Benzodiazepines are widely used in our country, with seven different names among the top 20 medicines purchased directly by customers with a prescription at pharmacies. This alone shows that their use goes beyond the theoretical indication of limited or occasional use, considering that for long-term treatment there are now preferred alternatives (for example, in the treatment of epilepsy).
Data on requests for treatment related to benzodiazepine problems roughly correspond to the ranking of the most widely used benzodiazepines, although some in particular are especially prominent among those associated with problematic use.
Lormetazepam (MINIAS), lorazepam (TAVOR, CONTROL), bromazepam (LEXOTAN, COMPENDIUM), alprazolam (XANAX, MIALIN), zolpidem (STILNOX), and triazolam (SONGAR, HALCION). Others have been banned, not so much because of dependence itself, but because they have been associated with misuse, including so-called “date-rape” drugs, or because they have been abused by people already using other drugs (flunitrazepam – RHOYPNOL, DARKENE).
For reasons that are not known, the first drug in particular is at the top of the statistics for abuse, especially among people who use “mega-doses.” Abuse occurs both with the liquid formulation and with tablets, and in a minority of cases through intravenous administration.
Use in combination with, or as an alternative to, other medicines (such as painkillers), alcohol, or non-pharmaceutical drugs is not uncommon. However, there is an increasing number of cases in which dependence begins with a tranquilizer in people with no previous involvement with other drugs. Several cases involve people who develop dependence at a relatively advanced age. In the past, those affected were predominantly women; nowadays, the ratio between the sexes is more balanced.
There is probably no clear reason why some compounds are prohibited while others remain on the market. Not from a scientific standpoint, at least. It is important to understand that some compounds carry a significant risk of abuse, and this is not simply because someone consciously decides to abuse them, nor because of the original reason for taking them (insomnia, anxiety). This property is related to the characteristics of the compound itself, and dependence goes beyond the intentions of anyone involved, including someone who initially intends to use the drug for non-therapeutic purposes.
Dependence is probably not the same in every case, but there is currently a therapeutic approach. There is both an acute intervention, which may require hospitalization and is used to cover the initial phase, and the possibility of outpatient treatment, in which differences among benzodiazepines in their potential for abuse can actually be used therapeutically. Some benzodiazepines have properties that allow them to interfere with the dependence phenomena stimulated by others. In this way, certain benzodiazepines can act as regulators, helping to extinguish pathological craving. The underlying principle is analogous to that of other treatments that have been available for a long time for other forms of addiction.