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Long-term benzodiazepine use is less likely when shorter courses, a single medication or short-acting agents are prescribed, per cohort study of more than 1.8 million Canadian adults which could inform prescribing practices
Patients are less likely to become long-term benzodiazepine users when they are initially prescribed shorter courses, a single medication, or short-acting agents, according to a large new study published in PLOS Medicine.
The population-based retrospective cohort study, which analysed data from more than 1.8 million Canadian adults, examined how initial prescribing patterns influence whether patients go on to use benzodiazepines over the long term. The findings highlight a critical window of opportunity at the point of first prescription, suggesting that the decisions clinicians make early on can have a significant bearing on a patient’s longer-term trajectory.
Benzodiazepines are widely prescribed for conditions including anxiety, insomnia, and seizure disorders, but long-term use carries well-documented risks including dependence, cognitive impairment, and difficulties with withdrawal. Concerns about overprescribing and the potential for harm have made identifying modifiable risk factors a priority for researchers and health systems alike.
The study – funded by a Womenmind Grant to co-principal investigators at the Centre for Addiction and Mental Health (CAMH) – found that three initial prescribing characteristics were associated with earlier discontinuation: keeping the initial course short, prescribing a single benzodiazepine rather than multiple agents, and opting for short-acting formulations over longer-acting ones.
The research team say the results could directly inform prescribing guidelines, offering clinicians practical, evidence-based levers for reducing the risk of patients transitioning from short-term to long-term use.
The full paper, Association between initial benzodiazepine prescribing patterns and time to benzodiazepine discontinuation: A population-based retrospective cohort study, is freely available at https://plos.io/4uxybkF.
Image: Researchers assess long-term benzodiazepine use in Canada.
