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Benzodiazepines are one of the most highly prescribed classes of drugs, [7] and they are commonly used in self-poisoning. [8] [9] Over 10 years in the United Kingdom, 1512 fatal poisonings have been attributed to benzodiazepines with or without alcohol. [10] Temazepam was shown to be more toxic than the majority of benzodiazepines.
Long-acting benzodiazepines with long-acting active metabolites, such as diazepam and chlordiazepoxide, are often prescribed for benzodiazepine or alcohol withdrawal as well as for anxiety if constant dose levels are required throughout the day. Shorter-acting benzodiazepines are often preferred for insomnia due to their lesser hangover effect.
Polydrug use involving benzodiazepines and alcohol can result in an increased risk of blackouts, risk-taking behaviours, seizures, and overdose. [229] Dependence and tolerance, often coupled with dosage escalation, to benzodiazepines can develop rapidly among people who misuse drugs; withdrawal syndrome may appear after as little as three weeks ...
However, benzodiazepines with intermediate half-lives like lorazepam may be safer in people with liver problems. [34] Benzodiazepines showed a protective benefit against alcohol withdrawal symptoms, in particular seizure, compared to other common methods of treatment. [35]
Dosing of the benzodiazepines can be guided by the CIWA scale. [10] The scale is available online. [11] Regarding the choice of benzodiazepine: Chlordiazepoxide (Librium) is the benzodiazepine of choice in uncomplicated alcohol withdrawal due to its long half-life. [12]
Many drivers had blood levels far exceeding the therapeutic dose range, suggesting a high degree of potential for misuse of benzodiazepines, zolpidem, and zopiclone. [116] In Northern Ireland, in cases where drugs were detected in samples from impaired drivers who were not impaired by alcohol, benzodiazepines were found in 87% of cases ...
Benzodiazepines can be addictive and induce dependence even at low doses, with 23% becoming addicted within 3 months of use. Benzodiazepine addiction is considered a public health problem. Approximately 68.5% of prescriptions of benzodiazepines originate from local health centers, with psychiatry and general hospitals accounting for 10% each.
A 1999 study of 1,179 urine specimens from victims of suspected drug-facilitated sexual assaults in 49 American states found six (0.5%) positive for Rohypnol, 97 (8%) positive for other benzodiazepines, 48 (4.1%) positive for GHB, 451 (38%) positive for alcohol and 468 (40%) negative for any of the drugs searched for. [4]