I just retired as a children's psychotherapist at our community mental health center. I also served some adults. First, I want to correct one of the comments above, Ativan is not an opioid. It is a benzo, that is also addictive and has abuse potential, especially if mixed with alcohol -- a very cheap drunk.
A couple of years ago, our State Board of Pharmacy started monitoring prescription practice of doctors state-wide for benzos. It scared the sh** out of most doctors who had been prescribing bezos as a front line for anxiety, panic, and insomnia (Ambien). It even frightened psychiatrists who were using Librium to get folks with alcoholism through the intial withdrawal of 2 or 3 weeks.
Today, the practice is to urine screen all consumers prescribed any psychotropic med to ensure that each are taking the med, and whether is is a therapeutic dosage. Of course, while the lab is "at it" it looks for nonprescribed substances, such as pot.
The practice is fueled by managed care, including Medicaid, that wants to cut down on the costs of benzos. What happened to one of my consumers was tragic. He had severe panic disorder, but his mother kept his benzo lock up because a nephew that visited was addicted -- a pill head. The parents went on vacation for a couple of weeks, left the box locked, and when the guy came in to the center, he was required to piss. It was too clean, and he was cut off of his much needed benzo. The panic attacks increase to the point that he wouldn't leave his parent's house. He was afraid of having a panic attack in public -- very sad.
I just got a script for Ambien filled. My insurance company would only pay for 15 instead of 30 pills -- it's the policy, 15 a month no matter what the doctor ordered.
When I was a younger man, I used to get anxiety when I smoked. We called it "paranoid" and there are several rock song lyrics that refer to the phenomena. Of course, it wasn't paranoia as defined in the diagnostic and statistical manual of mental disorders, but it felt bad. So, I've not smoked for decades. But, now that I'm retired and life is much less "Heads and Feds" maybe I'll give it another try.
I've had several kids with ADHD and teens and adults with PTSD and Bipolar Disorder who would advocate for its medicinal use as an alternative to pharmaceuticals.
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