Tufts Medical Center psychiatrist Dr. Edward Silberman: ‘Benzos safer than aspirin’

Abuse may be obscuring other dangers

The war against the opioid epidemic in Massachusetts may be pushing another potential public health crisis into the shadows.

According to research by the U.S. Centers for Disease Control and Prevention, benzodiazepines – a class of anti-anxiety and insomnia drugs, such as Ativan, Klonopin and Xanax – were involved in 31 percent of all opioid-related overdose deaths in 2014.

Benzos, the shorthand name for the drug class, relieve anxiety by slowing the central nervous system. Opioids work on the brain and nervous system in the same way. The combination of the two can severely depress respiratory activity, with life threatening consequences. CDC data from 1999 through 2014 shows that overdose deaths due to benzos has increased 600 percent from 1,135 people in 1999 to 7,945 people in 2014.

An analysis of the CDC data by Dr. Marcus Bachhuber for the American Journal for Public Health, found that between 1996 and 2013, the number of adults filling a benzodiazepine prescriptions increased 67 percent, from 8.1 million to 13.5 million people. And, among people who filled benzo prescriptions, the amount more than doubled between 1996 and 2013, suggesting higher doses per patient. The study also showed that benzo-related deaths rose at a faster rate than both the number of people filling prescriptions or the quantity filled.

State Rep. Paul McMurtry, D-Dedham, has proposed a bill to limit and regulate benzodiazepine prescriptions. A hearing on the proposal held at the Statehouse in April, which included emotional testimony from addicts, survivors and healthcare providers. The bill was sent back to committee on study order and could remain there for months. Fall River Rep. Carole Fiola, who co-sponsored the bill, says the state should be doing more to regulate the drugs. “Massachusetts has always been a leader in many areas of legislation, and we are bringing up a conversation that is important to a lot of people,” Fiola said. “That’s our role and we will continue to gather the facts and research this over the next several months, and see what comes from that.”

Opponents say the threat from benzos is overblown.

Tufts Medical Center psychiatrist Dr. Edward Silberman, who testified against the bill, said benzos are a relatively safe drug. Unless a patient suffers from addiction to other substances as well, benzos can’t do much harm, he said. “These medications, taken alone, are amongst the safest medications that doctors prescribe,” Silberman said. “They’re safer than aspirin. It’s practically impossible to kill yourself by overdosing on benzodiazepines.”

However, Dr. Richard D. Lewis, who has worked in a New Bedford mental health clinic for 20 years, says doctors need to understand the deadly interaction between benzos and opiates. He maintains a blog for an addiction website called Mad in America, where recent post focuses on the deadly mix. “I think this crisis is going pretty much unnoticed,” Lewis said. “I would argue that you can’t solve or make a dent into the opiate crisis without addressing the benzo issue. Lewis says opioid addicts often are given Suboxone or Methadone, which are opiates, themselves. These individuals will, Lewis says, experience anxiety or trouble sleeping, often leading doctors to prescribe benzos. And that, Lewis says, can contribute to opioid overdoses because of the negative interactions of the two drugs. “Benzos and opiates will kill you,” Lewis said. “It’s the synergistic effect of one plus one becomes five.”

Statistics on benzo-related deaths in Massachusetts are hard to come by. Most of the focus by pathologists has been on calculating and tracking opioid deaths. According to Felix Browne, a spokesman for the state Office of Public Safety, statistics for overdose deaths can be misleading. He said cause of death is pulled from death certificates, which can be hastily done. Any conclusive determination in final autopsy reports require a full toxicology screening that can cost upwards of $2,500. The state Medical Examiner’s Office usually doesn’t do such screenings unless there are suspicious circumstances or the family requests it and pays the cost. Final autopsy reports can take from a few months to a few years, due to backlog in cases. Until completed, there’s no way of knowing how much of each drug was in the victim’s system at the time of death.

“The Medical Examiner’s Office has their own way of operating that is very little understood.” Browne said. “Survivors just want to know how their loved one died so they can move on. That’s what the death certificate is for. It’ll say something like ‘acute intoxication’ or ‘cardiac arrest,’ but it’s often more than one substance that’s involved. They don’t know until the full autopsy report is filed.”

For now, it is unlikely any action will be taken on benzos.

