The prescribing dilemma of benzodiazepines.

BACKGROUND: Benzodiazepines are the most commonly prescribed psychoactive drug in western societies. While associated with risk and harm, they have a legitimate place in therapeutics. Prescribing practice does not reflect guidelines and guidelines rarely provide the practical strategies required to manage the complex clinical management of conditions such as anxiety, insomnia and drug dependence.
OBJECTIVE: This article proposes a model for rational prescribing of benzodiazepines that may be transferable to other therapeutic situations requiring the consideration of complex health, social and system factors. DISCUSSION: Benzodiazepines, like all psychoactive drugs, have their 'good', 'bad' and 'ugly' side. Prescribing decisions are complex along the spectrum of use. Many subtle factors influence how each of us prescribe such as our knowledge of our patients, their medical histories, their personal situations and the individual doctor-patient relationship.