Only a quarter of prescriptions for benzodiazepines in young people are for an approved indication

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1. This cohort study analyzed healthcare demands from 2008 to 2019 and found that prescribing benzodiazepines among adolescents and young adults peaked in 2015 and 2013 respectively, and has declined since.

2. Only about a quarter of the cases involved an approved indication for the use of benzodiazepines, raising concerns that these drugs are frequently prescribed for indications that are not based on evidence.

Level of Evidence Assessment: 2 (Good)

Study overview (retrospective cohort): In addition to being dangerous and addictive substances themselves, benzodiazepines are also associated with an increased risk of opioid-related mortality in children and adolescents. The purpose of this study was to analyze and describe trends in prescribing benzodiazepines among young people between 2008 and 2019. The researchers collected data on health care claims from a commercial insurance plan that covered more than four million adolescents (aged 13-18) and six million young adults (aged 19-18). 25). Overall, benzodiazepines have been prescribed at least once in 1.8% of adolescents and 4.0% of young adults, with diazepam being the most common choice in adolescents and alprazolam in young adults. . A concurrent opioid prescription was issued to 26.1% of adolescents receiving benzodiazepines and 24.0% of young adults. The prevalence of dispensing benzodiazepines peaked in 2015 for adolescents and in 2013 for young adults, and then declined steadily until the end of the study period. Alarmingly, only a quarter of cases involved an approved indication for the use of benzodiazepines.

This study highlights the frequency of use of these dangerous drugs despite a lack of factual indications. Clinicians should remain judicious in their use of these drugs, prescribing only when necessary for approved indications and limiting co-prescribing with opioids when possible. This study is reinforced by its very large cohort, although limited in that the data was collected from a single private insurance provider and may not be generalizable to those using Medicaid or who are uninsured. It also relies on diagnostic coding to assess prescribing indications, which can be unreliable.

Click to read the study in JAMA Pediatrics

Relevant reading: Benzodiazepine Exposure and Overdose of Children and Adolescents in the United States: 16 Years of Poison Control Center Data

Image: PD

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