As a psychiatry resident, while I see a lot of patients with comorbid pain and mental health disorders in the outpatient setting, if there's a question about opiate prescribing and not opiate replacement treatment, my work with patients revolves around helping them connect and engage with primary care. However, a clearer parallel for me is benzodiazepine prescribing. I more commonly face questions around structural iatrogenesis, flexibility, and so on, when treating patients on benzodiazepines. One thing this has also brought up is the prescribing of benzodiazepines and opiates by emergency room providers and primary care. I'm wondering about communication between providers, loopholes in prescribing in emergency room settings, etc. Any thoughts on prescribing benzodiazepines in primary care when patients are also connected with psychiatrists? Do any psychiatrists have recommendations for management of benzodiazepines (with and without chronic pain tx)?
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