Preventing harm from benzodiazepines
| Primary prevention15 Educate the public about benzodiazepine harms |
| Educate prescribers and patients about cognitive behavioral therapy for insomnia |
| Educate patients about risks of falls, fractures, and addictive potential |
| Limit use to a carefully selected population |
| Set the stage for limiting use to less than 4 weeks |
| Secondary prevention13,22 Taper after 4 weeks |
| Use behavioral interventions, letters, brochures, or face-to-face interventions to encourage patients resistant to intervention |
| Educate prescribers about the need to discontinue benzodiazepines |
| Tertiary prevention5,11 Use motivational interviewing to evaluate the stage of change |
| Use shared decision-making to discuss risks and benefits to help move the patient to the action level of change |
| Optimize deprescribing by addressing rebound (through education), withdrawal (through gradual tapering), and relapse (through addition of psychological support) |