The Problem of Prolonged Withdrawal Syndrome (PWS)

Benzodiazepines and ‘Z’ drugs are frequently coprescribed to pain patients. They were developed for legitimate medical needs, but unbridled success and application has led to serious problems, some of which are known. The potential extreme duration of the withdrawal syndrome, however, is virtually unknown by providers and regulators. Patients suffer, not knowing the symptoms have a cause and not having medical professionals to turn to for help. They may become “difficult” patients, marginalized, or told that their symptoms are psychological. Paradoxically, the simplicity and success of GABA-A receptor knowledge has distracted from studying other pharmacology of these drugs. A glaring example is the almost universal lack of awareness of peripheral benzodiazepine receptors. Despite the higher risk, benzodiazepines have not been increased in scheduling per the DEA’s Controlled Substances Act. This course will address the unmet and largely unrecognized medical need of overprescription, dependence, and withdrawal, and discuss actionable change to improve the knowledge, attitudes, preemptions, and practices of stakeholders. (Recorded at PAINWeek 2018)