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Welcome back to the Easing Anxiety blog series, "What We Learned from the Benzo Survey," where we dive deep into the data from the Benzodiazepine Survey of 2018/2019 to learn more about benzos, BIND, and the individuals who have taken these medications.
In our first posts in this series, we explored age groups, gender, country, drug type, and warnings. Today in our fifth installment, we look at how many respondents took different medications at the same time and whether or not they took their medications as prescribed by their doctor. Check out the findings below.
*** Scroll to the end of this post for details about the survey and research team. ***
CONCURRENT MEDICATIONS
Most of the survey respondents (83.6%) took more than just a single benzodiazepine and over half (56.2%) took two or more medications at the same time. The most significant pairing was between benzodiazepines and antidepressants. 45% of those who had taken benzodiazepines also took some type of antidepressant. Since SSRIs and SNRIs are commonly prescribed to individuals in benzo withdrawal, this finding may not be surprising.
If we look at the benzodiazepine class only, 52.4% (632) of the respondents only took one benzo, 23.0% (278) took two, 14.0% (169) took three, 5.7% (69) took four, and 3.5% (42) took five or more. One respondent even stated that they took 10 different benzodiazepines.
Taking multiple psychiatric medications — what is commonly referred to as polydrugging — is not uncommon in mental health treatment and can create a nightmare scenario for individuals dealing with physical dependence and/or addiction (SUD).
Question (n=1,207):
Did you take different medications concurrently (at the same time) or sequentially (different ones at different times).
TAKEN AS PRESCRIBED
Over 90% of the respondents took their benzodiazepine mostly as prescribed. Only 8.7% definitely did not.
This key finding backs the experience of most professionals in the benzo community. The majority of individuals we work with have taken their medication as prescribed by their doctors — and while substance use disorder (SUD) can happen with benzodiazepines, it is rare. Most complications we've seen have nothing to do with SUD or addiction, but instead are caused by physical dependence, withdrawal, and BIND.
Question (n=1,207):
Was your benzodiazepine med always taken 'as prescribed,' in the dose recommended by a doctor?
References
Survey papers are listed below.
About the Benzodiazepine Survey
About the Research
The largest survey of its kind, "The Benzodiazepine Survey of 2018/2019" was created and administered by Jane Macoubrie, PhD and Christy Huff, MD. Over 1,600 individuals took the survey, resulting in 1,207 qualified respondents. The survey constituted 20 questions, including demographic inquires. Some of these questions had multiple sub-questions and/or allowed multiple answers.
The survey generated three published research papers in scientific journals (as noted below) between April 25, 2022 and June 29, 2023. The research team is still together working on new benzodiazepine-related research projects.
Special thanks to the Alliance for Benzodiazepine Best Practices for sponsoring and organizing this research.
Published Papers
PAPER 1 — April 25, 2022
Finlayson AJ, Macoubrie J, Huff C, Foster DE, Martin PR. Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey. Therapeutic Advances in Psychopharmacology. 2022;12. doi:10.1177/20451253221082386. https://journals.sagepub.com/doi/full/10.1177/20451253221082386.
PAPER 2 — February 6, 2023
Huff C, Finlayson AJR, Foster DE, Martin PR. Enduring neurological sequelae of benzodiazepine use: an Internet survey. Therapeutic Advances in Psychopharmacology. 2023;13. doi:10.1177/20451253221145561. https://journals.sagepub.com/doi/10.1177/20451253221145561.
PAPER 3 — June 29, 2023
Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, Martin PR. (2023) Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey. PLOS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584.
Research Team
Research Team / Authors (alphabetical)
A. J. Reid Finlayson, MD, MMHC — Vanderbilt University Medical Center
D E Foster — Benzodiazepine Action Work Group / Easing Anxiety
Christy Huff, MD — Benzodiazepine Information Coalition
Peter R. Martin, MD, MSc — Vanderbilt University Medical Center
Alexis Ritvo, MD, MPH — University of Colorado Anschutz Medical Campus
Bernard Silvernail — The Alliance for Benzodiazepine Best Practices
Acknowledgements
The Alliance for Benzodiazepine Best Practices — Sponsoring Organization
Jane Macoubrie, Ph.D. — Survey originator
Jo Ann LeQuang — Medical Writer
Limitations
This study has several limitations.
The study reported on ‘suicidal thoughts’, which can range from fleeting notions of self-harm to passive desperation, preparatory planning, and disinhibition. Suicidal thoughts may be underreported, even in an anonymous online survey, as respondents might hesitate or be embarrassed to report self-destructive thoughts.
There was no control group. Much of the survey dealt with symptoms presented in multiple-choice lists, and it is possible that patients may have been suggestible to the list presented, may not have correctly remembered past symptoms, or may incorrectly attribute certain symptoms or feelings to benzodiazepines.
We did not account for a nocebo effect.
The large number of write-in comments suggests that many respondents felt the survey did not allow them to fully describe the extent of their experiences and emotions.
Another limitation of our survey is that it recruited respondents from social media and online sources that deal with benzodiazepine use and withdrawal. Respondents were self-selected, forming a convenience sample that may not represent the population of benzodiazepine users as a whole because visitors may have sought sites such as these specifically because they have experienced problems. Moreover, those who use the Internet for health information tend to be younger, and those who join online support groups for medical conditions tend to be in generally worse health. Our results thus may not be generalizable to the population of all people taking benzodiazepines.
Data Analysis
A medical statistician produced the initial results of this survey utilizing SAS Software. Subsequent data analysis was performed in greater detail by an experienced data scientist who imported the survey data into a custom SQL Server data model.
Customized queries were employed to obtain correlations among the data. In particular, this analysis examined conditions for which benzodiazepines were prescribed and compared them to symptoms and adverse life effects reported by patients who were tapering or had discontinued benzodiazepine use.
All analyses were delivered via a structured reporting process and validated against the original SAS reports. The survey was made available online through websites and internet benzodiazepine support groups and general health and wellness groups.
The data scientist mentioned above is D E Foster, who is also the author of this blog series and the founder of Easing Anxiety. D has been a member of the Benzodiazepine Survey Research Team since 2019, providing general benzodiazepine knowledge and lived-experience in addition to formal data analysis and reporting. Prior to his withdrawal from benzodiazepines, D worked as a database developer and data scientist for over 25 years.
For Informational Purposes Only
All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician.
This article was written by a living, breathing, human person.
Please read our site disclaimer for more information.
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