Drugs of Abuse - Benzodiazepines B

Question 1

Examples of benzodiazepams

Answer 1

• Short acting
  
  • Temazepam, oxazepam
• Medium acting
  
  • Lorazepam, alprazolam
• Long acting
  
  • Diazepam, nitrazepam, chlordiazepoxide

Question 2

Acute effects of benzodiazepams

Answer 2

• Forgetfullness
• Drowsiness
• Impaired concentration and co-ordination

Question 3

Chronic effects of benzodiazepams

Answer 3

• Impaired concentration and memory
• Depressed mood

Question 4

How long does dependency take

Answer 4

3-6 weeks of regular use

Question 5

MANAGEMENT

General

Answer 5

• Harm reduction advice
• Specifying safe injecting advice
• Consider managed detox or transfer to maintenance prescribing in established dependence

Question 6

Investigations

Answer 6

• Urine screen
• Blood tests

Question 7

PRESENTATION

Symptoms of benzodiazepine withdrawal

Answer 7

• Appear within 24 hours of stopping short acting, but up to 3 weeks for longer acting
  
  • Anxiety
  • Insomnia
  • Agitation
  • Depersonalisation
  • Headache
  • Seizures
  • Delirium
  • Tremor
  • Nausea
  • Sweating

Question 8

MANAGEMENT

Substitute prescribing

Answer 8

• Diazepam - divide the dose to avoid sedation