This won’t surprise anyone on here, but does confirm what we are all anecdotally seeing. I occasionally browse Reddit’s subreddits (basically topic specific subforums) for doctors, psychiatrists and other medical professionals. Reddit’s demographics trend on the younger side so I assume a lot of these doctors are in their 30’s.
The subject of benzos comes up pretty regularly and the general consensus among these young docs is that benzos are outdated meds with little-to-no therapeutic value and many refuse to prescribe them at all unless they inherited an older patient who has taken them for years. In that case they immediately move to push a taper plan regardless if the patient is doing well and not abusing.
For patients with anxiety, panic, and other related disorders, the most often recommendations are starting an SSRI/SNRI, which they really believe are so effective they should almost completely replace benzos. If that doesn’t work, next step is CBT therapy. If that doesn’t work they will refer to a psychiatrist for evaluation of a short term course of small dose benzos while they try and adjust different antidepressants. They also recommend lots of crap like hydroxizine, tramadol, buspar, and clonidine.
If internists/family medicine MD’s actually do prescribe any amount of benzos, I often see they will purposely make it as embarrassing and onerous as possible so patients will give up or look for another doctor. All the usual things like under-prescribing, mandatory monthly in-person visits, mandatory drug testing, addiction assessments, predetermined date which the benzo will be discontinued, etc.. This level of scrutiny is even advised for occasional PRN benzo use.
There is also a serious disdain for benzo patients and you see a lot of comments about patients just hiding from reality because they have an inadequate ability to adapt to normal stressors and basically just need to suck it up and learn how to be an adult. Extremely patronizing and arrogant coming from the professionals who are supposed to be the ones to help folks like us.
Finally, they are definitely aware of many of the ways we obtain our meds, be it through concierge medical practices, telehealth doctors, old-school psychiatrists, etc.. and there is a push to report these doctors to the DEA and ostracize any docs who regularly prescribe benzos. Thankfully, I haven’t seen places like PR mentioned.
As a PRN user of benzos for 30-years it’s certainly concerning. I’ve dealt with my issues for about as long as many of these doctors have been alive. I’ve tried every antidepressant known to man with little to no benefit and often serious side effects. I’ve also seen more therapists than I can count and have never found one that I felt addressed or even understood my issues.
I know what works for me that allows me to continue to work and be a contributing member to society. And I’m doing pretty good! But, If I lost my meds I have no doubt I would lose my job and would probably become an alcoholic. It’s so disappointing and I am fearful what the medical world will look like in the coming decade.
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