Benzodiazepines, when to prescribe
Benzodiazepines are useful for the short-term treatment of anxiety, insomnia, agitation, seizures, muscle spasm as well as the management of alcohol and other drug withdrawal. However, they should be prescribed with caution as dependence is common and can develop quickly and easily. For more information, see the Risks associated with benzodiazepines (PDF 128KB) fact sheet.
The Royal Australian College of General Practitioners (RACGP) publishes guidelines for prescribing benzodiazepines on its website.
Prescribing should only be considered if other options (non-pharmacological) are unsuitable and/or ineffective. Patients should be advised that any beneficial effects, for example better sleep, quickly wear off and there is a high likelihood of dependence developing with ongoing use (>2 to 3 weeks).
The Insomnia Management Kit is a useful tool for using with clients who have sleep problems.
Benzodiazepines are the mainstay of alcohol withdrawal treatment and may be used for up to a week for this indication. There is no indication for long-term prescribing in alcohol dependence as they are likely to increase rather than decrease problems where there is ongoing drinking. Prescribing in these circumstances needs to be in the context of an organised, supervised and time-limited treatment for withdrawal.
For more information on alcohol withdrawal management, visit the Management of substance withdrawal page.
Other drug withdrawal
Benzodiazepines have a lesser role in other drug withdrawal treatment. If they are prescribed, quantities should be restricted (1 to 2 days at a time) and only prescribed for a short duration (1 to 2 weeks maximum).
Long-term benzodiazepine dependence
Extreme caution should be exercised in prescribing for long term use. Prescribing doctors need to ensure there is adequate protection for both themselves and for the patient to avoid the risks and potential harms that may arise if patients gain benzodiazepines (and/or other depressant medications) from more than one prescriber/source. Appropriate approaches include the use of guidelines, written patient agreements and restricting access to large quantities of benzodiazepines by stipulating that the medications be dispensed on a weekly, twice weekly or even daily basis.
For more information of benzodiazepine withdrawal management, visit the Management of substance withdrawal page.
Medication-assisted treatment for opioid dependence
Before prescribing benzodiazepines to patients who are on any form of medication-assisted treatment for opioid dependence (PDF 126 KB) with Drug and Alcohol Services South Australia (DASSA) or a private (GP) prescriber, make contact with the relevant doctor to ensure optimal care and reduce the risks associated with concurrent consumption of opioids and benzodiazepines.
If the person is a DASSA client, or the private GP prescriber cannot be contacted, ring the Alcohol and Drug Information Service (ADIS) 1300 13 1340 or the Drug and Alcohol Clinical Advisory Service (DACAS) telephone 7087 1742.
If uncertain about the name of the prescriber, contact the SA Health Drugs of Dependence Unit on 1300 652 584 for assistance.
For information on prescribing responsibilities and legal obligations visit the Legal control over medicines page.
Further information and advice
- Alcohol and Drug Information Service (ADIS) 1300 13 1340
8.30 am to 10.00 pm everyday.
- Drug and Alcohol Clinical Advisory Service (DACAS)
Telephone: 7087 1742.
Provides general practitioners and other health professionals, who are seeking advice in managing drug and/or alcohol affected patients, with direct telephone access to an addiction medicine specialist medical practitioner. 24-hour service.