As I began to encounter more clients in my community practice, I had a growing realization that benzodiazepine (BNZ) dependence is an insidious and widespread issue. More often than not the dependent person, is not an "addict", but a person using their medication as prescribed.
I understand that providers in their desire to lessen the suffering of those they serve, feel that benzodiazepine medications are the answer. They work to quickly quell anxiety and insomnia almost miraculously. However, they are a short-term solution for what is frequently a long-term problem. As I tell my clients, its like putting a patch on a breaking dam - it will hold in water very effectively for awhile, but it isn't getting to the root of the problem that underlies the symptoms.
Benzodiazepines have their time and place for psychiatric distress, but that is short-term limited duration therapy (with some specific exceptions) and it is important that the client taking these medications is aware of this. Too often, I have individuals in my office dependent on a medication, like Xanax who were never informed about the nature and possible consequences of BNZ use.
Prescribers have "gotten smart" about prescribing practices with pain medications, like Oxycodone, its time we do the same for benzodiazepines. And that starts with education.
- Ahmed, M., Westra, H. A., & Stewart, S. H. (2008). A self-help handout for benzodiazepine discontinuation using Cognitive Behavioral Therapy. Cognitive and Behavioral Practice, 15(3), 317-324.
- Ashton, H. (1994). Guidelines for the rational use of benzodiazepines. Drugs,48(1), 25-40.
- Ashton, H. (2005). The diagnosis and management of benzodiazepine dependence. Current opinion in Psychiatry, 18(3), 249-255.
- Baldacchino, A. (2013). Guidelines for Benzodiazepine Prescribing in Benzodiazepine Dependence.
- Centre for Addiction and Mental Health. (2011). Benzodiazepines.
- Reconnexion. (2010). Beyond Benzodiazepine Manual.
- O'Brien, C. (2005). Benzodiazepine use, abuse, and dependence. Journal of Clinical Psychiatry, 66(2) 28-33.
- Mechcatie, E. (2005). Long-term benzodiazepines for anxiety linked to adverse events. Clinical Psychiatry News Digital Network.
- Vermont Academic Detailing Program. (2013). Should I stop my benzodiazepine or benzo?
- Gorenstein, C., Bernik, M. A., Pompéia, S., & Marcourakis, T. (1995). Impairment of performance associated with long-term use of benzodiazepines. Journal of Psychopharmacology, 9(4), 313-318.
- Parr, J. M., Kavanagh, D. J., Cahill, L., Mitchell, G., & Young, R. M. (2009). Effectiveness of current treatment approaches for benzodiazepine discontinuation: a meta‐analysis. Addiction, 104(1), 13-24.
- Cloos, J. M. (2010). Benzodiazepines and addiction: Myths and realities (Part 1&2). Psychiatr Times.
- Lader, M. (2011). Benzodiazepines revisited—will we ever learn. Addiction,106(12), 2086-2109.
- National Prescribing Service Ltd. (1999) Benzodiazepines. Reviewing long term use: A suggested approach. Prescribing Practice Review, 4