Clinics Struggle to Curb Xanax Abuse

Clinics around the country have stopped prescribing the anti-anxiety drug Xanax. The reason – an 89 percent increase in emergency room visits nationwide related to the abuse of benzodiazepines like Xanax between 2004 and 2008, according to figures from the U.S. Centers for Disease Control.

One of those clinics is Seven Counties in Louisville, Kentucky, which aims to wean its Xanax patients off the drug by the end of the year. According to The New York Times, Xanax, and its generic equivalent, alprazolam is one of the three most-prescribed controlled substances in Kentucky, along with hydrocodone and oxycodone.

“The top two drugs that are abused and diverted in Kentucky are narcotics like oxycodone and Xanax,” Dr. Scott Hedges, director of Seven Counties told WLKY.com.

Seven Counties Nurse Practitioner Gayle Mink agreed, calling Xanax “the most OD’d on, the biggest and baddest of the agents.”

The clinic has decided it will no longer write prescriptions for the anti-anxiety medication. At Seven Counties, 3,000 patients who were on Xanax have been switched to clonazepam, a longer-acting benzodiazepine that does not kick in as quickly and is thought to pose less risk of addiction. It doesn’t come with the same high as Xanax, or the same withdrawal problems. The goal is to eventually wean those patients from clonazepam, The New York Times said.

According to the Times, Xanax poses a particular risk for abuse and withdrawal because its effects are felt almost immediately, but last only a few hours. Users soon want more, and their tolerance for the drug increases quickly. People addicted to opiates like oxycodone find Xanax attractive because they fear withdrawing from opiates. But quitting Xanax can also cause severe withdrawal symptoms, especially panic attacks that are even worse than the ones that prompted a patient to seek medical help in the first place.

While more and more clinics are trying to move patients off Xanax, the Times says the practice remains contentious. Some doctors say that refusing to prescribe certain drugs under any circumstance is overly rigid, noting that Xanax helps many people who use it responsibly.

According to a report from BNET.com, one of the problems with Xanax is that while the U.S. Food & Drug Administration (FDA) does require an addiction warning for the drug, it is not highlighted in the Black Box the agency uses for its most important safety notices. This says BNET.com, allows Pfizer to downplay addiction on its website for Xanax XR. It’s included in small gray type at the bottom of the web page, “buried amid other less serious warnings about sleepiness and not operating heavy machinery.”

According to BNET.com, communities are trying other methods to get a handle on the Xanax abuse epidemic. Atlanta, Georgia, for example, is considering a ban on new “pill mill” clinics. Other Georgia counties, including Marietta, Woodstock, Cartersville, Milton and Kennesaw, have all at one time or another suspended licensing of new clinics.

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