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Psychiatrist Decision-Making Towards Prescribing Benzodiazepines: The Dilemma with Substance Abusers
Psychiatric Quarterly, 04/30/2012
Clinical Article
Marienfeld CB et al. – Psychiatrist self–reported dilemma and behavior in prescribing BZDs largely reflected concerns with substance abuse and less frequently workload or time issues.
Methods- An anonymous survey of outpatient psychiatrists in an academic–affiliated public mental health center was conducted using a 45–item questionnaire developed based on the results of a previous study.
- Sixty–six percent of responses indicate that, at times, psychiatrists experienced requests for behaviors suspicious for abuse, including ‘lost/missing prescriptions’ and ‘use of BZD by others’.
- Patient characteristics such as ‘history of abuse’, ‘unknown patient’, and ‘patient use of illicit substances’ were occasional or common reasons for NOT prescribing BZDs (75 %).
- The most common contexts in which the majority of the authors' sample was uncomfortable prescribing BZDs involved a patient history of substance abuse, fear of initiation of dependence, diversion, and feeling manipulated by the patient.
- Time limitations were a dilemma for 20 %.