Xanax
Addiction
- As one of the class of drugs benzodiazepines Xanax has been shown to be a dangerous drug to withdraw from. The reason that Xanax withdrawal is dangerous is that as a CNS depressant that slows neural activity in the brain when the drug is abruptly stopped brain activity can rebound and accelerate out of control. Prolonged Xanax users should not attempt to withdraw from the drug without medical supervision.Drug Rehabilitation Drug Rehabilitation
is an umbrella term for a variety of processes by which a person addicted to a
drug stops using that drug. These processes can vary from cold turkey to the use
of substitute drugs which do not have the same action upon the state of consciousness
as the original drug to which the person was addicted. Oxycontin Addiction: Oxycontin is a prescription painkiller used for moderate to high
pain relief associated with injuries, bursitis, dislocations, fractures, neuralgia,
arthritis, lower back pain and pain associated with cancer. It contains oxycodone,
an opium derivative and is produced in a time released tablet. Oxycontin commonly
referred to as OC, OX, Oxy, Oxycotton and kicker, was introduced in 1996 and has
had a rapid escalation of abuse. The tablets can be chewed, crushed and snorted
like cocaine, crushed and dissolved in water and then injected like heroin. The
most serious side effect is respiratory depression, particularly dangerous for
the elderly. Oxycontin
addiction and demand has resulted in pharmacy robberies and forged
prescriptions. The estimated number of people aged 12 or older with an oxycontin
addiction has increased from 1.9 million in 2002, to 3.1 million in 2004.
The largest increase occurred among young adults aged 18 to 25. Inpatient Treatment is most often residential in that they require that the client live within the facility during treatment. Inpatient treatment centers and programs are a higher level of care than outpatient programs and provide more intensive services and treatment than lower levels of the care continuum.
Valium is a benzodiazepine with properties of being a sedative, hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant drug. Valium is generally used to treat short term moderate to severe anxiety or insomnia. The drug has been shown to lead to the development of tolerance, physiological and psychological dependency when used for long periods.
Uses of Valium
Valium is useful for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety. In cases of acute alcohol withdrawal, Valium may be useful in the relief of hallucinations, paranoia, acute agitation, tremors, or acute delirium tremens.
Valium is a useful for the relief of muscle spasms, spasticity caused by neurological disorders (e.g. cerebral palsy and paraplegia), stiff-man syndrome; and tetanus.
Valium is very useful in the treatment of status epilepticus and recalcitrant recurrent convulsive seizures.
Valium is a useful premedication for relief of anxiety and apprehension in patients who are to undergo surgical procedures. Intravenous administration takes effect within a few seconds to relieve the anxiety.
Side Effects of Valium Include:
CNS- lethargy, fatigue, difficulty walking, mental confusion, depression, difficulty with speech, headache, dizziness, tremor and sleepiness
GI: constipation, nausea, vomiting
GU: loss of bladder control, impotence, failure to maintain erection
Heart- slow heart rate, low blood pressure and shock.
HEENT: altered vision, double vision,
Skin: skin rash, urticaria.
Other: hiccups, mouth dryness, liver problems
Sometimes an individual will develop paradoxical reactions to valium which may include anxiety, hyperexcitation, hallucinations, increased muscle spasticity, insomnia, anger and insomnia. All individuals who take long term valium should have their liver function regularly monitored.
Valium Abuse Potential
Although valium is invaluable in the treatment of anxiety disorders, it has the potential for abuse and may cause dependence/addiction. It is important to distinguish between addiction to and normal physical dependence on valium. A number of valium abusers also abuse other illicit drugs. Valium is usually a secondary drug of abuse, used mainly to potentiate the “high” obtained from other drugs. However, even legitimate and therapeutic usage of valium is associated with an inherent risk of addiction and physical/psychological dependence.
