Discussion: Impact of the Problem – Nursing Assignment Gurus

NURS 8502 Discussion: Impact of the Problem

Discussion: Impact of the Problem

Since their discovery in the 1950s, the popularity of benzodiazepines (BZDs has significantly grown and are among the most widely used drugs in treating mental disorders in the population. The use of BZDs in the treatment of numerous psychiatric conditions has dramatically risen, with the drug gaining popularity as the primary pharmacological mainstay in relieving sleep and anxiety disorders and acting as an add-on therapy for addressing severe symptoms for schizophrenia. Although clinical practice guidelines (CPGs) recommend limited use of BZDs to offer adjunctive short-term relief, about one in every four patients with a mental condition use the medicine to eradicate adverse symptoms of anxiety disorders (Benard et al., 2018). Recently, the field of clinical medicine has made considerable advances towards identifying the benefits and risks associated with the use of BZDs and the working principle of the medication. The increased use of BZDs, the negative side effects, and the dangers of abusing the drug made this project imminent to provide particular training interventions to minimize numerous malpractices in the prescription of the drug among prescribers misusing of the drug by the patients.

The current prescriber malpractices in the prescription of BZDs and misuse of the drug among patients with mental disorders can result in various dangers. Empirical evidence shows that these drugs can severely impact career, relationships, physical and emotional health due to their misuse (Malloy, 2021). Cognitive impairment is one of the most common problems linked to the misuse of BZDs. The drug can cause drowsiness, motor incoordination, increased reaction time, anterograde amnesia, and ataxia, which degrade mental functioning. Second, BZDs increase the risk of causing an accident because drivers using the drug almost have the same rates as those driving while under alcohol. Third, patients using BZDs risk suffering from hip fractures. Empirical evidence shows that using BZDs increases the dangers of hip fracture by around 50% (Malloy, 2021). The negative clinical features associated with this drug show that it does not fit into the current healthcare practice.

Impact of the Practice Change

The project’s purpose was to implement a change to lower the prescription and use of BZDs among mental health patients. Therefore, I held a conference call with the preceptor and chief medical operator (CMO) in Umass Memorial Community Health Link in Massachusetts to review the current policies of Benzodiazepines, previous educational in-services on Benzodiazepines and to identify the needs of the facility. The program’s goals were to reduce the usage of benzodiazepine in the facility through an increase in client and staff education on evidence-based clinical practice guidelines. There are various side effects of BZD use, including cognitive impairment, sedation, and increased risk of falls, wounds, and injuries. As a result, one of the long-lasting impacts of the change is that it will lower the use of BZDs in mental health settings, hence improving the health and wellbeing of the patients.

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Comprehensive knowledge of CPG guidelines and training on traditional pharmacological interventions would help minimize patient misuse of BZDs and prescriber malpractices. BZDs increase the risk of motor vehicle crashes that lead to devastating losses of life and

property. CPGs prevent the use of BZDs as first-line medications in treating mental disorders and only recommend adjunctive use of these drugs as short-time relievers awaiting administration of antidepressants. The practice change would create awareness of CPGs for the use of BZDs that would significantly help to reduce the number of motor vehicle accidents improving the morbidity and mortality of the population. I found from meeting with the preceptor and leading team that most healthcare workers lack knowledge regarding traditional pharmacological treatments like tricyclic antidepressants, lithium, and antipsychotics in the alleviation of negative effects of psychological disorders. Lack of knowledge regarding these interventions results in misuse of BZDs (Malloy, 2021). Therefore, this program sought to improve the knowledge of healthcare workers and patients concerning the traditional pharmacological interventions reducing the risks associated with the BZDs.

References

Bernard, M. M. T., Luc, M., Carrier, J. D., Fournier, L., Duhoux, A., Côté, E., … & Roberge, P. (2018). Patterns of benzodiazepines use in primary care adults with anxiety disorders. Heliyon, 4(7), e00688.

Malloy, M. A. (2021). Guideline Utilization to Promote De-escalation of Benzodiazepine Use in Adults with Generalized Anxiety Disorder.

