From the Research
Approximately 17.2% of benzodiazepine use is attributed to misuse, highlighting the significant risk of addiction associated with these medications. The risk of addiction to benzodiazepines is a critical concern in clinical practice, with factors such as higher doses, longer duration of use, and use of high-potency benzodiazepines like alprazolam or lorazepam increasing the likelihood of dependence 1. Individuals with prior substance use disorders or certain psychiatric conditions are also at higher risk of addiction.
Key Factors Influencing Addiction Risk
- Higher doses and longer duration of use (especially beyond 2-4 weeks) increase the risk of addiction
- Use of high-potency benzodiazepines like alprazolam (Xanax) or lorazepam (Ativan) is associated with a higher risk of dependence
- Prior substance use disorders or certain psychiatric conditions increase the risk of addiction
- Concomitant use of central nervous system medications and presence of central nervous system or pulmonary diseases also increase the risk of adverse effects and misuse
Minimizing Addiction Risk
- Benzodiazepines should be prescribed at the lowest effective dose for the shortest duration possible, with regular monitoring and a gradual tapering schedule when discontinuing use 1
- Adjunctive treatment with antiepileptics, antidepressants, and pregabalin can help lessen withdrawal symptoms
- Incorporating behavioral interventions, such as cognitive behavior therapy, can improve deprescribing outcomes and minimize the risk of addiction
Recent Evidence
The most recent study from 2023 highlights the importance of balancing the perceived benefits of benzodiazepines with known risks and lack of evidence supporting their use 1. This study emphasizes the need for careful consideration and monitoring when prescribing benzodiazepines to minimize the risk of addiction and other adverse effects.