SHORT-TERM USE: NOT WITHOUT RISK

Although prescriptions for 2-4 weeks (including the tapering off time), or short-term, use are what guidelines recommend for benzodiazepines, it is important to note that even short-term use of benzodiazepines is not without risks.

Professor Sam Timimi, a consultant child and adolescent psychiatrist and director of postgraduate education in the NHS in Lincolnshire and a visiting professor of child and adolescent psychiatry at the University of Lincoln, points out why in this video: 

Risks of short-term use from CEP.

Even though they can be useful in the short-term, one of the big problems is – particularly in the way we think about what we’re doing when we’re prescribing drugs, psychiatric drugs – these days, is that even a short-term prescription can open the window towards a long-term one. Particularly if the prescriber is not aware of the potential for withdrawal symptoms, even after short-term prescriptions. What that can lead to is the prescriber confusing withdrawal symptoms with a return or even worsening of the original problem. And, from there, the window is opened towards a more long-term prescription rather than helping the person work through whatever withdrawal symptoms are occurring.

Also, even in short-term use, there are reports of people experiencing adverse effects (like paradoxical reactions, etc.) —sometimes severe ones—which can also be misdiagnosed as something else and is usually “treated” with more drugs (poly-drugging or dangerous co-prescribing, which often just prolongs or worsens the problem) or is the cause of other expensive testing and “treatments”. This is why it is so important that the medical community is aware of the risks and dangers of benzodiazepines, even in the short-term, so that they can quickly and accurately recognize and diagnose such things as resulting from the benzodiazepines before the patient is further harmed or improperly poly drugged.

Anecdotally, there are reports in the benzodiazepine withdrawal support communities from individuals who became physiologically dependent in a very short time (less than 4 weeks) and/or who also reported experiencing tolerance, interdose, and subsequent withdrawal symptoms upon attempts at cessation even when the drugs were taken as prescribed for less than the recommended 4 weeks time.

Lastly, a meta-analysis published in May 2017 in the journal Clinical Pharmacist shows that fracture risk is highest among new users of both benzodiazepines and Z-drugs: 

Researchers carried out a systematic review and meta-analysis of studies involving benzodiazepines, Z-drugs and hip fracture risk. They identified 18 studies involving benzodiazepines and 6 involving Z-drugs. Compared with non-exposure, short-term use (up to 14 days) of benzodiazepines was associated with a 140% increased risk of hip fracture. medium-term use carried a 53% increased risk; and long-term use (>month) carried a 20% increased risk. For Z-drugs, short-term use was associated with a 139% increased risk of hip fracture and mixed-term use carried an 80% increased risk.

Therefore, it is clear—even short-term use, while recommended when benzodiazepines are prescribed, is not without risks.