Best practices in benzodiazepine prescribing and management in primary care

Abstract

Despite the lack of evidence on the long-term effectiveness of benzodiazepines and their potential harmful effects, prescriptions of the drug have significantly increased in the US over the past decade. This article reviews best practices regarding primary care benzodiazepine prescriptions and how providers can best prevent and treat benzodiazepine use disorder and other harmful effects.

Predictors of Benzodiazepine Re-Prescription Among U.S. Veterans with a History of Chronic Benzodiazepine Use

“…Although there are varying definitions of chronic benzodiazepine use, we defined chronic benzodiazepine use as >30 consecutive days supply during FY2019 to be consistent with clinical guidelines 1,4,21 . The number of days a patient was prescribed benzodiazepines was identified based on pharmacy fills beginning 3 months prior to FY2019 to ensure the study accounted for benzodiazepine prescriptions dispensed before the FY began 8 .…”

“…Benzodiazepines are considered safe and effective for short-term use (about 2-4 weeks) to treat anxiety disorders, alcohol withdrawal, insomnia, muscle-stretching, and seizures [1][2][3] , but lack long-term effectiveness and can have harmful effects (e.g., increased risk of falls in older patients) 4 . However, healthcare providers are prescribing benzodiazepines for longer periods 1,5 .…”

A Pharmacist-Led Process to Monitor Discrepant Urine Drug Screen Results

“…rine drug screen (UDS) monitoring is a common risk-mitigation strategy tool for prescribing controlled substances. [1][2][3] Not only is UDS monitoring highlighted by clinical practice guidelines for opioid prescribing for chronic pain, 1,2 it has also been suggested as best practice for benzodiazepines 3 and a consideration for other controlled substances. Monitoring UDSs helps confirm adherence to the prescribed treatment regimen while also screening for substance use that may increase patient risk.…”