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Primary care

More than 250,000 people in UK taking benzodiazepines and Z-drugs for longer than recommended

More than a quarter of a million people in the UK are likely to be taking dependency-forming benzodiazepine and Z-drugs (BZD) far beyond the recommended usage of 2–4 weeks, according to a study in The British Journal of General Practice published on 18 July 2017[1].

The study looked at data taken from a survey of GP surgeries in Bradford, UK. In each surgery, information was gathered by the respective clinical medical lead and project worker, and then assessed using the NHS patient record system, SystmOne, to produce a list of long-term (taking the medication for at least 12 months) and short-term BZD users.

The surgeries surveyed had a total of 97,798 registered patients, and the mean percentage of registered patients aged 16–80 classed as long-term users was 0.69% (95% confidence interval [CI] 0.54 to 0.84). When applied to nationwide patient numbers this resulted in a mean projection of 296,929 (95% CI 232,553 to 361,305) long-term users of BZD in the UK.

It was also calculated that as many as 119,165 of these patients may be willing to accept help with withdrawal. However, as the study points out, NHS provision for involuntary dependency services is currently sparse. From 100 primary care trusts who responded to a parliamentary survey in 2012, only six confirmed that they had services to support people with prescribed drug dependence.

Helen Stokes-Lampard, chair of the Royal College of General Practitioners, said: “Withdrawal from benzodiazepines requires careful management by healthcare professionals. It is vital that there are sufficient addiction management services available in the community to facilitate this, and at present this unfortunately is not the case.”

“NHS England’s ‘GP forward view’ includes pledges for every GP practice to have access to a trained mental health therapist — this promise needs to be implemented urgently, if we are to deliver the best possible care to patients with mental health problems, including addiction.”

Concerns regarding the addictive potential of BZD have been highlighted for many years, leading the British National Formulary (BNF) to recommend that uninterrupted usage not exceed four weeks. Long-term benzodiazepine use, and withdrawal, can cause several long-term disabling effects that can impact on all aspects of a person’s life.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2017.20203221

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