Benzodiazapine Policy
At Spring Hill Practice we take medicine prescribing very seriously and strive to ensure we are prescribing safely.This policy was created with repect to the prescribing of benzodiazepines and their associated hazards. These drugs include Temezepam, Diazepam, Nitrazepam, Lorazepam and Clonazepam.
These medications are not liscenced for long term use due to the danger they pose. If prescribed at all, they are only meant for very short term use however there are usually several safer alternatives. We do not prescribe for fear of flying due to the potential risk to other passengers on flights -see separate policy.
The risks associated with benzodiazapine usage have been highlighted by the Drug Safety Update 2011 and a large study published in the BMJ in 2014.
There is now very strong evidence that taking these medications reduces brain function including – but not limited to – reduced concentration, memory problems, daytime sleepiness (especially in the elderly population increasing their risk of falls and hip fractures) and worsening anxiety. Using these medications long term increases the risk of developing dementia.
These medications are highly addictive and therefore stopping them suddenly can cause withdrawal symptoms and worsening of sleep. To mitigate this, the doseage can be slowly reduced over time.
The practice does not commence new prescription of these medications.
The practice does appreciate the anxiety that this policy may cause for some of our patients, especially those who are new to the practice who may have already be prescribed these drugs long term but we will endeavour to work with them to ensure they experience no or minimal discomfort during the process of withdrawal.
Frequently Asked Questions and Answers
- My medicine was started by the consultant, why are you changing it
The consultant has transferred your care to the GP and the GP has to make sure that the medicine is being used safely. It is now the GPs responsibility
- I have been taking this medicine for several years and I am happy with it, why do you need to change it
The medicine was not designed to be used for long periods of time. The prolonged use of the medicine has harmful effects which may include addiction and dependence and possibly loss of memory.
- I am not able to sleep or function if you stop this medicine. It was stopped before and I felt very bad so the doctor put me back on it
The medicine should not be stopped abruptly. If it does, you may feel bad as you said. The GP is going to work with you to reduce the dose gradually at a pace at which you are comfortable with over several months.
- I have been using the medicine for several years and it has caused me no harm. Why do I have to stop using it now
The use of benzodiazepine is associated with harmful effects which include addiction and dependence. It can cause partial or total loss of memory. It may cause confusion and loss of full control of bodily movement especially as you get older. These medicines affect the natural way in which you sleep and because of that your state of mind can be disturbed making you restless, delusional and incoherent. The disturbed mental ability may result in confused thinking and reduced awareness of your environment.
If you are not experiencing any of these yet, then it will be good that you are taken off before you experience any of them.
- What if I do not want to come off my benzodiazepine
The GPs will have a discussion with you to encourage and help you in any way possible to come off it. The practice cannot continue to do the wrong thing for patients, especially now that the matter has been highlighted and the practices have been made aware of it directly. The practice therefore has agreed that this is our policy and will apply to all patients for the reasons we have outlined