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Content note: Mentions suicide.
The Benzodiazepine Information Coalition (BIC) has raised the alarm about draft clinical deprescribing guidelines for benzodiazepines (BZDs) and other classes of prescription drugs, written by the University of Western Australia’s Centre for Health and Ageing and Centre for Optimisation of Medicines. The guideline proposes a rapid BZD tapering rate of 25% to 50% every 1–4 weeks, which BIC warns is dangerously fast, risking severe withdrawal, especially for older adults. The same rate is suggested for antidepressants, antipsychotics, hypnotics, and sedatives. The guideline ignores physical dependence, encourages forced discontinuation without full informed consent, and lacks discussion of long-term risks. Here’s why this matters and how you can help by May 30.
The Evidence Against Rapid Tapering
BIC’s concerns are grounded in research. As noted on their website, BZD withdrawal symptoms can persist for months or years in some people, with the FDA noting a median duration of 9.5 months. In 2020, the FDA finally announced a new BZD boxed warning describing risks of abuse, addiction, physical dependence, and withdrawal reactions, after years of denying or ignoring these risks. The Maudsley Deprescribing Guidelines, available on Amazon, recommend slow 5–10% reductions every 2–4 weeks. The American Society of Addiction Medicine (ASAM)’s Joint Clinical Practice Guideline on Benzodiazepine Tapering warns that BZD use increases risks like falls, motor vehicle accidents, cognitive impairment, delirium, overdose, and death, particularly when BZDs are used in combination with CNS depressants such as alcohol or opioids (pp. 7, 12–13).
Patients unable to tolerate rapid tapering are only identified after harm occurs, making the University of Western Australia’s drafted approach especially risky. BIC accurately refers to the draft’s 25–50% rate as oversized and dangerous.
Why Older Adults Are at Risk
Older adults, often long-term BZD users, face higher risks of adverse events. They’re more prone to falls and cognitive issues, as ASAM notes in its clinical practice guideline (pp. 13, 82). Forced discontinuation without full informed consent increases risks of severe withdrawal and suicide.
Take Action by May 30
Your feedback can protect vulnerable patients by aligning guidelines with the evidence about withdrawal effects.
How to Help
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