Background
There is a growing concern in international public health systems due to increasing worldwide benzodiazepine prescription prevalence and associated risks. The resulting movement toward benzodiazepine de-prescribing also comes with risks. Benzodiazepines are among the most highly used groups of pharmaceuticals, especially in industrialized countries. In the United States of America, benzodiazepine overdoses have increased seven-fold from 1999 to 2016. Other risks include complicated withdrawal and post-acute withdrawal syndromes, harm when co-administered with other substances, risk of dependence after a short time of use, risks of long-term use, risk of benzodiazepine misuse, risk of complex persistent dependence, and increased harm in older adults and other special populations. Reports of failed discontinuation programs emphasize the difficulty for many of stopping and staying off benzodiazepines, with one-third of participants unable to fulfill their intention to do so; there is recent data of increased mortality within twelve months for those who discontinued benzodiazepines after chronic use.
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