Medical Use And Abuse

The benzodiazepines are among the most widely prescribed psychotropic medicines in the world. The World Health Organization (1988) labeled them "essential drugs" that should be available in all countries for medical purposes. Of the widely used psychotropic drugs, they are the least likely to cause any adverse effects, including serious medical complications and death.

Workplace drug testing is usually limited to identification of marijuana, cocaine, morphine-codeine, amphetamine-methamphetamine, and phencycli-dine (PCP). However, benzodiazepines and barbiturates may be added to the test panel. Laboratory positive test results for patients with legitimate prescriptions for benzodiazepines and barbiturates are reported to employers by medical review officers (MROs) as negative, as are other laboratory results that reflect appropriate medical treatment with other controlled substances (MacDonald, DuPont, & Ferguson, 2003).

Several important health concerns about benzodiazepine use that are unrelated to addiction have been expressed, especially about the long-term use of benzodiazepines, including the effects on the brain, the possibility of cerebral atrophy associated with prolonged benzodiazepine use, and other problems, such as memory loss and personality change (American Psychiatric Associa tion Task Force on Benzodiazepine Dependence, Toxicity and Abuse, 1990; Golombok, Moodley, & Lader, 1988). The evidence for these problems is both preliminary and disputed, except for the well-studied acute effect of benzodiazepines on memory, which has no clinical significance for most patients.

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