Strongest FDA Warnings Out on Opioid, Benzodiazapine Risks

The Food and Drug Administration (FDA) has issued its strongest warnings that prescription opioids and benzodiazapines pose major risks to users, especially if they are taken together or in combination with alcohol.

In a notice published at http://www.fda.gov/Drugs/DrugSafety/ucm518473.htm, the FDA told health care professionals to stop prescribing opioid cough medicines for patients taking benzodiazapines — or other depressants of the Central Nervous System (CNS) including alcohol. They should prescribe opioids for pain only when other treatment options are inadequate.

Opioids — such as codeine, hydrocodone (HYSLINGA, NORCO, ZOHYDRO) and oxycodone (OXYCONTIN) — are widely prescribed for pain and cough. Benzodiazepines — such as diazepam (VALIUM) and alprazolam (XANAX) — are often used for anxiety, insomnia, seizures, and sleep problems.

Combinations of these drugs can cause extreme sleepiness, slowed or difficult breathing, coma, and death, the FDA said. Get details at the web site, and be sure to scroll down and click up several additional pages which explain the risks and list the dozens of opioids and benzodiazapines on the market.

The FDA said it now requires black-box warnings — its strongest warnings — on the dangers of combining opioid pain medications with benzodiazepines. Public Citizen’s Health Research Group lists most opioids as “Limited Use,” noting that they are overprescribed and can be addictive. They list most benzodiazepines as “Do Not Use,” with the exception of alprazolam, which is Do Not Use except for panic disorder.

Yes, the PCP doesn't even prescribe meds to my family member, all meds go through pain clinic and they have reduced meds signaficantly. My question is what is the goal of a pain mgt. clinic? Are they supposed manage pain or has the focus now switched to reduction of pain medication? Are they all entered for a drawing at the end of the year for a trip to a tropical destination based on the # of people they are documenting as having a reduction of medication? The pcp tells one thing and the pain clinic dr. says something else. What is the truth. When in chronic pain and somebody says the pain is unbearable and quite frankly would rather just give up than live in pain what good have you served them by removing a potentially harmful medication from them? I get you have people who drug shop but there are millions of other people who do not.

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@galady

Well, isn't that wonderful for me. I'm 72 with insurable pain disease. What am I supposed to do?

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@jimhd, can you ask your PCP whose restrictions he's dealing with? Is the FDA warning becoming another authority's requirement? Is the Justice Department involved? Is the CMS (Medicare and Medicaid) threatening to not pay on the basis of dosage or combinations? Is this a case of a state Medicaid agency or program placing restrictions? Are insurance companies threatening to not pay? If so, how do they know about dosage? Which companies? Are there any organizations gearing up to resist the dosage and combination limitations?

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@stfnwtl89 I liked what you said. I have maintained for a long time that some objective measure of individual pain must be developed so that much of the problems with pain medication can be resolved. To the best of my knowledge, there is little research going on in this area and even less funding being provided for it. 19lin

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@galady

Well, isn't that wonderful for me. I'm 72 with insurable pain disease. What am I supposed to do?

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@predictable

The clinic my doctor works with is under the hospital umbrella. The dosage decree came from them. I don't know how the decision was made by them. I might see if I can find out.

Jim

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@galady

Well, isn't that wonderful for me. I'm 72 with insurable pain disease. What am I supposed to do?

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I believe it is requiem ent of the DEA. These Dr's are scared to death of the DEA. they can close down, arrest, or lose their licence. I'm on my 4th opinion, but the DEA can red flag me for "doctor shopping". It's bad.

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@stfnwtl89

Yes, the PCP doesn't even prescribe meds to my family member, all meds go through pain clinic and they have reduced meds signaficantly. My question is what is the goal of a pain mgt. clinic? Are they supposed manage pain or has the focus now switched to reduction of pain medication? Are they all entered for a drawing at the end of the year for a trip to a tropical destination based on the # of people they are documenting as having a reduction of medication? The pcp tells one thing and the pain clinic dr. says something else. What is the truth. When in chronic pain and somebody says the pain is unbearable and quite frankly would rather just give up than live in pain what good have you served them by removing a potentially harmful medication from them? I get you have people who drug shop but there are millions of other people who do not.

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Follow the money and fear of DEA.

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kdoconnell2003 I was on Clemazopam on and off since January of 2018. I have used it steady (at .5 mg) for about a month now. I am withdrawing now, but I am experiencing blurry vision. I am taking Paxil 25mg CR and am now using Trazodone 50mg for sleep instead of Clemazopam.. A week ago my psychiatrist recommended melatonin at 9mg but it didn't work. Is there any discussion on blurred vision? Does melatonin cause blurred vision or is it the benzodiazapine? After withdrawing from a benzodiazepine, does your vision go back to normal? If so, how long does it take, or will it stay blurred?

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@kdoconnell2003

kdoconnell2003 I was on Clemazopam on and off since January of 2018. I have used it steady (at .5 mg) for about a month now. I am withdrawing now, but I am experiencing blurry vision. I am taking Paxil 25mg CR and am now using Trazodone 50mg for sleep instead of Clemazopam.. A week ago my psychiatrist recommended melatonin at 9mg but it didn't work. Is there any discussion on blurred vision? Does melatonin cause blurred vision or is it the benzodiazapine? After withdrawing from a benzodiazepine, does your vision go back to normal? If so, how long does it take, or will it stay blurred?

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Hello @kdoconnell2003– Welcome to Mayo Clinic Connect. You will notice that I moved your topic to this already existing discussion thread. Members here are talking about FDA warnings and Benzo risk. There is a wealth of information here. Feel free to ask questions to the participants in this group.

Have you talked with your doctor about your blurred vision?

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