benzo use in hospital

[sassyann85]

Hey everyone,

Quick question. When pts receive PRN benzos at therapeutic doses while they are hospitalized, but then we discharge them without the benzos, are they at risk for withdrawal? Or is a week long (give or take) hospitalization with use of PRNS benzos too short of a time frame that they could have serious consequences like withdrawal seizures after they leave the hospital and don't have access to these meds? F

or example, we had a patient that had PRN Ativan 1 mg q 4 hours who was getting it every chance she could..she was in the hospital about a week....when she leaves and doesn't get the med anymore, was she on enough of the benzo for long enough a time period for there to be bad effects once she doesn't take it?

thanks!

[Whispera, MSN, RN]

One thing is for sure. If she was taking it around the clock, as often as it was prescribed, and suddenly she isn't getting any doses, she's going to be extremely anxious. It's kind of like winding her up tighter than a spring and letting her loose against a brick wall. This has nothing to do with whether she's addicted or not.

[TerpGal02, ASN]

If the person is fairly benzo naive (as, doesn't take them often/at all) outside Tue hospital, I highly doubt they would have a serious w/d problem. If they are taking them at home in all likelihood their output doc will likely continue them or (in the worst case scenario) will get them on the street. There seems like there's no really rhyme or reason our docs order vs not order a henzo. On one pts who's abviously an addict, they try to wean them off while in Tue hospital, and another almost identical pt, they will give henzos till the cows come home. Who knows

[Meriwhen, ASN, BSN, MSN, RN]

If she's only had the Ativan for a week, it's very unlikely she has developed a physiological dependence. It's too short of a time period. However, she could have developed a psychological dependence in that short amount of time, as Whispera pointed out. Patients like benzos: they take the edge off, dull the emotions and make the world seem warm and fuzzy. That perception in itself can be highly addictive.

Now, if she was on regular doses of Ativan or another benzo before she admitted, then she may already have a physiological dependence in place before she got to you. In that case, the MD would continue her on the benzo or taper her down. However, your MD isn't going to know that unless she was honest about her medical history and told him/her.