The symptoms typically occur after sudden discontinuance of diazepam. The more severe withdrawal symptoms have usually been limited to those patients who had received excessive doses over an extended period of time. Generally milder withdrawal symptoms (e.g., dysphoria and insomnia) have been reported following abrupt discontinuance of valium taken continuously for several months.
Therefore, after prolonged therapy with valium, abrupt discontinuation should generally be avoided and a gradual dosage tapering schedule followed. Addiction-prone individuals (such as drug addicts or alcoholics) should be under careful surveillance when receiving diazepam or other psychotropic agents because of the predisposition of such patients to habituation and dependence.
Valium Precautions
Valium should be injected with a great deal of caution in the elderly and in those with difficulty breathing. Concomitant use of valium with alcohol, other CNS depressants and barbiturates can cause respiratory arrest.
When Valium is used in combination with any narcotic, the dosage of both valium and the narcotic should be started at the lowest dose and slowly titrated based on symptoms. In some cases the use of a narcotic may be curtailed. Resuscitative equipment including that necessary to support respiration should be readily available.
Valium users should be cautioned against engaging in hazardous occupations requiring complete mental alertness, such as operating machinery or driving a motor vehicle. The impairment is worsened by consumption of alcohol, because both act as central nervous system depressants. The effects of long-acting benzodiazepines can also linger over to the following day.
Tolerance
Tolerance develops to many of the therapeutic effects of valium rapidly with daily or frequent use. Generally, tolerance to the hypnotic and sedative effects occurs within days, however, tolerance to the anxiolytic effects of valium rarely, if ever, occurs.
Dependence
Long-term valium usage generally leads to some form of tolerance and/or dependence. It is estimated that up to 50 percent of patients prescribed diazepam for 6 months at therapeutic dosages are physically dependent. Withdrawal symptoms due to abrupt discontinuation may include
• Insomnia
• Anxiety
• panic attacks
• fast heart rate/palpitations
• Hypertension
• Depression
• Tremors/ hyperactivity
• sweating
• Loss of appetite
• agitation and mental clouding
Therefore, any individual on long-term or high dosage of valium should be slowly and carefully weaned off the drug, preferably under medical supervision by a physician who is a specialist in addiction medicine. Withdrawal symptoms can usually be avoided or minimized by use of a long half-life benzodiazepine and very gradually tapering off the drug over a period of many weeks or even months.
Onset of the withdrawal syndrome from long half-life benzodiazepines might be delayed, although withdrawal from short-acting benzodiazepines often presents early. Some of the withdrawal symptoms are identical to the symptoms for which the medication was originally prescribed. The ability to determine the difference between relapse and rebound is very important during the withdrawal phase.
Intoxication
Overdosage of valium, particularly when combined with alcohol, may lead to coma, or repsiratory arrest. The antidote for all benzodiazepines is flumazenil, a benzodiazepine antagonist, which is occasionally used empirically in patients presenting with unexplained loss of consciousness in an emergency room setting. As with all overdose situations, the physician must be aware of the possibility that other/multiple substances were ingested by the patient.
Legal Status
Nearly all medically-used benzodiazepines are Schedule IV in the USA under the Federal Controlled Substances Act. Even though valium is a commonly prescribed class of drugs, the Medicare Prescription Drug, Improvement, and Modernization Act specifically states that insurance companies that provide Medicare Part D plans are not allowed to cover benzodiazepines.
This article was last modified on 4/11/2007.
References 1. Atack JR. Anxioselective compounds acting at the GABA(A) receptor benzodiazepine binding site. Current drug targets. CNS and neurological disorders. 2003 Aug;2(4):213-32.
2. Gerada C, Ashworth M. ABC of mental health. Addiction and dependence--I: Illicit drugs. BMJ 1997;315:297-300.
3. O'Brien, CP. "Benzodiazepine use, abuse, and dependence", Journal of Clinical Psychiatry. 2005;66 Suppl 2:28-33.
4. Sternbach LH. The discovery of librium. Agents Actions 1972;2:193-6.
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