Fiola says she hopes the bill will be reconsidered next session. But, Silberman says legislation isn’t the answer. “It’s really very difficult to legislate good medical practice. It’s a little bit like trying to legislate morality. You can have an impact, but it’s using a very broad brush to deal with a problem,” Silberman said. “In medicine, one should think about the individual patient, and one size doesn’t necessarily fit all.”

SCIENCE VS. CULT FEAR OF BUTTER

Re: Banned for spamming too many kitty pics
« Reply #219 on: July 18, 2012, 12:51:57 AM »

Colin

Quote from: wharfrat666 on July 15, 2012, 04:32:18 AM
but when someone is afraid of mayonnaise or butter, that’s an issue that should not be encouraged. Shame on you and your cohorts for not stifling such.

Why don’t you do your own research instead of just swallowing the crap from your friend. Though, frankly, I think you know the content posted at the blog is nonsense. The ‘butter’ stuff was at the benzowithdrawal.com forum (not BenzoBuddies), and as it was explained to me, like the vast majority of the stolen content appearing at the abusive blog, it was totally misrepresented. My experience is that 99% of the content there lies somewhere between deliberate misrepresentation, and damn lies.

The only mayonnaise stuff of which I am aware (and blogged about at the abusive blog) is a recent comment from a BB member stating that they prefer full-fat mayo over half-fat because off all the additional crap they put in the half-fat version. They just felt that, ‘on balance, a modest amount of full-fat mayo was a healthier option’. In what world should they be disciplined for such a statement? It is you and your friend that are the control freaks, not I, not the team here at BB. You!

Even if from time-to-time members should post something about an irrational fear, why is this a reason for them to be vilified, humiliated, and targeted? Why is it of any surprise that some people (particularly at a support forum where many members suffer from anxiety disorders) post about their anxieties and phobias? WharfRat: get – a – grip! Stop believing everything you read at your friend’s blog – read the original material – read it context – and if you still don’t like it: consider that the person posting it probably doesn’t deserve to be abused, have their words distorted, their visage superimposed upon a dog, their personal details published, or receive crank calls from a crank.

How food marketers made butter the enemy

James McWilliams—a historian who has made a name for himself in prestigious publications like the New York Times and The Atlantic for his contrarian defenses of the food industry—is back at it. In an item published last week in the excellent Pacific Standard, McWilliams uses the controversy over a recent study of saturated fat as a club with which to pummel food industry critics like the Times’ Mark Bittman.

Here’s what happened: A group including Harvard and Cambridge researchers analyzed 72 studies and concluded that there’s no clear evidence that ditching saturated fat (the kind found mainly in butter, eggs, and meat) for the monounsaturated and polyunsaturated kind (found in fish and a variety of vegetable oils) delivers health benefits.

Bittman responded to the study’s release with a Times item declaring that “butter is back.” His real point was more nuanced than that, though. The study’s conclusion “doesn’t mean you [should] abandon fruit for beef and cheese,” he wrote. Rather, he urged, “you [should] just abandon fake food for real food, and in that category of real food you can include good meat and dairy.”

Not so fast, McWilliams countered. He pointed out, correctly, that the study turned out to have errors, which the authors had to correct. But even after the corrections, the study’s lead author stood by the overall findings, Science reported. Another one of the authors told Science that the study’s main problem was the way it was covered by media. “We are not saying the guidelines are wrong and people can eat as much saturated fat as they want,” he told Science. “We are saying that there is no strong support for the guidelines and we need more good trials.”

Of course, headline aside, Bittman didn’t fall into that trap. He merely urged his readers to accept some fat when they’re “looking for a few chunks of pork for a stew,” and to use real butter in place of “I Can’t Believe It’s Not Butter.” Indeed, Bittman’s call for moderation in eating animal products is long-standing—he’s the author of a book called Vegan Before Six and a longtime champion of the “Meatless Mondays” practice.

But McWilliams’ real beef (so to speak) ultimately didn’t involve the study itself, or the debate over fat’s place in our diets. Rather, it centered on Bittman’s critique of the food industry, which Bittman blamed for stoking the public’s fat phobia, and manipulating to its own ends. McWilliams chides Bittman for the “disingenuousness of using a study on fat and heart health as grounds for condemning processed food,” and laments the “dubious manner in which processed foods are condemned.”

