The Benzodiazepines Crisis

by John Peppin (Editor), Joseph V. Pergolizzi (Editor), Robert B. Raffa (Editor), Steven L. Wright (Editor)

Overview

Developed decades ago to treat a legitimate medical need, benzodiazepines promisingly displaced less-effective and less-safe drugs, though prescribing has since exceeded their intended use and outpaced the available data. The current situation is characterized by excessive prescribing and extended utilization beyond good therapeutic practice. Evidence indicates that prolonged use of benzodiazepines causes a wide range of adverse reactions, and withdrawal can be particularly challenging. Misused, abused, diverted, and counterfeited, benzodiazepines have serious potential for substance use disorder, and are among the leading causes of drug-related overdose deaths. The Benzodiazepines Crisis sounds the alarm against the overuse of benzodiazepines, presenting an updated, evidence-based overview of this class of drugs and their negative consequences. Bringing together years of research, clinical expertise, and scientific evidence, this book aims to address a perceived lag between evidence and action in order to call for rational and dramatically reduced usage of benzodiazepines.

Product Details

ISBN-13:	9780197517277
Publisher:	Oxford University Press
Publication date:	10/21/2020
Pages:	288
Product dimensions:	9.10(w) x 6.10(h) x 0.90(d)

About the Author

John Peppin, Clinical Adjunct Professor, Marion University, College of Osteopathic Medicine, Joseph V. Pergolizzi, Chief Operating Office, NEMA Research, Robert B. Raffa, Adjunct Professor, University of Arizona College of Pharmacy, Steven L. Wright, Medical Director, Mountain Medical Care

John F. Peppin, DO, FACP, is board certified in Internal Medicine and pain medicine. Elected Fellow of the American College of Physicians, Kentucky Colonel in 2009, and PainWeek 2011 Clinician of the Year. He currently is a consultant in the areas of pain, palliative and internal medicine and Clinical Adjunct Faculty for Marian University, College of Osteopathic Medicine. He has published over 70 articles in the fields of pain management, palliative care, internal medicine and bioethics and edited books and given numerous lectures, papers and posters at national and international conferences. Dr. Peppin has been a principle investigator for over 80 clinical trials, as well as having other research projects and grants in his career including in conjunction with the NIH.


Joseph V. Pergolizzi, Jr., MD, is Chief Operating Office of NEMA Research, chairman of the Abstract and Poster Selection Committee for PAINWeek, and a member of the CHANGE PAIN Board. Dr. Pergolizzi's research interests focus on acute and chronic pain in adults with a particular focus on pain in the elderly. Dr. Pergolizzi has held various adjunct and/or part-time academic positions and faculty over the past decade. He is the author of more than 100 peer-reviewed articles, abstracts, platform presentations and book chapters in his areas of interest and expertise.


Robert B. Raffa, PhD, is Adjunct Professor at the University of Arizona College of Pharmacy and Professor Emeritus at Temple University School of Pharmacy. He is a cofounder of CaRafe Drug Innovation and the CSO of Neumentum Inc, both companies directed to the discovery and development of non-opioid analgesics. He has published more than 300 papers in peer-reviewed journals, and co-authored or edited several books on pharmacology and thermodynamics and is a Co-Editor of Journal of Clinical Pharmacy and Therapeutics. He is a past president of the Mid-Atlantic Pharmacology Society of ASPET and is the recipient of research and teaching awards.


Steven Wright, MD, is a residency-trained family physician with a 37-year clinical career. Board-certified in addiction medicine and experienced in medical pain management, he is involved in a variety of roles including medical director of Mountain Medical Care. His clinical interests include the neurophysiology and treatment of pain and addiction, non-opioid analgesia, opioids, benzodiazepines, cannabis, best practices, and systems of care. He is the medical consultant for The Schreiber Research Group and the Alliance for Benzodiazepine Best Practices.

Table of Contents

Overview ix

Foreword: Addiction A. J. Reid Finlayson xi

Foreword: Pain Lynn Webster xiii

Foreword: Patient Advocacy Bernie Silvernail xvii

Foreword: Patient Carrie Silvernail xix

Preface John F. Peppin Joseph V. Pergotizzi Jr. Robert B. Raffa Steven L. Wright Contributors xxv

Benzodiazepines: A Chronology xxvii

1 Introduction: The Origins and Rise of Benzodiazepines Michael M. Miller John F. Peppin 1

2 The Evolution of Benzodiazepine Receptor Agonists: Developments in Pharmacology and Toxicology Jamie L. Hansen Timothy J. Atkinson 6

3 Benzodiazepine Therapy: The Good, the Bad, and the Ugly Jeffrey Guina Brian Merrill Jo Ann LeQuang 17

4 Use of Benzodiazepines and Z-Drugs in the Geriatric Population Jan M. Kitzen 41

5 The Central Benzodiazepine Receptor Michael H. Ossipov 68

6 Benzodiazepine Receptors in the Periphery Robert B. Raffa 81

7 Drug Withdrawal: A Modern Motivational View and Neurobiological Substrates George F. Koob 97

8 Benzodiazepine Withdrawal: Clinical Aspects Steven L. Wright 117

9 Benzodiazepines and Pain Management John F. Peppin Steven L. Wright 149

10 The Regulatory History of Benzodiazepines in the Age of the Dark Web and Other Threats John J. Coleman 160

11 Benzodiazepines Today and Tomorrow: What We Know and Don't Know About Them John J. Coleman 193

12 In Search of Benzodiazepine Guidelines Jo Ann LeQuang 216

Conclusion John F. Peppin Joseph V. Pergohzzi Jr. Robert B. Raffa Steven L. Wright 237

Disclosure Agreements 239

Index 241