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As a final comment regarding mixing benzos and opioids, I inquired on the SDN psych board regarding BZD practices taught in contemporary psych residencies and several points were driven home by those practicing pyschiatrists.
1- absolutely no one should ever ever be written xanax bid, tid, qid!
1a- no one should be on chronic Xanax, period
2- most pysch only use daily benzos as part of induction until they are stable on a non addicting anxiety medication, and even that is fairly rare.
3- # of patients which truly require daily benzo are extremely small, and if daily BZD it should be long acting like klonopin and very low dose.
4- Some patients do benefit from 3-5 benzos a month for true emergencies, but again, not daily usage and certainly not TID usage, and not xanax!
5- weaning benzos is a huge pain, just like weaning high dose COT patients
So basically 98% of the patients send to us for pain consults who are also on chronic daily benzos shouldn't be on BZD, so I feel quite justified in telling these chemical copers, they don't get both opioids and benzos, and really most of those patients should not be written for either med.
Benzo vs other options for anxiety
1- absolutely no one should ever ever be written xanax bid, tid, qid!
1a- no one should be on chronic Xanax, period
2- most pysch only use daily benzos as part of induction until they are stable on a non addicting anxiety medication, and even that is fairly rare.
3- # of patients which truly require daily benzo are extremely small, and if daily BZD it should be long acting like klonopin and very low dose.
4- Some patients do benefit from 3-5 benzos a month for true emergencies, but again, not daily usage and certainly not TID usage, and not xanax!
5- weaning benzos is a huge pain, just like weaning high dose COT patients
So basically 98% of the patients send to us for pain consults who are also on chronic daily benzos shouldn't be on BZD, so I feel quite justified in telling these chemical copers, they don't get both opioids and benzos, and really most of those patients should not be written for either med.
Benzo vs other options for anxiety