Your new PCP is being prudent and cautious in her discussions with you on not being comfortable providing you with concurrent prescript
ions for a benzodiazepine and an opiate/narcotic.
We hear a lot about
the opioid crisis. The other crisis that receives less news coverage is a concerning and growing use of prescript
ion benzodiazepines. Prescript
ions for benzos increased some 37% between 1996 and 2014 (My reported figure may be slightly off the official statistic. You can check the specific data on the National Institute of Health website).
The 2016 CDC guidelines urge physicians to avoid prescribing a benzodiazepine concurrently with an opoid/narcotic wherever possible. Both benzos and opioids now carry “Black Box” warnings highlighting the dangers of using these drugs together. A “Black Box” warning is the highest level of precaution issued by the FDA or CDC.
While it is not technically “illegal” for a physician to prescribe both, the degree of heightened concern for serious or life-threatening possible side effects disseminated in the CDC recommendations is enough for most physicians to take a serious pause. I can see where a new physician to your care would be less than comfortable extending prescript
ions that you have had for both a benzo (Ativan) and an opioid, as he/she would be placing their medical license and state board certification at risk if you were to have an adverse event.
Opioids and benzos are both powerful medications.
The National Institute of Health (NIH) has an informative website and information on this discussion of concurrent use of benzos and opioids as well as on the concerning incidence of benzo prescript
Talk with your psychiatrist to get his/her assessment of your particular situation of your pain and anxiety issues and risk/benefit of the combined medications. You will want to discuss this with a medical provider who knows you and with whom you have an established relationship.
Pituitary failure, wide-spread endocrine dysfunction
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)
Post Edited ((Seashell)) : 3/5/2019 1:30:42 PM (GMT-7)