Louisville Community Health Center Bans Xanax To Curb Problems With Abuse: Is This a Good Thing?

 In Louisville, Kentucky, community health center Seven Counties Service is attempting to combat a grave pill abuse problem by refusing to write prescriptions to Xanax, the New York Timesreported. Patients already taking Xanax will be gradually weened off it, but newcomers will be flat-out denied the anti-anxiety medication. 

Highly addicting, Xanax is used to treat debilitating anxiety and panic disorder, and it has become a staple medication in psychiatry, as well as in the illegal drug culture. In Kentucky as the rest of America, pill use and abuse is rampant. Benzodiazepines like Xanax and Klonopin contributed to an 89% increase in Kentucky emergency room visits between 2004 and 2008. Xanax, when mixed with other drugs, like opioids, becomes especially deadly.  So deadly, in fact, that pill overdoses alone have become the second leading cause of accidental death in America. 

To save lives and fight the draining of resources funneled into handling addicts, Seven Counties Service is abandoning Xanax altogether.  The decision is bold: Xanax withdrawal is so terrible that users can actually die from it.  But by weening patients off the drug and continuing to treat them, SCS is attempting to avoid problems surrounding withdrawal, such as dangerous relapse and illness.  

Cutting off access to particular pills does not only affect addicts.  Patients who did well with Xanax will have to switch to other meds, but the clinic maintains that most are comfortable with their new treatment.  Clonazepam, known by its brandname Klonopin, is still offered at the clinic because its slow-release formula prevents the dreary high associated with Xanax's fast-acting formula. Clonazepam, however, is popular to abuse just as well, and when snorted or injected, produces the same kind of high as Xanax.  The pill must remain available because to deny people access to medication is unfair and cruel. But addicts are sick people too, and when they do not get their drugs, they are in desperate need of treatment. 

It is a complicated issue, and the clinic, which mostly serves the poor, is inheriting the problems - or corruptions -  of other physicians. 

From The New York Times:

Dr. Hedges said that while Seven Counties bore some blame for prescribing Xanax in the first place, many patients initially got it from primary care doctors. Alprazolam is one of the three most-prescribed controlled substances in Kentucky, along with hydrocodone andoxycodone, according to the state’s Cabinet for Health and Family Services.

“We pick these folks up way down the road,” said Dr. Robert Caudill, a Seven Counties psychiatrist, “where they’re already on a big dose and don’t want to give it up because they’ve been given no skills along the way” for otherwise dealing with panic and anxiety.

For people dependent on opiates, Xanax can be especially alluring because the fear of withdrawing from the opiates is so huge. After someone has experienced opiate withdrawal, Dr. Caudill said, “they really are scared to go into it again because it’s so horrible.”

The over-prescribing of medications is a huge problem in America, but cutting down on prescriptions will not solve the problem.  Opioid users often turn to heroin, the street equivalent of oxycodone pills like OxyContin.  And Xanax users, should they be denied access to all benzos, will become sick and even die if untreated. They may also turn to other drugs or, perhaps worse, take too large a dose of Xanax once they are finally able to obtain the drug, thus overdosing because their tolerance had decreased.  

Doctors must be held responsible for their prescriptions, and pharmaceutical companies must be accountable for their pill pushing.  But treating addicts, the victims of big pharma's greed, should be our first priority. And conscious community centers like Seven Counties Service do not have the resources to do it alone. 

AlterNet / By Kristen Gwynne

Posted at September 16, 2011, 5:23am

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