But he misses an important point: You can’t meaningfully debate the role of fat in our diets without looking hard at the way the food industry has manipulated the evolving scientific consensus around fat. On NPR last week, reporter Allison Aubrey showed how widespread fat phobia among the public gained traction from a 1977 decree by a US Senate committee that people should consume less saturated fat—which then got interpreted by the food industry as a license to promote sugar-laden, carbohydrate-rich products as “low fat” and thus healthy.

Simultaneously, as Bittman correctly noted, trans fats—cheap vegetable oils treated with hydrogen so that they remain solid at room temperature—emerged as the food industry’s butter substitute of choice for decades, providing the main substance for margarine. Based on relentless food industry marketing, generations of people grew up thinking trans-fat-laden margarine was healthier than butter—even after science definitively showed that it was much, much worse (a sorry tale I laid out here).

These fat-related marketing triumphs, quite profitable for the food industry, coincided with a surge in diet-related health troubles, including heightened obesity, diabetes, and metabolic-syndrome rates. Bittman is correct to discuss highly processed food in the context of the controversy over fat; and in trying to force it out of the conversation, McWilliams is playing his usual role: reasonable-sounding defender of a highly profitable but dysfunctional industry.

Cult laments destruction of benzowithdrawal.com

Tiffany
Buddie
« Reply #28 on: Today at 04:00:03 AM »

Hi,

Does this information mean that benzowithdrawal.com has shut down permanently?

Thank you.

Quote from: Colin on September 27, 2011, 09:19:55 PM
Hi all,

There appears to be some concern about what has happened to BW; there even have been worries that it has been hacked. My first thought was that Andrew (RUNVS) forgot to renew the domain, but this appears to not be the case – a ‘whois’ lookup indicates no recent changes to the domain details (so no change of ownership). It seems that the domain (benzowithdrawal.com) is now ‘parked’ with GoDaddy (Andrew’s webhost). ‘Parking’ is generally used for the purposes of making money by running adverts on webpages that are no longer being used.

I see that another site of Andrew’s, opiatewithdrawal.org, has been parked too. It seems unlikely, as has been suggested to our team, that BW (and OW) have been ‘hacked’. There is no evidence that there has been a security breach.

I can allay fears regarding ‘security’ at this forum. Our forum has not been hacked, nor was Andrew’s forum when he experienced problems last week. ‘Hacking’ refers to exploiting weaknesses in software; ‘cracking’ refers to compromising (weak) passwords. Although some accounts were indeed cracked at BW, as far as we know, no accounts were compromised here. Last week, we published some recommendations about how to properly secure your accounts with BB, and e-mail, etc. (link to follow). So long as you take reasonable precautions in generating passwords, do not share your passwords or login details, or fall for ‘phishing’ e-mail, your accounts at BB (and elsewhere) should be safe from cracking attempts.

http://www.benzobuddies.org/forum/index.php?topic=38876.0

 Logged

On benzo’s for almost four months for anxiety/stress.  Off benzo’s for almost 21 months, did a c/t unknowingly.  Symptoms are much better, but I continue to suffer with w/d’s each and every day.  I have always been very sensitive to medications.

Suggestions, opinions and/or advice provided by the author of this post should not be considered as medical advice and is no substitute for professional medical care. Consult your doctor before making any changes to your medication.

Hope1962
Senior Moderator
Online
Gender:
Posts: 1,894
« Reply #29 on: Today at 04:05:58 AM »

Yes Tiffany. It seems so.
Logged

2 mgs of clonazepam for 4 yrs.
6/29/11-2 mg to 1 mg in one day.-sick
7/25-.875 mg
8/4-.75 mg
8/15-.625 mg-sick
8/24-.562 mg
9/7-.5 mg.-tremors.
10/20-Have decided to continue to hold until stable.Buddie Blog:
http://www.benzobuddies.org/forum/index.php?topic=35136.310
About me and my role on the BenzoBuddies Team.Please read this message before sending me a PM.

Suggestions, opinions and/or advice provided by the author of this post should not be considered as medical advice and is no substitute for professional medical care. Consult your doctor before making any changes to your medication.