Benzodiazepines

Misuse has been an important problem: to some extent, they can be seen to have replaced the barbiturates as an over-prescribed sedative for the ups and downs of life, although with less serious side-effects (that is, lack of respiratory depression; this means they are safe in overdose). They act at receptors associated with gamma-aminobutyric acid (GABA) receptors.

The BNF (http://www.bnf.org/bnf/bnf/current/3139.htm) carries a sensible withdrawal schedule for patients who have become dependent. The patient is switched to an equivalent dose of diazepam (e.g. lorazepam 1 mg = diazepam 10 mg), and then about one-eighth of the daily dose is reduced per 2 weeks. Diazepam is chosen because it is long-acting.

References

Mattick, R. P., Breen, C., Kimber, J. and Davoli, M. (2006). Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev Issue 2, CD002209.

Robson, P. (2001). Therapeutic aspects of cannabis and cannabinoids. Br J Psychiatry 178, 107-115.

Resources

Department of Health guideline on treatment. http://www.dh.gov.uk/assetRoot/04/07/81/

98/04078198.pdf. Resources and information. http://www.drugscope.org.uk. Society for the Study of Addiction. http://www.addiction-ssa.org.

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