Benzodiazepines: Dependence and Withdrawal

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Abstract
In the past two decades, billions of benzodiazepine prescriptions have been written for millions of patients who have taken these substances intermittently or continuously. Extensive use has caused health authorities and government agencies to become concerned about unknown hazards of protracted benzodiazepine use, possible dependence and tolerance, and the potential incidence of withdrawal reactions. The news media have bruited charges of overuse, misuse, and abuse, of birth defects, and of death attributable to these drugs. For the most part, however, the case against benzodiazepines remains weak, and their efficacy and safety have been demonstrated. Critics attribute the widespread use of benzodiazepines to overprescribing by irresponsible physicians—a charge refuted by a recent National Institute of Mental Health survey of psychotropic drug use by 2,500 randomly selected American adults.1 This survey disclosed that only 30% of highly distressed persons had taken any psychotropic drugs during the year. Even if physicians are

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