Beyond Prejudice in Prescribing Benzodiazepines in Disadvantaged Communities

• Published in: International journal of applied psychoanalytic studies 2014-06, Vol.11 (2), p.130-137
• Main Authors: Webber, Patricia, Cohen, Ralph L.
• Format: Article
• Language: English
• Subjects: benzodiazepines; cost containment; harm reduction; personality disorders; trauma
• ISSN: 1742-3341; 1556-9187; 1556-9187
• DOI: 10.1002/aps.1406

ABSTRACTThis paper argues for the use of benzodiazepines as a harm reduction strategy when combined with long‐term psychotherapy for high‐risk adults with personality disorders resulting from chronic exposure to trauma and current unstable living conditions. This prescribing practice is outlined based on a review of 185 cases in therapy at a community mental health clinic. The careful use of benzodiazepines can increase engagement in therapy in a population often resistant to outpatient treatment. The approach is clearly a harm reduction effort to prevent clients from cycling through the emergency room and county correctional facilities. The risks of benzodiazepine misuse are reviewed and procedures for monitoring risk are detailed. There is a prejudice identified in the use of benzodiazepines that is based on society's condemnation of euphoric experiences rather than on a medical basis alone. Benzodiazepines are suggested as a harm reduction strategy as well as an alternative in the control of serious mental health symptoms such as delusions, hallucinations, and panic. Copyright © 2014 John Wiley & Sons, Ltd.