Drug law backfires

ROCHESTER, N.Y.--A 1989 state law aimed at curbing abuse of Valium, Xanax, and other benzodiazepine tranquilizers may be backfiring. While a recent survey does indicate a sharp drop in benzodiazopine prescriptions in New York, the decrease has been more than offset by an upsurge in prescriptions for substitutes that are often costlier, less effective, more dangerous, and more addictive.

The law requires pharmacists to notify the state every time a doctor prescribes benzodiazepines for any reason, to limit prescriptions for most uses to 30 days, and to supply the names and addresses of the doctor and patient--all meant to keep tabs on careless or unscrupulous doctors and patients who abuse drugs.

To see how much the law was affecting prescribing trends among doctors, University of Rochester pharmacologist Michael Weintraub, together with psychiatrist Laurence Guttmacher and several colleagues, checked the records of two of the state's largest medical insurers and those of a major market research firm for the pharmaceutical industry. In every case, prescriptions for benzodiazepines had dropped--between 30 and 60 percent. But each drop was also accompanied by a big jump in prescriptions for other sedatives such as barbiturates, which are less effective in quelling anxiety, have a narrower margin between safe and lethal doses, and tend to be more addicting than benzodiazepines.

"For a whole variety of conditions," Guttmacher says, "including panic disorder, short-term anxiety, insomnia, and some seizure disorders, benzodiazepines remain the treatment of choice." While the drugs can be abused--and sometimes are, particularly by alcoholics and cocaine addicts--most people don't risk addiction by taking these drugs. Officials in other states or members of Congress considering a law similar to New York's, Guttmacher says, should think again.

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