Description <p>The American Society of Addiction Medicine (ASAM) has partnered with nine other medical societies and professional associations representing a wide range of clinical settings and patient populations to provide guidance on evidence-based strategies for tapering benzodiazepine (BZD) medication across a variety of settings.</p> Methods <p>The guideline was developed following modified GRADE methodology and clinical consensus process. The process included a systematic literature review as well as several targeted supplemental searches. The clinical practice guideline was revised based on external stakeholder review.</p> Recommendations <p>Key takeaways included the following: Clinicians should engage in ongoing risk–benefit assessment of BZD use/tapering, clinicians should utilize shared decision-making strategies in collaboration with patients, clinicians should not discontinue BZDs abruptly in patients who are likely to be physically dependent and at risk of withdrawal, clinicians should tailor tapering strategies to each patient and adjust tapering based on patient response, and clinicians should offer patients adjunctive psychosocial interventions to support successful tapering.</p>

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Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits

  • Emily Brunner,
  • Chwen-Yuen A. Chen,
  • Tracy Klein,
  • Donovan Maust,
  • Maryann Mazer-Amirshahi,
  • Marcia Mecca,
  • Deanna Najera,
  • Chinyere Ogbonna,
  • Kiran F. Rajneesh,
  • Elizabeth Roll,
  • Amy E. Sanders,
  • Brett Snodgrass,
  • Amy VandenBerg,
  • Tricia Wright,
  • Maureen Boyle,
  • Amanda Devoto,
  • Sarah Framnes-DeBoer,
  • Bethea Kleykamp,
  • Janette Norrington,
  • Dawn Lindsay,
  • Emily Brunner,
  • Chwen-Yuen A. Chen,
  • Tracy Klein,
  • Donovan Maust,
  • Maryann Mazer-Amirshahi,
  • Marcia Mecca,
  • Deanna Najera,
  • Chinyere Ogbonna,
  • Kiran F. Rajneesh,
  • Elizabeth Roll,
  • Amy E. Sanders,
  • Brett Snodgrass,
  • Amy VandenBerg,
  • Tricia Wright,
  • Maureen Boyle,
  • Amanda Devoto,
  • Sarah Framnes-DeBoer,
  • Bethea Kleykamp,
  • Janette Norrington,
  • Dawn Lindsay

摘要

Description

The American Society of Addiction Medicine (ASAM) has partnered with nine other medical societies and professional associations representing a wide range of clinical settings and patient populations to provide guidance on evidence-based strategies for tapering benzodiazepine (BZD) medication across a variety of settings.

Methods

The guideline was developed following modified GRADE methodology and clinical consensus process. The process included a systematic literature review as well as several targeted supplemental searches. The clinical practice guideline was revised based on external stakeholder review.

Recommendations

Key takeaways included the following: Clinicians should engage in ongoing risk–benefit assessment of BZD use/tapering, clinicians should utilize shared decision-making strategies in collaboration with patients, clinicians should not discontinue BZDs abruptly in patients who are likely to be physically dependent and at risk of withdrawal, clinicians should tailor tapering strategies to each patient and adjust tapering based on patient response, and clinicians should offer patients adjunctive psychosocial interventions to support successful tapering.