Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA.
Yale School of Medicine, New Haven, CT, USA.
Int J Psychiatry Med. 2023 Sep;58(5):426-432. doi: 10.1177/00912174231166252. Epub 2023 Mar 27.
Though clinical guidelines and policies discourage the chronic prescribing of benzodiazepines, rates of prescribing have continued to rise in the United States with an estimated 65.9 million office visits per year made for this purpose. Quietly, we have become a nation on benzodiazepines. There are numerous reasons for this discrepancy between official recommendations on the one hand, and actual clinical practice on the other. Drawing from the literature, we argue that while patients and providers both shoulder some of the responsibility, they cannot be solely blamed. Rather, policies and guidelines regarding benzodiazepine prescribing have become out of touch with the clinical reality that benzodiazepines are now deeply entrenched in modern medicine. We propose that guidelines regarding benzodiazepines need to reconsider how to apply concepts such as harm reduction and other lessons learned in the opioid epidemic in order to help physicians manage this increasingly pressing problem affecting millions of Americans.
尽管临床指南和政策不鼓励长期开具苯二氮䓬类药物，但美国的开具此类药物的比率仍在持续上升，每年为此目的的就诊估计有 6590 万次。我们悄悄地成为了一个依赖苯二氮䓬类药物的国家。这种官方建议与实际临床实践之间的差异有很多原因。从文献中可以看出，尽管患者和医务人员都有一定的责任，但不能仅仅归咎于他们。相反，关于苯二氮䓬类药物处方的政策和指南已经与苯二氮䓬类药物现在已深深扎根于现代医学这一临床现实脱节。我们提出，关于苯二氮䓬类药物的指南需要重新考虑如何应用减少危害等概念，以及在阿片类药物流行中吸取的其他经验教训，以帮助医生应对这一影响数百万美国人的日益紧迫的问题。
