Benzodiazepines, opiod analgesics and other sedatives have indispensable medical uses, but they can also stimulate the reward center in the brain. In susceptible individuals, this can lead to sedative abuse and misuse (defined as any use of those prescription medications outside of the intent for which it was prescribed), and create a plethora of serious consequences. Sedative use disorders are regarded as considerable contributors to disability and mortality worldwide. Despite strict government regulation of these drugs in most of the countries, their abuse and its consequences have not only persisted, but also increased. Therefore physicians who are in charge of prescribing sedatives have a significant role in reversing such trends. One …show more content…
Abuse of benzodiazepines is commonly defined as non-medical, recreational use for the sole purpose of creating an intoxicated or "high" state of mind. The National Survey on Drug Use and Health conducted in the United States in 2010 revealed an estimated 186 thousand new abusers of benzodiazepine drugs. Studies suggests that the abuse burden of benzodiazepines may only be evident in specific clinical populations, most notably in detoxified alcoholics and recreational users of other types of drugs. In addition, the abuse of benzodiazepines among individuals kept on opioid agonists (e.g. methadone and buprenorphine) has been repeatedly described in the medical literature. In accordance with the latter claim, the U.S. Treatment Outcome Prospective Study showed that 73% of heroin users entering into treatment reported some extent of benzodiazepine use in the preceding year, with substantially lower rates of barbiturate use. Furthermore, almost 25% of such patients reported daily benzodiazepine …show more content…
Thus, attention should be focused on maintaining adequate oxygenation, airway, as well as hemodynamic support. Supplemental oxygen and aspiration prevention are considered the cornerstones of treatment. Invasive therapy (other than respiratory support) is rarely required in patients with sedative overdose. Hemodialsysis is sometimes considered when patients who overdose with large quantities of chloral hydrate develop life-threatening cardiac symptoms. 24 hours of observation is requred for patients overdosed with long-acting sedative hypnotics such as clonazepam. Albeit the effectiveness of delayed orogastric lavage is not confirmed, this approach is often considered in overdoses with sedatives that slow the motility of the gastrointestinal tract or those that develop concretions (namely meprobamate and phenobarbital). The use of orogastric lavage in overdose cases should always be done with