance.

How can I cope with my sleep problems if I don’t use benzodiazepines?

A Benzodiazepines do not really help sleep problems that have existed for any length of time. The benzodiazepines do not treat the cause of the sleep problem, and long term use of benzodiazepines actually worsens the quality of sleep. See The Better Sleep Booklet in Resources for information on achieving a restful night’s sleep.

Do some people have to take benzodiazepines long term for medical reasons?

A There are some rare medical situations where a person and their doctor might decide that the benefits of taking benzodiazepines long term outweigh the risks associated with the use of these drugs. The risk of dependency would be minimised by taking the benzodiazepines infrequently if this is possible.

How can I cope with my anxiety if I don’t use benzodiazepines?

A Benzodiazepines relieve the symptoms of anxiety only and do not change the causes or improve your ability to cope with anxiety. For long standing anxiety, specific counselling therapies such as Cognitive Behavioural Therapy (CBT) work extremely well and do not have the risk of dependency.

What IOP has the best prices for drugs like benzodiazepines, and is an IOP my only option?

Since many NROP(no record online pharmacies) have gone, international is about the only other option for meds like benzodiazepines. It is getting harder to trust overseas pharmacies, since the government has tightened restrictions, but there are still a few places left to get some at various prices and brands. However, some ROP's will sell anti-anxiety medication too, you just need to find which ones do, and get your records and order a consult. ...

Benzodiazepines are excluded drugs under Medicare Rx; what happens if a consumer is prescribed these and other excluded drugs?

Medicaid will continue to pay for benzodiazepines and other categories of drugs specifically excluded from Medicare Rx. The other categories include barbiturates, some weight loss drugs, or prescribed over-the-counter medications.

What's wrong with staying on benzodiazepines indefinitely? Are there serious long-term effects?

The most troubling long-term effects of this class of agents include forgetfullness, an inability to concentrate and related memory changes. Over time, it's felt that these so-called cognitive effects may be important, especially in the elderly in whom similar changes tend to occur with age. The elderly are also more prone to become dizzy, especially on standing, and the benzodiazepines can make this tendency worse. ...

I have been off all benzodiazepines for six months, yet still feel really unwell. Could I still have withdrawal after all this time?

A Benzodiazepine withdrawal can last for a long time if a person has been taking the drugs for a number of years.

Many of my patients are seniors and people who have disabilities. They frequently use Barbiturates, Benzodiazepines, and over-the-counter (OTC) drugs. How will my patients gain access to these drugs?

The Oregon Department of Human Services (DHS), Office of Medical Assistance Programs (OMAP) will continue to cover the following: Drugs for anorexia, weight loss, or weight gain; Prescription cough and cold drugs; Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations; Nonprescription drugs/Over-the-Counter (OTC) drugs; Barbiturates (e.g. Barbital, Phenobarbital), and Benzodiazepines (e.g. Klonopin, Valium, Xanax).
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