Benzodiazepines as Drugs of Abuse and Dependence

Cappell, Howard; Sellers, Edward M.; Busto, Usoa E.

doi:10.1007/978-1-4615-7743-0_2

Cited by 9 publications

(3 citation statements)

References 179 publications

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“…In recent years, barbiturates have been replaced by benzodiazepines in clinical use mainly because of the decreased toxicity of the latter group but also with the idea that they may be less prone to induce dependence (Mark, 1978). Recent experience, however, indicates that the benzodiazepines do, in fact, induce dependence (Cappell et al, 1986;Haefely, 1986;Lader, 1987Lader, , 1988Wood et al, 1987;Murphy and Tyrer, 1988). Since the benzodiazepines are now used extensively for various indications in man, the problem of dependence will increase in magnitude.…”

Section: Introductionmentioning

confidence: 93%

Cholinergic mechanisms in physical dependence on barbiturates, ethanol and benzodiazepines

Nordberg

Wahlström

1992

J. Neural Transmission

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The aim of this review is to summarize the effects of acute and chronic treatment with barbiturates, ethanol and benzodiazepines on cholinergic mechanisms in the brains of experimental animals. A single dose of each of these substances reduces the turnover of ACh in the brain. Long-term treatment has the opposite effect; complicated interactions including decreased content of ACh are induced. Barbiturates have been shown to bind stereospecifically to muscarinic and nicotinic receptors in the brain, but this has not been observed for ethanol or the benzodiazepines. The effects on the cholinergic system are affected by the length of treatment and choice of treatment regimen. No effect on cholinergic parameters, such as muscarinic receptors, in the brain is observed on withdrawal of ethanol or barbiturate treatment when the animals are still tolerant towards the substances. The increase in the number of muscarinic receptors observed in several brain regions on withdrawal is seen as a sign of cholinergic supersensitivity. The number of receptors returns to normal when abstinence convulsions have occurred. The assumption of a cholinergic influence is supported by the finding that atropine, given as a single dose on the day of withdrawal of barbital, can prevent the muscarinic receptor changes. Furthermore, long-term barbital or ethanol treatment can induce permanent persistent changes in the cholinergic system in the brain. Cognitive defects and a significant permanent reduction in the content of ACh can be measured in rats which have had long-term barbital treatment. Similarly, a reduced number of muscarinic receptors has been measured in different brain regions of chronic alcoholics. Accumulating data support the role of the cholinergic system in expressing symptoms of physical dependence on barbiturates, ethanol and benzodiazepines as well as in the permanent long-term effects observed after end of treatment.

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Section: Introductionmentioning

confidence: 93%

Cholinergic mechanisms in physical dependence on barbiturates, ethanol and benzodiazepines

Nordberg

Wahlström

1992

J. Neural Transmission

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“…Over the years, psychotropic dmgs, particularly benzodiazepines, have been identified as creating withdrawal symptoms and pharmacological and psychological dependence (Owen and Tryer 1983;Petemsson and Lader 1984;Cappell et al 1986;Montagne 1991;Smith 1985;Medawar 1992). They have also been found to be frequently abused by chemically dependent patients (DuPont 1990).…”

Section: The Medical Discourse On Psychotropic Drug Usementioning

confidence: 99%

“…Psychotropic drugs comprise one of the most commonly prescribed categories of drugs in industrialised countries. Over the past twenty years, the widespread use of these types of drugs and specifically the potential for abuse and dependency of benzodiazepines have become an area of concern for scholars in a variety of fields (Cappell et al 1986). In assessing the issue of psychotropics on an international scale, medical experts have suggested that if the character of psychotropic drug use is to be understood and indeed effective health and social policies are to be developed, the abuse potential and dependency liability of these drugs be thoroughly investigated (Idanpaa-Heikkila et al 1987, Medawar 1992.…”

Section: Introductionmentioning

confidence: 99%

Psychotropics, sociology and women: are the ‘halcyon days’ of the ‘malestream’ over?

Ettorre

Riska

1993

Sociology Health & Illness

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The purpose of this paper is to lay the foundation for the development of a gender-sensitive perspective on psychotropic drug use. This paper reviews existing research on psychotropic drug use and highlights gender biases in three ways. First, a review of the early work on gender differences in tranquilliser use reveals how 'one-dimensional' accounts are offered by proponents who are either 'no-objections', 'cautious-noanswer', 'women's-role' or 'political' advocates. Second, with special reference to women, a critical review of the two predominant discourses, the medical and the sociological, are outlined. It is argued that they have a common approach that makes women's drug use invisible. The paper concludes that the approach prevailing in current research is individualistic and gender blind and needs to be complemented with an analysis that problematises gender.

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