Benzodiazepine Prescribing: A Warning Unheeded

Arefa Cassoobhoy, MD, MPH


March 09, 2018

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

With all of the attention on opioid prescribing, it's easy to miss an important and overlapping issue: the potential harms of benzodiazepine use. This includes alprazolam, clonazepam, and lorazepam.

Benzodiazepine prescribing rose to 13.5 million by 2013. Overdose deaths increased from about 1000 in 1999 to almost 9000 people in 2015, and three fourths of these deaths involved opioid use. Benzodiazepine use raises the risk for falls, accidental injuries, and cognitive decline, in addition to the risk for addiction, overdose, and death.

The benefits drop and the risks increase further when benzodiazepines are used daily for extended periods. They can actually worsen anxiety and insomnia. And there are better treatment options, including selective serotonin reuptake inhibitors and lifestyle changes. Zolpidem, however, does not have a safer profile.

We need to be as vigilant with our benzodiazepine prescriptions as we are with opioids. The window for appropriate use is small.

Follow Dr Cassoobhoy on Twitter at @ArefaMD


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