It has been said Opioids and tranquilizers can increase risk of overdose death five fold.
In my population, there is a subgroup of cases with bipolar disorder. Indeed, a meta-anlysis found 21 – 25% of Fibromyalgia disorder have it and I suspect more not diagnosed. In a mixed state, a pain patient gets little sleep and is in considerable distress with agitation and will inadvertently be put on significant doses of tranquilizers to deal with this “pain” when tolerance to atypical anti-psychotics is limited. March is a good time to see it and I have seen a couple cases already this year. After the mixed state subsides, they end up continued to take them because they can contend it helped them.
It is also easy to put pain patients that don’t sleep and have restless legs, on Clonazepam which is some cases is dangerous, particularly if subjects are obese and subject to sleep apnea.
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