Victoria Ratliff, the wife of the rich financier in season 3 of “The White Lotus” of the HBO, has a problem: he continues to break out the pills.
And his favorite drug, the anti-anxiety drug Lorazepam, left it a little full.
In the show, which follows guests on vacation in an imaginary resort, Victoria combines her medicines with wine, which leads her to nod at the table. Sometimes he inserts his words.
When he notes that his escort of pills is mysteriously decreasing, he asks his children if they are stealing them.
“Don’t you have Lorazepam enough to spend a week in a wellness spa?” His daughter, Piper, asks.
“The White Lotus” is not the only show to recently present these drugs. The new Max series “The Pitt”, which takes place in an emergency room, includes a plot on a benzodiazepine called Libium.
This is no coincidence that Hollywood takes dramatic freedom. Benzodiazepine such as Lorazepam and Clordiazepiposido are famous for having the potential to be highly compelling. They can also come with difficult, sometimes fatal abstinence symptoms.
The improper use of Benzodiazepine drug characters is not rare, said dr. Ian C. Neel, UC geriatrician San Diego Health. “We certainly see it a lot also in real life.”
And in recent years, he added, studies have shown that it is a bigger problem than doctors have initially made.
A very abused collection of drugs
The drugs, which are often called benzos or downers, are commonly used to treat anxiety, panic attacks and sleep disorders such as restless legs syndrome. But they can also be used for other reasons, as if to help people manage alcohol retirement.
Other common benzodiazepines include Diazepam (Valium), Clonazepam (Klonopin) and Alprazolam (Xanax).
Unlike antidepressants, who can take weeks to start working, most benzodiazepines can provide relief in a few minutes, which can comfort nerve flyers and others who need rapid anxiety relief for a specific situation. But if taken for longer periods, patients may develop a tolerance within weeks of the start of the drug, even when they use it as prescribed, said Dr. Ludmila de Faria, President of the American Psychiatric Association for Mental Health of Women.
“Here’s where people get into trouble,” he added and start taking more drugs. “The same dose will no longer get rid of the symptoms.”
Also, drugs like Clonazepam and Diazepam last longer in the body than short -term drugs such as Alprazolam. “People don’t realize it,” he said. “So they take multiple doses and accumulate”, which can cause people “walk as if they had a couple of drinks.”
All these combined factors led drugs to be used improperly. In 2019, the most recent data available, the pharmacies paid an estimated prescription of 92 million benzodiazepine, according to the US food and Drug Administration. Research suggests that drugs are prescribed more frequently to adults aged between 50 and 64.
Delirium, falls and other risks
In 2020, the FDA updated the information provided to prescribers and patients for all benzodiazepines to warn the risks of physical dependence, abstinence reactions, improper use, abuse and dependence.
Ideally, these dangers are explained to a patient before taking their first pill. But this does not always happen. And even if a patient receives adequate advice, “it is one thing to say and then another thing to experience it,” said dr. Neel.
He said he often sees patients who are already taking a cocktail of other medicines and do not understand the dangers of combining benzodiazepine, who are depressive, with other drugs that also have sedating effects, such as sleep medicine or Benadryl.
And if you intend to drink alcohol or use cannabis, it is better not to have benzodiazepine in your system. When people combine substances that have a depressive effect, it can also interfere with their breath.
The geriatric population that Dr. Neel Treat is particularly vulnerable because the benzodiazepines are metabolized in a different way as we age, he added, lingering in the body for a longer period of time. Consequently, the elderly people who bring them can be more prone to falls or car accidents. Drugs can also cause delirium in patients with dementia.
But drugs can be risky for people of any age, which is why they are generally prescribed for a short period of time – usually four weeks or not – and are considered one last resource to treat a chronic condition, said dr. Neel.
A delicate withdrawal process
A study from 2019 discovered that almost 20 percent of people who improper benzodiazepines abuse them. If someone develops an addiction, quitting can be difficult, in part due to the intense symptoms of abstinence.
These symptoms can include sleep disorders, irritability, sweating, cardiac palpitations, high blood pressure problems and stomach like a dry lifting.
Knock the drug must be done kindly, ideally under the supervision of a doctor.
It is “almost like landing a plane, where there is a gradual descent,” said dr. John Torous, a psychiatrist of Beth Israel Deaconess Medical Center in Boston.
While this is happening, he added, the patient can try several methods to sleep more and speak with a therapist on strategies to help manage anxiety.
In addition, there are other drugs such as clonidine, which can be used to treat anxiety and also help with any abstinence symptoms.
In the end, it is increasingly effective to try to identify and face the main cause of anxiety, added Dr. Torous. “Benzos are giving you rapid relief in the brain but then one day they consume – that rapid relief has gone.”