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C58. Managing the care of patients with pre-existing benzodiazepine prescriptions in PHP/IOP level of care

About The Event

Learner category:

  • Beginning Level
  • Novice Level


Learning objectives:

  • Participants will be able to describe the risks of benzodiazepines
  • Participants will understand how to evaluate and manage complex patients with co-occurring
    psychiatric and substance use disorders with special attention to PHP/IOP level of care.
  • Participants will be able to determine how to appropriately and safely taper benzodiazepines
  • Participants will understand how to increase safety and decrease discomfort/distress during discontinuation

Abstract

While the opioid epidemic has taken center stage, another epidemic may be looming. According to Lembke et al. (2018), from 1996 to 2013, prescriptions for benzodiazepines increased by 67%. Overdose deaths involving benzodiazepines increased from 1,135 in 1999 to 8,791 in 2015 (). Despite these statistics, the rate at which benzodiazepines continue to be dispensed is alarming. As a result, clinicians are often faced with the quandary of inheriting patients who have been prescribed high-dose benzodiazepines for a significant length of time. Managing these patients presents a significant challenge, particularly at the PHP or IOP level of care, as when patients present for admission, they are often highly distressed, despite pre-existing benzodiazepine prescriptions. Therefore, clinicians may be reluctant to quickly switch their medication regimen due to fear of further decompensation that may necessitate a higher level of care. Also, patients are often reluctant to change due to attachment or dependence on the benzodiazepine. It is vital that clinicians are prepared to effectively evaluate and manage patients who are present with pre-existing prescriptions for benzodiazepines (Lin & Weaver, 2019). This presentation will educate on the risks of benzodiazepines and their management in complex patients. It will cover indications for benzodiazepines, risk factors for misuse, and signs of intoxication and withdrawal. Lastly, the presentation will touch on developing rapport, monitoring, recognizing withdrawal/intoxication, tips for effectively managing these patients in PHP or IOP settings, and determining the appropriate level of care.

Authors

Morgan Borine
CNP, PMHNP-BC Rogers Behavioral Health

Morgan Borine, MA, MS, PMHNP-BC, is a board-certified psychiatric mental health nurse practitioner who primarily works with adults in partial hospitalization and intensive outpatient care at Rogers Behavioral Health in St. Paul, MN. Borine is a dual bachelors (BS, Nursing, BA, Psychology) and dual masters (MS, Nursing, MA, Counseling Psychology) degree holder. She graduated summa cum laude from Virginia Commonwealth University (VCU) with a BS in Nursing and received her MS in Nursing from VCU. She brings a unique combination of experience in professional psychology, psychiatric nursing, and addiction, with over 12 years of academic training and clinical experience across a wide variety of settings.

Our Speakers

Morgan Borine
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