Why We Shouldn't Blame Benzos

Sometimes I hear from well-meaning medical practitioners that methadone is unfairly maligned as it is blamed for so many deaths. Benzodiazepines, these doctors argue, are to blame for so many methadone poly-drug deaths. Benzodiazepines are the real killers. I don't buy it. While admittedly the dangers of combining benzodiazepines with methadone are well-known in the medical community, many people dependent on benzodiazepines continue to use them for years and years, without dying. In addition, benzodiazepines are highly addictive, and withdrawal can lead to fatal seizures. The New York Times recently reported:

"A majority of victims also used large quantities of alcohol or benzodiazepine sedatives but few would have died without an opioid as the primary culprit. 'You can take a lot of benzodiazepines without dying,' said Dr. Charles E. Inturrisi of Weill Cornell Medical Center, who said they strengthen the depressive effect of methadone."

What I am concerned about more than all the people using benzodiazepines, is all the doctors prescribing methadone to the people using benzodiazepines. A patient with a long-standing history of benzodiazepine use should not be started on methadone until the physician confirms the patient is benzodiazepine-free.