Engage the pt

By rray, 25 September, 2023
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Footnote
<sup>1</sup> <b>VA 2021.</b> Re-evaluating the Use of Benzodiazepines. A Quick Reference Guide. U.S. Department of Veterans Affairs. October 2021. <a href=https://www.pbm.va.gov/PBM/AcademicDetailingService/Documents/508/10-1527_BENZOS_QRG_508conformant.pdf><u>Free full-text PDF</u></a>
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• Sample tapers available
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<sup>2</sup> Benzodiazepines: Tapering and Prescribing. Presbyterian Healthcare Services. February 2023. <a href=https://onbaseext.phs.org/PEL/DisplayDocument?ContentID=pel_00943236><u>Free full-text PDF</u></a>
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<sup>3</sup> Benzodiazepine and Z-Drug Safety Guideline. Kaiser Permanente. January 2022. <a href=https://wa.kaiserpermanente.org/static/pdf/public/guidelines/benzo-zdrug.pdf><u>Free full-text PDF</u></a>
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<sup>4</sup> Cloos J-M, et al. Benzodiazepine high-doses: The need for an accurate definition. <i>Int J Methods Psychiatr Res.</i> 2021 Dec;30(4):e1888. <a href=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8633930/><u>Free full-text article in PubMed® Central</u></a>
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• No universally accepted definition of high-dose BZD
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<sup>5</sup> <b>VA/DoD 2021.</b> VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders. (Based on evidence reviewed through June 30, 2020.) Version 4.0. U.S. Department of Veterans Affairs. U.S. Department of Defense. August 2021. <a href=https://www.healthquality.va.gov/guidelines/MH/sud/VADoDSUDCPG.pdf><u>Free full-text PDF</u></a>
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<sup>6</sup> Ogbonna CI, et al. Tapering Patients Off of Benzodiazepines. <i>Am Fam Physician.</i> 2017 Nov 1;96(9):606-610. <a href=https://www.aafp.org/pubs/afp/issues/2017/1101/p606.html><u>Free full-text article</u></a>
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<sup>7</sup> Gold J, et al. Pharmacist Toolkit: Benzodiazepine Taper. College of Psychiatric and Neurologic Pharmacists (CPNP). 2018. <a href=https://www.opioidlibrary.org/wp-content/uploads/2019/07/CPNP_BenzoTapering.pdf><u>Free full-text PDF</u></a>
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Discuss risks of continued BZD use disinhibition ineffectiveness mental acuity loss benefits of stopping possible w d sx and likely duration1 2
Assess pt readiness willing committed w adequate social support and suitability no complicated drug w d hx to d c or darr BZD dose1 3
Assess condition for which BZD originally prescribed consider alternative tx and or behavioral services referral as clinically appropriate1 3
Consider specialist referral if substance use d o hx severe medical or psychiatric d o high dose BZD 4 concurrent stimulant or opioid use drug w d sz hx2 3
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Engage the pt