NBC News recently featured a segment on another worrisome drug epidemic – benzodiazepines. The report featured a patient, a cardiologist, who took Xanax to help with insomnia. She followed the directions taking one pill at night as she was prescribed. Within three weeks, her body was dependent upon the drug. Her journey on the drug-induced nightmare has not been easy.
Benzodiazepines, also known as Benzos or Downers, is a class of drugs that depress function in the central nervous system. They are approved for insomnia, sleep disorders, anxiety, muscle spasms, acute alcohol withdrawal, and seizure disorders and are used in other off-label situations. The most common benzos are Valium, Xanax, Halcion, Ativan, and Klonopin. The drugs alprazolam/Xanax, clonazepam/Klonopin, and lorazepam/Ativan are amongst the top 10 most commonly prescribed psychiatric medications.
The NBC News report also featured Dr. Anna Lembke, Chief of Addition Medicine at Stanford University Medical Center. As an expert in her field, she has taken a stance in speaking out about the dangers of these prescription medications. In the New England Journal of Medicine February 22, 2018 issue, Dr. Lembke reported on the addictive dangers of benzodiazepines. Here are some findings pertaining to this silent drug crisis.
The number of adult benzodiazepine prescription fills rose from 8.1 million to 13.5 million or 67 percent increase between 1996 and 2013. Dosage amounts per prescription tripled in that time. Death due to drug overdose from benzos also dramatically increased. Worse yet, these drugs are often prescribed with opioids which increases the risk of serious and life-threatening adverse effects.
Dr Lembke notes, “Benzodiazepines have proven utility when they are used intermittently and for less than 1 month at a time. But when they are used daily and for extended periods, the benefits of benzodiazepines diminish, and the risks associated with their use increase. Many prescribers don’t realize that benzodiazepines can be addictive and when taken daily can worsen anxiety, contribute to persistent insomnia, and cause death. Other risks associated with benzodiazepines include cognitive decline, accidental injuries and falls, and increased rates of hospital admission and emergency department visits.” She continues by recommending other methods of drug treatment and behavioral interventions instead of benzos.
Benzos combined with opioids cause serious life-threatening risks. In fact, the FDA applied its strongest warning – a black box warning on the use of benzodiazepines with opioids. There are nearly 400 different drug products with benzos and opioids. Drug combination can cause extreme sleepiness, respiratory depression (failure), coma, and death.
Benzos suppress brain function by affecting the neurotransmitter GABA (gamma-amino butyric acid). GABA works in the brain by buffering or inhibiting nerve impulses. Benzos are thought to enhance the activity of GABA which creates the anti-anxiety and sedation effects.
Medications like Ativan, Xanax, and Klonopin may be needed for severe concerns and should be used with proper management. However, what about the individual who has occasional sleepless nights, anxiety from stress or overwork, or muscle soreness and is looking for or given a quick fix? A plan of action must be in place for proper medical management and discontinuation of the medication with the warning that the drug is addictive. A healthier, safer way is to be proactive to take care of oneself with nutritional fortification and self-care techniques.
The Brain Requires Nutrients for Relaxation
Relaxation and stress tolerance requires healthy GABA function and receptor sites in the brain. If these receptor sites are faulty or impaired from lack of nutrients and oxidative stress, GABA cannot “dock” on the receptor site to do the job of relaxation and inhibition. In addition, cell membrane and nerve excitability or relaxation and electrical activity depends on several nutrients. Essential fatty acids like the omega-3 fish oil DHA, along with electrolytes like magnesium and potassium are essential nutrients for calming nerve excitability and cell stability.
The brain requires magnesium to buffer glutamatergic or excitatory stimulus from the neurotransmitter glutamate. Magnesium helps support GABA release and decrease stress hormones in the brain.
Historical use of lemon balm (Melissa officinalis) has often been used for its relaxation properties in the mind and body. Animal research shows that lemon balm helps decrease stress hormones and increase GABA levels in the brain. In addition to lemon balm, other herbs have been historically used to help support relaxation, sleep, and stress and GABA function. These include passion flower, ashwagandha, hops, chamomile, and others. Research shows that these herbs help naturally and safely modulate GABA-pathways.
Fisetin, a naturally occurring flavonoid may also help GABA receptors throughout the body. Researchers found that fisetin helps support and protect nerve function due to its antioxidant effects. 2016 research showed fisetin has an affinity for GABA receptors in the spinal cord which may help relaxation, nerve pain, and stress throughout the body.
Some of the first indications that the brain is running low with nutritional support pertains to changes in energy production and mood. This may be seen as anxiety, irritability, and poor mood. Sleep often gets disrupted with brain stress and not enough rest, relaxation, and nutritional vitality.
Here are some articles to help expand your knowledge base on how to help support a healthy brain, mood, stress tolerance, and sleep.
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Research shows that the use of the herb, vinpocetine, may help offset the some of side effects due to benzodiazepines. Some benzodiazepines also deplete zinc and copper out of the body. Supplementation may be needed if the diet is lacking in zinc (shellfish, pumpkin seeds, nuts, legumes, eggs, and red meat) and copper (seafood, kale, mushrooms, seeds, nuts, beans, dried fruit, avocados, goat cheese, and organ meats). Some benzodiazepines also injure mitochondria.
The patient in the NBC story continues to struggle with drug withdrawal. Even with her medical training and appropriate prescription use of the benzos, she abruptly became a statistic after just three weeks. It is important to recognize when we need to take care of ourselves. Small disruptions that manifest with occasional mood stress, sleep disruption, and increased wear-and-tear must be managed before crisis and engrained problems are locked in that require mind-numbing, potentially highly addictive drug.
Benzos are incredibly powerful. We preach to our kids not to get hooked on the big street drugs like heroin and cocaine, yet the benzo addiction happens in properly prescribed medications and is a drug of choice for illicit use too. Benzodiazepines create a high risk and burgeoning problem on the society. Thankfully, steps are being taken to help announce this problem. Drugs have the appeal of quick fixes and are made glamorous in TV commercials. The solution starts with you, good nutrition, self-care, and good stress management. Nutrition and diet may be mundane compared to the lure of quick-fixes, but it is certainly much safer and required for healthy daily function.