Acute Sedative Prescribing: Safe Practices

The use of sedatives (including benzodiazepines) and risk of complications has become increasingly recognized over the last decade. Just as with the opioid epidemic, increasing patterns of prescribing for benzodiazepines has led to increased complications.

Safety Guideline

New patients who have not previously been on sedative medications should generally be prescribed less than 15 days of medication and always less than 30 days, except in exceptional cases such as end-of-life care.

BPBT Acute Benzodiazepine / Sedative Prescribing Reports

• Launched in 2024, the BPBT Acute Benzodiazepine/Sedative Prescribing Reports provide feedback on the number of prescriptions written by prescribers and the average days prescribed compared to peers.
• Each quarter, the WSMA distributes reports to individual prescriber reports by email for free. Prescribers may use the reports to monitor their prescribing for their own purposes.
• Data definitions and metric specifications are available.

Quick Facts

• 12.5% of Americans have used a sedative in the past year ⁱ.
• 17.7% of sedative use was misuse without a prescription, obtained from a friend or relativeⁱ.
• Benzodiazepines and tranquilizers are the third most used illicit or prescriptions drug in the US, with 2.2% of the population reporting misuse ⁱⁱ.
• In 2020, 16% of overdoses involving opioids had a co-administered benzodiazepine ⁱ.
• Benzodiazepine-related overdose mortality has risen from 0.6 per 100,000 adults to 4.4 over the first part of the 21st Century ⁱⁱⁱ.
• Co-prescribing of benzodiazepines and opioids quadrupled from 1999 to 2015 to 2% of all patients on opioidsⁱⁱⁱ.
• The odds ratio for chronic benzodiazepines is 1.94-fold higher for every additional interval of 9.7 days in the initial prescription^iv.

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