RE: Discussion – Week 10

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Hi, F….. Great post! Misuse of benzodiazepines (BZDs) is indeed an issue of concern in healthcare today. Benzodiazepines include long-acting diazepam, chlordiazepoxide, flurazepam, clorazepate, along with intermediate-acting alprazolam, clonazepam, lorazepam, oxazepam, and temazepam with short-acting agents being midazolam and triazolam (Sarangi et al., 2021). BZDs are prescribed for a wide range of conditions, including insomnia, agitation, anxiety, and convulsions. However, when used in large quantities, benzodiazepines (BZDs) can also result in a dopamine rush, which is responsible for creating a sense of pleasure and reward (Sarangi et al., 2021). Flunitrazepam is a commonly abused drug and has been referred to as a date rape drug, roofies, or forget-me-pill (Sarangi et al., 2021). Over the past several years, there have been rising concerns about the misuse of benzodiazepines. Sarangi et al. (2021) based on a study that estimated 30.6 million adults (12.6%) reported benzodiazepine use in 2015-2016. These people report that 2.2% have misused a BZD prescription (Sarangi et al., 2021). Therefore, I agree with you education can be used to enlighten nurses and the members of the public on the appropriate use of the benzodiazepines (Schmitz, 2016)

References

Sarangi, A., McMahon, T., & Gude, J. (2021). Benzodiazepine Misuse: An Epidemic Within a Pandemic. Cureus, 13, 6.

Schmitz, A. (2016). Benzodiazepine use, misuse, and abuse: A review. Mental Health Clinician, 6, 3, 120-126.

Thank you for your post on the impact of benzos. I enjoyed reading from you this week. I agree that improper consumption of BZDs may increase automobile accidents, resulting in deaths and property damage. Promoting awareness of CPG for BZD usage will considerably assist in reducing the incidence of motor vehicle accidents, thereby lowering population morbidity and mortality. High dosages of benzodiazepines can cause people to display characteristic CNS-depressant side effects such as nystagmus, ataxia, slurred speech, and poor divided attention skills (Stone et al., 2015; Dassanayake et al., 2011; Drummer, 2002). As with hypnotics and sedatives, sleep deprivation or situations that cause drowsy driving might reduce the mental capacity to concentrate and stay focused. Benzodiazepines generate a wide range of physiological and psychological reactions in people, frequently leading to catastrophic behavioral changes and negative impacts on driving skills. Examples are decreased lane control, higher response times, decreased hand-eye coordination, and cognitive impairment (Stone et al., 2015, Drummer, 2002).

It is well understood that long-term or incorrect usage of benzodiazepines can develop tolerance and psychological and physical dependency. When you stop using benzodiazepines, you may have withdrawal symptoms such as anxiety, perceptual disturbances, and tremors. As a result, correct benzodiazepine prescribing is crucial to avoiding benzodiazepine addiction and withdrawal issues. Switching to a long-acting benzodiazepine in both withdrawal and maintenance treatment is beneficial unless the patient is elderly (Brett & Murnion, 2015). Brief treatment approaches and supervised progressive withdrawal of benzodiazepines may be recommended. It has been proven to be more beneficial than simply discontinuing use.

References

Brett, J., & Murnion, B. (2015). Management of benzodiazepine misuse and

dependence. Australian Prescriber, 38(5), 152–155. https://doi.org/10.18773/austprescr.2015.055

Dassanayake, T., Michie, P., Carter, G., & Jones, A. (2011). Effects of benzodiazepines, antidepressants and opioids on driving. Drug Safety, 34(2), 125–156. https://doi.org/10.2165/11539050-000000000-00000

Drummer O. H. (2002). Benzodiazepines – effects on human performance and

behavior. Forensic Science Review, 14(1-2), 1–14.

Stone, B. T., Correa, K. A., Brown, T. L., Spurgin, A. L., Stikic, M., Johnson, R. R., & Berka, C.

(2015). Behavioral and neurophysiological signatures of benzodiazepine-related driving impairments. Frontiers in Psychology, 6, 1799. https://doi.org/10.3389/fpsyg.2015.01799