Strict Guides for Benzodiazepines Prescription
A new set of guidelines has been developed for GPs prescribing benzodiazepines, due to a significant debate in the medical community about the appropriate role and use of these drugs and this has been exacerbated by a lack of clinical guidelines in the area.
The Royal Australian College of General Practitioners (RACGP) has created a new guide on prescribing benzodiazepines, focusing on patient-centred care, accountable prescribing and harm reduction.
“It is vital GPs are aware of the issues benzodiazepines have created at a broad society level and among individual patients,” RACGP President Dr Frank R Jones says.
“The RACGP’s new guide, Prescribing drugs of dependence in general practice, Part B: Benzodiazepines is the first in Australia to comprehensively address these issues.
“Prescription of benzodiazepines, as with any treatment, should be based on a comprehensive medical assessment, a diagnosis, an examination of risks and benefits and a management plan.
The guide instructs the medications to primarily be used after other options have been explored; in short-term treatments; and only with caution if used for more than four weeks - with close monitoring. It also calls strongly for the roll-out of a drug database to monitor prescriptions.
“It is also important for patients to understand that medication is only part of the answer to managing complex mental health issues and non-drug therapies should also be explored,” Dr Jones says.
Every year in Australia nearly 7 million prescriptions for benzodiazepines are issued, with Valium and Temazepam among the most common for the class of drugs most commonly used to treat anxiety and insomnia.
“As GPs we need to be vigilant in identifying patients who may be misusing or abusing benzodiazepines because this can become a long-term and distressing problem.
“Patients who have a substance use disorder may ‘doctor shop’ to gain prescriptions and increase their use and dosage. When taken in combination with other substances such as opioid medications, illicit drugs and alcohol, this can result in death.”
Dr Jones said GPs could help patients recognise they have a problem, set goals for recovery and ensure they received the right treatment.
“There needs to be an immediate rollout of a real-time prescription drug database, something the RACGP has long called for. There is also the need for consistency across states when it comes to laws and definitions regarding drugs of dependence because current variations complicate and confuse health professionals,” Dr Jones says.
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