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Benzodiazepines: Falling Use, Unsolved Tapering

7:11 PM ETDeveloping

Health Desk

In Short: Clinicians face a lack of trial evidence for safely tapering long-term use despite new guidelines.

In 2025, ten medical societies published the first multisociety clinical practice guideline on benzodiazepine tapering, developed using a modified GRADE process and a structured consensus process.

Prescribing of benzodiazepines is declining, but mortality rates have not followed suit, indicating an ongoing challenge.

The American Geriatrics Society's 2023 Beers Criteria further restricted benzodiazepine use, listing them as potentially inappropriate for older adults across most indications.

Benzodiazepines were involved in 10,870 US overdose deaths in 2023, with nearly 70% of those deaths also involving illicitly manufactured fentanyl.

What this adds

What's still developing

• NIDA The guidance clinicians actually need to safely unwind existing long-term use is also barely a year old, and it is more consensus-based than it might first appear: in 2025, ten medical societies led by the American Society of Addiction Medicine published the first multisociety clinical practice guideline on benzodiazepine tapering, developed using a modified GRADE process combined with a structured (modified Delphi) consensus process specifically because so little trial evidence exists on tapering itself.
• J Gen Intern Med This reflects the current state of the evidence base rather than a limitation of the guideline itself: benzodiazepine tapering practice is presently guided by structured expert consensus rather than clinical trial data, and the 2025 guideline's principal contribution is rendering that consensus explicit and systematic rather than ad hoc.
• So the picture for 2026 is a genuine but incomplete correction: prescribing is falling, mortality has not, and the deprescribing playbook is still being written in real time.

Sources

• Medscapelink