Antianxiety agents (Forensic Science)
The drugs classified as antianxiety agents are frequently prescribed for patients complaining of tension, muscle strain, sleep problems, panic attacks, and phobias. Among the drugs’ effects are drowsiness, impaired social or occupational functioning, slurred speech, rapid mood changes, and impaired judgment; these effects become more pronounced with increased dosage. Because of the negative impact on occupational functioning that abuse of antianxiety agents can produce, many employment settings have implemented urine testing of employees to screen for these drugs.
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Benzodiazepines (Forensic Science)
The most commonly prescribed antianxiety agents are the benzodiazepines, which are classified as controlled substances by the U.S. Drug Enforcement Administration (DEA). These include such drugs as chlordiazepoxide (Librium), diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Tranxene), and lorazepam (Ativan). The benzodiazepines act on the central nervous system and produce intoxication and withdrawal symptoms. These drugs can produce physical and psychological dependence within two to four weeks of usage. The symptoms of withdrawal from antianxiety drugs can range form mild discomfort to severe reactions, including seizures. Some of the common symptoms include weakness, rapid pulse, tremor, insomnia, restlessness, nausea, hallucinations, and irritability. Sudden withdrawal from benzodiazepine dependence can lead to seizures and even death. Detoxification involves a gradual decrease of the drug over a period of weeks. Persons who are addicted to antianxiety medications often respond best to detoxification in residential treatment programs.
In medical practice, the benzodiazepines have replaced the usage of barbiturates for control of anxiety. Barbiturates were commonly used throughout the early to mid-twentieth century to induce relaxation, promote sleep, and quell tension, but they had a high abuse potential. Common barbiturates include amobarbital (Amytal), phenobarbital (Luminal), pentobarbital...
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Abuse and Negative Impacts (Forensic Science)
Although antianxiety agents are legitimately prescribed for the treatment of psychiatric disorders associated with anxiety, a large number of individuals use the drugs illicitly for their mood-altering relaxation effects. Some use only benzodiazepines, but others often use them in conjunction with other controlled substances, including stimulants and hallucinogens, to diminish anxious feelings; some use benzodiazepines with cocaine to reduce withdrawal symptoms or with heroin as a way to enhance the euphoric feelings heroin causes. Benzodiazepine abusers, the majority of whom are under forty years of age, account for approximately one-third of all substance-abuse-related hospital emergency room visits in the United States.
Benzodiazepine intoxication is associated with behavioral disinhibition that can result in heightened physical and sexual aggressiveness, especially when combined with alcohol use. The effects of benzodiazepines are additive to those of alcohol, and in combination the two can lead to respiratory depression that can result in death. In general, when the additive central nervous system depressant effects of alcohol are combined with a benzodiazepine, the results can include excessive sedation, cognitive impairment, and psychomotor slowing. The diagnosis of benzodiazepine intoxication is best confirmed through toxicological analysis of blood or urine samples.
Because of the disinhibition...
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Further Reading (Forensic Science)
Galanter, Marc, and Herbert D. Kleber, eds. Textbook of Substance Abuse Treatment. Washington, D.C.: American Psychiatric Publishing, 2004. Extensive volume provides information concerning the effects of substance abuse in the workplace and describes strategies to overcome the problems.
Meyer, Robert G., and Christopher M. Weaver. Law and Mental Health: A Case-Based Approach. New York: Guilford Press, 2006. Focuses on the various legal issues surrounding drug abuse. Includes discussion of drug screening and informed consent.
Sales, Bruce, D., Michael Owen Miller, and Susan R. Hall. Laws Affecting Clinical Practice. Washington, D.C.: American Psychological Association, 2005. Describes the issues associated with mental health professionals’ bringing evidence to trial in criminal and civil litigation.
Simon, Robert I. Concise Guide to Psychiatry and Law for Clinicians. 3d ed. Washington, D.C.: American Psychiatric Publishing, 2001. Brief volume aimed at mental health care professionals provides a good overview of the legal issues surrounding substance abuse.
Stern, Theodore A., et al., eds. Massachusetts General Hospital Handbook of General Hospital Psychiatry. 5th ed. St. Louis: C. V. Mosby, 2004. Handbook intended for health care professionals includes an extensive discussion of the screening process for abuse of controlled substances in health care settings...
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