Benzodiazepines are only recommended for short periods (2–4 weeks), yet there is evidence of substantial long-term use across the UK. Poor availability of services is one major challenge in supporting withdrawal. Confusion about terminology can lead to inaccurate or inadequate diagnosis of benzodiazepine dependence and addiction, and sub-optimal management of these patients. This article provides an overview of benzodiazepines, diagnostic criteria and available management strategies.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (fifth edition). Arlington, VA: American Psychiatric Association.
3.
BaldwinDAitchisonKBatesonA, et al.(2013) Benzodiazepines: Risks and benefits. A reconsideration. Journal of Psychopharmacology27(11): 967–971. DOI: 10.1177/0269881113503509.
4.
BatesonA (2002) Basic pharmacologic mechanisms involved in benzodiazepine tolerance and withdrawal. Current Pharmaceutical Design8(1): 5–21. DOI: 10.2174/1381612023396681.
5.
ChengTWallaceDPonteriB, et al.(2018) Valium without dependence? Individual GABAA receptor subtype contribution toward benzodiazepine addiction, tolerance, and therapeutic effects. Neuropsychiatric Disease and Treatment2018(14): 1351–1361. DOI: 10.2147/ndt.s164307.
6.
DarkerCSweeneyBBarryJ, et al.(2015) Psychosocial interventions for benzodiazepine harmful use, abuse or dependence. Cochrane Database of Systematic Reviews5: 1–110. DOI: 10.1002/14651858.cd009652.pub2.
7.
DaviesJRaeTMontaguL (2017) Long-term benzodiazepine and Z-drugs use in England: A survey of general practice. British Journal of General Practice67(662): e609–e613. DOI: 10.3399/bjgp17x691865.
8.
De las CuevasCSanzEde la FuenteJ (2003) Benzodiazepines: more “behavioural” addiction than dependence. Psychopharmacology167(3): 297–303. DOI: 10.1007/s00213-002-1376-8.
9.
Dell'OssoBAlbertUAttiA, et al.(2015) Bridging the gap between education and appropriate use of benzodiazepines in psychiatric clinical practice. Neuropsychiatric Disease and Treatment11: 1885–1909. DOI: 10.2147/ndt.s83130.
Joint Formulary Committee (2018) British National Formulary, London: BMJ Group and Pharmaceutical Press.
14.
KapilVGreenJLaitC, et al.(2014) Misuse of benzodiazepines and Z-drugs in the UK. British Journal of Psychiatry205(05): 407–408. DOI: 10.1192/bjp.bp.114.149252.
15.
Kennedy K and OãRiordan J (2019) Prescribing benzodiazepines in general practice. British Journal Of General Practice 69(680): 152–153. DOI: 10.3399/bjgp19x701753.
16.
LaderMKyriacouA (2016) Withdrawing benzodiazepines in patients with anxiety disorders. Current Psychiatry Reports18(8): 1–8. DOI: 10.1007/s11920-015-0642-5.
17.
Lingford-HughesAWelchSPetersL, et al.(2012) BAP updated guidelines: Evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: Recommendations from BAP. Journal of Psychopharmacology26(7): 899–952. DOI: 10.1177/0269881112444324.
SaundersJ (2017) Substance use and addictive disorders in DSM-5 and ICD 10 and the draft ICD 11. Current Opinion in Psychiatry30(4): 227–237. DOI: 10.1097/yco.0000000000000332.
21.
SoykaM (2017) Treatment of benzodiazepine dependence. New England Journal of Medicine376(12): 1147–1157. DOI: 10.1056/nejmra1611832.
22.
VinkersCOlivierB (2012) Mechanisms underlying tolerance after long-term benzodiazepine use: A future for subtype-selective receptor modulators?Advances in Pharmacological Sciences2012: 1–19. DOI: 10.1155/2012/416864.
