\n<\/p>\n
Victoria Ratliff, the wealthy financier\u2019s wife on season 3 of HBO\u2019s \u201cThe White Lotus<\/a>,\u201d has a problem: She keeps popping pills.<\/p>\n And her drug of choice, the anti-anxiety medication lorazepam, has left her a little loopy.<\/p>\n In the show, which follows guests vacationing at a fictional resort, Victoria pairs her medication with wine, which leads her to nod off at the dinner table. Sometimes she slurs her words.<\/p>\n When she notices that her pill supply is mysteriously dwindling, she asks her children if they\u2019re stealing them.<\/p>\n \u201cYou don\u2019t have enough lorazepam to get through one week at a wellness spa?\u201d her daughter, Piper, asks.<\/p>\n<\/div>\n<\/div>\n \u201cThe White Lotus\u201d is not the only show to recently feature these drugs. The new Max series \u201cThe Pitt<\/a>,\u201d which takes place in an emergency department, includes a story line about a benzodiazepine called Librium.<\/p>\n This isn\u2019t a case of Hollywood taking dramatic liberties. Benzodiazepines such as lorazepam and chlordiazepoxide are notorious for having the potential to be highly addictive. They may also come with difficult \u2014 sometimes fatal \u2014 withdrawal symptoms.<\/p>\n The characters\u2019 misuse of benzodiazepine drugs is not uncommon, said Dr. Ian C. Neel, a geriatrician at UC San Diego Health. \u201cWe definitely see that a lot in real life as well.\u201d<\/p>\n And in recent years, he added, studies have shown<\/a> that it\u2019s a bigger problem than doctors initially realized.<\/p>\n The drugs, which are often called benzos or downers, are commonly used to treat anxiety, panic attacks and sleep disorders like restless leg syndrome. But they can also be used for other reasons, such as to help people manage alcohol withdrawal.<\/p>\n<\/div>\n<\/div>\n Other common benzodiazepines include diazepam (Valium), clonazepam (Klonopin) and alprazolam (Xanax).<\/p>\n Unlike antidepressants, which can take weeks to start working, most benzodiazepines can provide relief within minutes \u2014 which can comfort nervous fliers and others who need quick anxiety relief for a specific situation. But if taken for longer periods, patients can develop a tolerance within weeks of starting the drug, even when using it as prescribed, said Dr. Ludmila De Faria, <\/strong>chair of the American Psychiatric Association\u2019s council on women\u2019s mental health.<\/p>\n \u201cThat\u2019s where people get into trouble,\u201d she added, and start to take more of the medication. \u201cThe same dose will no longer get rid of the symptoms.\u201d<\/p>\n In addition, drugs like <\/em>clonazepam and diazepam last longer in the body than short-acting drugs such as alprazolam. \u201cPeople don\u2019t realize that,\u201d she said. \u201cSo they take multiple doses and it accumulates,\u201d which can result in people \u201cwalking around like they have a couple of drinks in them.\u201d<\/p>\n<\/div>\n<\/div>\n All of these factors combined have led to the drugs being widely misused<\/a>. In 2019, the most recent data available, pharmacies dispensed an estimated 92 million benzodiazepine prescriptions, according to the U.S. Food and Drug Administration<\/a>. Research suggests that the drugs are prescribed most frequently to adults between the ages of 50 and 64<\/a>.<\/p>\n<\/div>\n<\/div>\n In 2020<\/a>, the F.D.A. updated the information given to prescribers and patients for all benzodiazepines to warn about the risks of physical dependence, withdrawal reactions, misuse, abuse and addiction.<\/p>\n Ideally, these dangers are explained to a patient before they take their first pill. But that doesn\u2019t always happen. And even if a patient does receive proper counseling, \u201cit\u2019s one thing to say it and then another thing to experience it,\u201d Dr. Neel said.<\/p>\n He said he often sees patients who are already taking a cocktail of other medicines and don\u2019t understand the dangers of combining benzodiazepines, which are depressants, with other drugs that also have sedating effects, like sleep medicine or Benadryl.<\/p>\n And if you\u2019re going to drink alcohol or use cannabis, it\u2019s best not to have any benzodiazepine in your system. When people combine substances that have a depressant effect, it can even interfere with their breathing.<\/p>\n<\/div>\n<\/div>\n The geriatric population that Dr. Neel treats is especially vulnerable because benzodiazepines are metabolized differently as we age, he added, lingering in the body for a longer period of time. As a result, older people who take them may be more prone to falls or car accidents. The drugs can also cause delirium in patients who have dementia.<\/p>\n But the medications can be risky for people of any age, which is why they are typically prescribed for a short period of time \u2014 usually four weeks or less \u2014 and they are considered a last resort to treat a chronic condition, Dr. Neel said.<\/p>\nA Widely Misused Collection of Drugs<\/h2>\n
Delirium, Falls and Other Risks<\/h2>\n
A Delicate Withdrawal Process<\/h2>\n