Are Benzos the next Opioids?

Benzodiazepines have been used since the 1960s to treat seizures, insomnia and anxiety. The big brand names include Valium, Ativan and Xanax. Such medications work on different receptors in the central nervous system than opioids. However, both potentially depress the respiratory system and, when taken together, they sometimes have lethal consequences. 

To delve deeper into the topic, I sat down with Dr. Mark Donaldson, our pharmacology expert, and I asked him whether benzodiazepines could cause another epidemic similar to opioids. 

I hope you enjoy the conversation. We always look forward to hearing your thoughts and receiving your questions and/or suggestions about this post and other topics. Leave a comment in the box below, send us your feedback by email, or call us at 1-855-716-2747.

Until next time!

Chiraz Guessaier, CDA Oasis Manager

Conversation Highlights 

1. Dr. Donaldson speaks about the history of Benzodiazepines and Dr. Leo Sternbach, who synthesized the very first benzodiazepine Librium, also known as Chlordiazepoxide. 
2. Benzodiazepines have been part of our social and medical culture for many years. And, while they may not necessarily be new or alluring, they are certainly still well prescribed. 
3. One of the unique properties of benzodiazepines is anterograde amnesia, where the patient starts to lose memories as the drug begins to take effect. So, if you take a high-fear dental patient, relax them and do the dentistry and they don't remember the appointment, at the next appointment they may not necessarily be as fearful.
4. Midazolam or Versed is the benzodiazepine primarily used with children. In 10% of the population, the drug has actually shown the opposite effect and children become agitated. Another safe alternative is to give an anti-histamine which is known to induce sleepiness. 
5. The headline of a benzodiazepine epidemic is not new; however, it has not gone away either. Taking a benzodiazepine in large quantity does not produce a lethal outcome. The real challenge is the co-prescribing of benzodiazepines with opioids.
6. Always practice with the 4 Rs in mind: Right drug, Right dose, Right patient, Right procedure.

Read/download the transcript of the conversation (PDF)

Further Reading

Chanpong B, Haas DA, Locker D. Need and demand for sedation or general anesthesia in dentistry: a national survey of the Canadian population. Anesth Prog. 2005 Spring;52(1):3-11.