Psychopharmacology and Psychiatry Updates

Benzodiazepines: Understanding Physical Dependence vs. Addiction

May 11, 2025
Alexis Ritvo, a board-certified addiction psychiatrist and Assistant Professor at the University of Colorado, shares insights on benzodiazepine use disorder. She clarifies the crucial distinction between physical dependence and addiction. Surprisingly, only 1.5% of users develop a use disorder despite common concerns. The discussion delves into responsible prescribing practices and the necessity of monitoring for potential misuse. Listeners gain valuable knowledge on recognizing warning signs and promoting safe medication use.
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ANECDOTE

Case Illustrates Use Challenge

  • A 32-year-old patient with panic disorder reported taking extra alprazolam doses and ran out early.
  • This exemplifies common challenges distinguishing appropriate use from developing benzodiazepine use disorder.
INSIGHT

Low Addiction Rate

  • Only 1.5% of benzodiazepine users develop a use disorder, less than clinicians often assume.
  • Physical dependence is common but should not be conflated with addiction.
ADVICE

Strategies to Minimize Risk

  • Screen for addiction risks and check prescription databases before prescribing benzodiazepines.
  • Use routine drug testing when possible to guide safer prescribing and monitor misuse.
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