Addiction Rotations

So have you guys heard what is next? You know how we call this the opioid epidemic? So what happens when patients cannot get a hold of opioids and no doctor is willing to treat their chronic pain legitimately? ( By the way legitimately means with all non-opioid medications as well okay? Not all treatment has to be an opioid. There are like 10 different medications and even therapies that help a lot with pain management.)

So the next epidemic is going to be benzodiazepines. For one everyone uses benzodiazepines to get over the opioid withdrawal is the experience but then they also quickly realize that benzodiazepines like Xanax help calm down their anxieties and presto we have the next epidemic. Should we treat chronic anxiety with benzodiazepines? Not anymore than we should treat chronic pain with just opiates.

We really need to focus on treating things properly. This means using opiates sparingly for true legitimate pain management issues. And it means using benzodiazepines for only true legitimate occasional mental issues. Opioids and benzodiazepines are not daily drivers. Think of them as small fire extinguishers we keep in the kitchen. They are great to put out an occasional grease fire but imagine watching a fireman run into a burning building with an arm full of small fire extinguishers. Do you think that would be a smart move? Probably not.

I think we would rather see him dragging in a big long firehose in addition to 20 other guys supporting him from 20 different angles using 20 different kinds of tools. Could a fireman get away with an arm full of tiny fire extinguishers? Maybe once in a while. But eventually it would bite him in the rear. That is what is happening with benzodiazepines and opiates. They are there to put out small fires but not to be used for the daily Treatment.

So many people are so afraid to come in and even have discussions about other methods of treating anxiety and so afraid that the first thing I will do is take their benzo away. Nothing could be further from the truth. All we need to do is sit down and think about which tools make the most sense and are the most safe and then gradually migrate away from the benzos ( not necessarily off just lower and safer) and migrate towards the safer medications.

Stay alive
Andreas J. Edrich MD FASAM ADM MRO “the addiction doc”