Frequency of benzodiazepine prescribing

Despite a substantial decline in prescribing of benzodiazepines, hypnotics still account for a large number of prescriptions issued by the primary care each year (1,2).

• the most commonly prescribed benzodiazepines are diazepam, temazepam and nitrazepam (1)
• dispensing data for benzodiazepine showed an overall substantial decrease in England from 1991 to 2009
  • a decrease in dispensing of hypnotic benzodiazepines was the main reason for the overall decrease
  • there was an overall increase in dispensing of anxiolytic benzodiazepines during this time period but it was less marked than the total decrease in all benzodiazepine dispensing
• according to 2002 data issued by the Department of Health:
  • GP’s in England wrote 12.7 million prescriptions (cost of £20.9 million) in 2002 compared to 15.8 million prescriptions (worth £13.8 million) in 1992. (higher cost despite fewer prescriptions was due to the more expensive newer agents)
  • 30% of prescriptions were for 56 or more tablets - suggesting that a large number of people receive long term treatment
  • 56% of prescriptions for the three most common benzodiazepines were prescribed for people over 65 years of age (3)

The General Practice Research Database (GPRD) has shown that

• the median length of benzodiazepine prescribing episodes (series of prescription) was 29 days which is slightly more than the maximum time frame recommended by NICE guidelines
• over 90% of benzodiazepine prescriptions in this population were prescribed as part of a series of repeat prescriptions,
• over one third of the repeat prescription episodes lasted more than 8 weeks (1)

Reference:

• (1) National Addiction Centre, King's College London and School of Social and Community Medicine 2011. The changing use of prescribed benzodiazepines and z-drugs and of over-the-counter codeine-containing products in England: a structured review of published English and international evidence and available data to inform consideration of the extent of dependence and harm.
• (2) National Prescribing Centre (NPC). MeReC Bulletin 2005;15(5)
• (3) Department of Health (DH) 2004. Patient safety: benzodiazepines warning. CMO Update 37.