Quantified patterns in outpatient benzodiazepine prescribing and compared them across specialties and indications using nationally representative. The yearly population-based sample of outpatient visits among adults; was analyzed and ranged from 20,884 visits in 2003 to 24,273 visits in 2015.


Benzodiazepines (BZDBDZBZs), sometimes called “benzos” are a class of psychoactive drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring the first such drug, chlordiazepoxide (Librium), was discovered accidentally by Leo Sternbach in 1955, and made available in 1960 by Hoffmann-La Roche.
In 1977 benzodiazepines were globally the most prescribed medications. They are in the family of drugs commonly known as minor tranquilizers. benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABAA receptor; Resulting in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties. High doses of many shorter-acting benzodiazepines may also cause anterograde amnesia and dissociation.
These properties make benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal and as a premedication for medical or dental procedures. Benzodiazepines are categorizing as short-, intermediate-, or long-acting. Short- and intermediate-acting benzodiazepines are preferring for the treatment of insomnia; Treatment of anxiety longer-acting benzodiazepines are recommending.

Safe, Effective for Short-Term use

Benzodiazepines are generally viewing for the safe and effective for short-term use, although cognitive impairment; Paradoxical effects such as aggression or behavioral disinhibition occasionally occur.  A minority of people can have paradoxical reactions such as worsened agitation or panic. Benzodiazepines are also associates with an increasing risk of suicide. As a result, Long-term use is controversial because of concerns about decreasing effectiveness, physical dependence, withdrawal, and an increased risk of dementia.
Therefore The researchers identified 919 benzodiazepine visits in 2003 and 1,672 in 2015; nationally representing 27.6 and 62.6 million visits; respectively There was an increase in benzodiazepine visits from 3.8 to 7.4 %. There was no change in the benzodiazepine visit rate to psychiatrists (29.6% in 2003 and 30.2 % in 2015); the rate increased among all other physicians, including primary care physicians (3.6 to 7.5 %).

There was a fourfold increase in the rate of prescribing of benzodiazepines with opioids, from 0.5 % in 2003 to 2.0 % in 2015; The prescribing rate with other sedating medications increased from 0.7 to 1.5 %. “As the researcher has seen with the opioid epidemic. And in light of increasing death rates related to benzodiazepine overdose; addressing prescribing patterns may help curb the growing use of benzodiazepines.

Outpatient Benzodiazepine Use

Using nationally representative data, They surveyed the landscape of outpatient benzodiazepine use and found that the rate for benzodiazepine visits doubled from 2003 to 2015. Use among psychiatrists are stable but increasing among all other types of physicians, including PCPs, medical specialists, and surgeons.
By indication, use was stable for visits related to insomnia and increased by only about one-quarter for visits related to anxiety or neurologic conditions; in contrast, it more than doubled for back and chronic pain as well for other conditions for which we could not identify a specific indication. In addition, benzodiazepines are increasingly prescribing with other sedating medications.