A patient prescribed a benzodiazepine may develop a complex and persistent dependence.
Features of complex persistent benzodiazepine dependence:
(1) The patient is taking the benzodiazepine as prescribed.
(2) The patient perceives the drug as being effective in controlling insomnia and anxiety.
(3) The patient does not take the benzodiazepine for intoxication or euphoria.
(4) The continued use is based on symptom control rather than cravings.
(5) Continued use is felt to be beneficial with better functioning and not asa cause of problems.
(6) Tolerance and physiological dependence may be present.
(7) The patient may experience significant psychological or functional decline during or after tapering or discontinuation.
where:
• Physiological dependence may develop with 2 weeks of continued use.
Differential diagnosis:
(1) benzodiazepine use disorder (BUD; sedative-hypnotic use disorder)
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Specialty: Toxicology, Pharmacology, clinical
