Impacts of Benzodiazepines on Human Health
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Long-term Prescribed Use: Long-term use (over 2-4 weeks) can lead to heightened anxiety, increased risk of accidents and falls, persistent insomnia, impaired learning, higher suicide rates, greater risk of dementia, and reduced efficacy of treatments for PTSD and panic disorders. Withdrawal effects are observed in 20-80% of patients stopping usage​​.
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Inadequate Cessation Advice: Many patients struggle to obtain proper cessation advice, with prescriptions often abruptly stopped, leading to dangerous outcomes like severe withdrawal symptoms or even death​​.
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Long-Term Disability: Patients using benzodiazepines may experience long-term disability, persisting for years. The lack of medical support for benzodiazepine-related injuries has historically been handled mostly by members of the public​​​​.
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Informed Consent Issues: There are concerns about the process of informed consent in benzodiazepine prescriptions, emphasising the need for patients to be fully aware of risks and alternatives​​.
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Side Effects: Long-term use is linked with numerous side effects like memory and cognitive impairments, sleep issues, neuropathy, increased risk of Alzheimer’s disease, and tremors​​.
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Impact on Mental Health Therapy: Benzodiazepines interfere with mental health therapies by impeding the ability to retain information and form memories, crucial for effective anxiety therapies​​.
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Concerns for the Elderly: Benzodiazepines are particularly concerning for the elderly, with prescriptions continuing to rise despite being listed as potentially inappropriate drugs for this age group​​.
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Environmental Impact of Benzodiazepines
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Persistence in Water Environments: Benzodiazepines are commonly detected in water environments and are persistent during conventional wastewater treatment, raising environmental concerns. They are discharged into municipal wastewater, surface waters, and seawaters​​.
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Impact on Aquatic Ecosystems: These drugs can negatively impact aquatic ecosystems. For example, diazepam at environmental levels can decrease the growth rate of Daphnia magna and increase mortality rates in young zebrafish. They can also alter the social behaviour and feeding rates of freshwater fish like European perch​​.
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Ineffective Conventional Treatment Processes: Conventional water and wastewater treatment processes (like biological processes, coagulation, filtration, and chlorination) are ineffective in removing benzodiazepines, leading to their discharge into receiving waters​​.
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Global Prevalence: Benzodiazepines have been used in more than 80 countries, with over 195 tons manufactured globally in 2019. Most of these drugs, not being completely metabolised in the body, end up in water systems.