Authors’ response

James Davies; Todd Rae; Luke Montagu

doi:10.3399/bjgp17X693257

Prof. Siriwardena is mistaken to state unequivocally that guidelines have failed to reduce BZD prescribing. Since their introduction in 2004,¹ benzodiazepine prescribing fell from 3.5% to 2.5% of patients between 2000 and 2015.² We agree that too many clinicians fail to follow guidelines but we do not accept we are wrong to insist on guidance adherence because the reasons for non-adherence are ‘multifaceted and complex’. We do not agree there is enough research on the harms of long-term BZD use. Patient reports indicate harms that have not been captured in the existing evidence base.

We are criticised for recommending national withdrawal services because ‘[we ignore] the evidence that points to multifaceted rather than simplistic solutions’ for long-term BZD prescribing. We fail to see how recommending national services can be considered simplistic given there is nothing to stop such services from taking a multifaceted approach. Indeed, there is now medical consensus for national withdrawal provision.

REFERENCES

1.↵
1. McIntosh A,
2. Cohen A,
3. Turnbull N,
4. et al.
(2004) Clinical guidelines and evidence review for panic disorder and generalised anxiety disorder. CG22 (NICE, London).
2.↵
1. Cartagena Farias J,
2. Porter L,
3. McManus S,
4. et al.
(2017) Prescribing patterns in dependence forming medicines (NatCen, London).