The length of a patient's very first benzodiazepine prescription could determine whether they stay on the drug long-term. A large Canadian cohort study found that initial prescriptions longer than 7 days were strongly linked to prolonged use, while sticking to a single, short-acting agent improved the odds of discontinuation. Simple tweaks to prescribing habits could make a real difference.
The way a benzodiazepine is first prescribed may have lasting consequences. A large population-based cohort study of over 1.8 million Canadian adults found that the longer the initial prescription, the less likely patients were to stop taking the medication. Compared to prescriptions of 7 days or fewer, those lasting 8–14 days, 15–30 days, or more than 30 days were progressively associated with much lower odds of discontinuation.
Beyond duration, the type and number of benzodiazepines prescribed also mattered. Patients started on long-acting agents — or on two or more benzodiazepines at once — were significantly less likely to discontinue compared to those given a single, short-acting drug.
Key Takeaways:
Why it matters: Benzodiazepine dependence is a well-documented public health concern linked to increased morbidity and mortality. These findings suggest that straightforward changes — keeping first prescriptions under 7 days and choosing a single short-acting agent — could meaningfully reduce the risk of long-term dependence.
