Developments in the management of benzodiazepine dependence: the views of Scottish Addiction Prescribers

Introduction: Problematic use of diverted and illicit benzodiazepines and benzodiazepine-type drugs (BZDs) is a significant concern for addiction healthcare providers in Scotland. BZDs are frequently implicated in drug-related deaths, especially in combination with opioids and/or alcohol. BZD use is also considered a barrier to optimal engagement, retention and outcomes of addiction treatment and recovery. Local and national policies highlight the need to address problematic BZD use, but there is a lack of clinical consensus or guidance on the management of dependence. The Drugs Research Network for Scotland established a BZD research group of addiction specialists, academics and people who use drugs to share information on evidence needs and opportunities to address these. This group includes Drs Seonaid Anderson and Michael Turner, NHS Grampian Addiction Psychiatrists Members who surveyed 61 (of 110) Scottish addiction medics in 2018 to understand their views and experiences of managing patients with BZD dependence. In 2020 this group developed a follow-on survey for Scottish addiction prescribers. Summary results were presented to the Royal College of Psychiatrists (Scotland)’s ‘Golden Lion group’, to the BZD Steering Group of the Drug Deaths Taskforce’s (DDTF) Medication Assisted Therapy group, and Scottish Drugs Forum/DDTF “Benzos - What can be done?” webinar. This report has been produced to inform development of clinical guidelines and consensus, and intervention development and testing research currently underway