The College of Psychiatric & Neurologic Pharmacists (CPNP) and members of its Substance Use Disorders Committee are pleased to announce the release of a toolkit intended to provide tips and a consolidated resource on benzodiazepine taper. The Pharmacist Toolkit: Benzodiazepine Taper is authored by CPNP members Jeff Gold, PharmD, BCPP, with the Veteran Affairs Medical Center in Denver, CO and Kristina Ward, PharmD, BCPS, BCPP, with the VA Northern California Health Care System in Martinez, CA. This guide is intended to highlight both the evidence base available as well as strategies of clinical decision making used by expert clinicians. The content reflects the views and practice of the authors as substantiated with evidence-based facts as well as opinion and experience. The toolkit provides quick tips and guideline summaries in the following areas of benzodiazepine taper:

  • Populations at Risk for Complications
  • Screening and Diagnosis
  • Benzodiazepine Withdrawal
  • Treatment
  • Special Populations
  • Harm Reduction
  • Clinical Pearls
  • Authors’ Experience
  • References

Co-author Jeff Gold, PharmD, BCPP, noted that the Pharmacist Toolkit: Benzodiazepine Taper is intended to fill a gap in information available to pharmacists. “After more than 60 years of prescribing benzodiazepines, clinicians and patients alike share a conflicted and complicated relationship with these agents. Over the years, as we gained clinical experience with benzodiazepines and more insight into their mechanism of action, the potential for abuse and dependence has become apparent as have issues around the effects of benzodiazepines on cognition and the elderly. We now appreciate an increased risk of accidental overdose and death when benzodiazepines are combined with other sedating medications, and an elevated risk for dementia with long-term use. Pharmacists can play a key role in providing education to patients and providers about the value of avoiding benzodiazepines, alternative, safer and more effective agents, and often in helping to directly or indirectly assist in the difficult process of tapering such agents.”

CPNP’s President Megan Ehret, PharmD, MS, BCPP, Associate Professor at the University of Maryland, pointed to the role that pharmacists can and should play in benzodiazepine taper. “Recent news reports are pointing to complications from benzos, such as dependency and addiction, that are fueling a hidden epidemic akin to the opioid crisis. Patients can quickly develop a tolerance, leading to higher and higher doses, and painful withdrawal symptoms between doses. This guide is intended to support pharmacists who can and should play a key role within the interprofessional team helping patients to taper off of benzodiazipenes.”

The Pharmacist Toolkit: Benzodiazepine Taper will be a living document that is updated and maintained on the CPNP website as a freely available source of information.