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)