Clinical question
How effective are psychosocial interventions for treating benzodiazepine (BZD) harmful use, abuse or dependence?
Bottom line
CBT plus tapering dose, compared with tapering dose alone, was effective in the short term (three months) in reducing BZD use. However, this was not sustained at six months and subsequently. There was emerging evidence to suggest that a tailored general practitioner (GP) letter versus a generic GP letter, a standardised interview versus treatment as usual (TAU), and relaxation versus TAU could be effective for BZD reduction. There was insufficient evidence to support other approaches e.g. motivational interviewing, relaxation, electronic counselling and GP advice.
Caveat
Some studies relied almost entirely on patients’ self-report to clinicians, which is not a very reliable way of measuring outcomes, especially in substance misuse research. Most studies involved small numbers of participants, and there was some inconsistency in the findings. In addition, many of the smaller studies were potentially confounded by having poorly defined control groups.
Context
BZDs have a sedative and hypnotic effect upon people. Short term use can be beneficial but long term BZD use is common, with several risks in addition to the potential for dependence in both opiate and non-opiate dependent patients.
Cochrane Systematic Review
Darker CD et al. Psychosocial interventions for benzodiazepine harmful use, abuse or dependence. Cochrane Reviews, 2015, Issue 5. Art. No.: CD009652.DOI: 10.1002/14651858. CD009652.pub2. This review contains 25 studies involving 1,666 participants.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
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