The two papers in the December issue of the BJGP on benzodiazepines and Z drugs are a timely reminder of the continuing (and, in my view, unacceptable) disparity between evidence and practice in primary care across the UK.1,2 That such attitudes towards these drugs persist is quite astonishing.
Concern over the use of these drugs was highlighted by the Committee on the Review of Medicines as far back as 1980.3 This concern led to the production of guidance on the use of benzodiazepines by the Committee on Safety of Medicines in January 1988,4 advice that was backed at the time by the RCGP and the Royal College of Psychiatrists. There is every reason to believe that this guidance should be extended to cover the Z drugs.5
There is now very real concern that chronic benzodiazepine use may result in permanent cognitive impairment.6 This, of course, may have legal as well as clinical implications for primary care physicians.
GPs in the UK pride themselves on their independent status within the NHS but this status cannot, and should not, be used as an excuse to continue to practice in the face of overwhelming evidence to the contrary. Failure to address these quality disparities really does bring our profession into disrepute.
- © British Journal of General Practice, 2007.
