CPE
Jeffrey Gold, PharmD, BCPP
Long-term use of benzodiazepines has been known to produce complications related to discontinuation, withdrawal symptoms, increased risk of accidental overdose when combined with other central nervous system depressants, persistence of benzodiazepine-related adverse effects, physical dependence, and benzodiazepine use disorders.
In 2008, approximately 272,000 emergency department visits in the United States involved nonmedical use of benzodiazepines. In many of these visits (40%), benzodiazepines were used in conjunction with alcohol. In 2011, the number of nonmedical benzodiazepine emergency department visits increased to 426,000. Alcohol use was present in 24.2% of these visits.
From 1996 to 2013, the number of adults who obtained a prescription for a benzodiazepine increased by 67%. The number of benzodiazepines dispensed more than tripled during that same time period, from 1.1-kg to 3.6-kg lorazepam-equivalents per 100,000 adults. Data from the National Institute on Drug Abuse show that the number of overdose deaths involving a benzodiazepine increased from 1,135 in 1999 to 8,791 in 2015. Three-quarters of the deaths involving a benzodiazepine also involved an opioid.
Because of concerns about patient safety, several guidelines and expert consensus statements have cautioned against chronic benzodiazepine use, especially in older adults and other at-risk populations. Though benzodiazepines remain first-line treatments for acute alcohol withdrawal and may be used as acute anticonvulsants, they should generally be avoided for anxiety disorders, panic disorder, and insomnia. Other effective treatment options with superior safety profiles should be used when possible for these conditions. If a benzodiazepine is used, it should be limited to 2 to 4 weeks.
CPE assessment
This assessment must be taken online; please see “CPE information” in the sidebar on the previous page for further instructions. The online system will present these questions in random order to help reinforce the learning opportunity. There is only one correct answer to each question.
CPE information
To obtain the 2.0 contact hours (0.2 CEUs) of CPE credit for this activity, you must complete the online assessment with a passing grade of 70% or better, complete the evaluation, and CLAIM CREDIT at http://apha.us/CPE. You will have two opportunities to successfully complete the assessment, and the questions will be in randomized order. The current policy of the APhA Education Department is not to release the correct answers to any of our CPE tests.
This policy is intended to maintain the integrity of the CPE activity. Learners who successfully complete this activity by the expiration date can receive CPE credit. Please visit CPE Monitor for your statement of credit/transcript.
To claim credit
1. Go to http://apha.us/CPE.
2. Log in to your APhA account, or register as a new user.
3. Select “Enroll Now” or “Add to Cart” (click “View Cart” and “Check Out”).
4. Complete the assessment and evaluation.
5. Click “Claim Credit.” You will need to provide your NABP e-profile ID number to obtain and print your statement of credit.
Assistance is available Monday through Friday from 8:30 am to 5:00 pm ET at APhA InfoCenter by calling 800-237-APhA (2742) or by e-mailing infocenter@aphanet.org.