A Proposal for a Service to come off Benzodiazepines in the Community Pharmacy

The use of benzodiazepines (BZD) in Spain is very far reaching, and is aggravated in two key situations: the use of BZDs with a long half-life by elderly people, which can lead to problems of daytime sleepiness, lack of orientation, falls, etc. and the prolonged use in all age groups that can lead to tolerance and addiction.

The proposal for services recently made by Sociedad Española de Farmacia Comunitaria (Sefac) includes treatment for dependency on BZDs as part of its portfolio of professional services.

When coming off BZDs there are mainly three schools of thought: those who advocate coming off it at a faster or slower rate, consisting of cutting back by 50 % every few days over a total period of six weeks; a second school of thought that prefers a more gradual, slower withdrawal of between three and six months, and a very slow option which advises coming off them over a period of years. This model could be suitable for people with great addiction to high doses of BZDs. In any case, pharmacists can adopt their own protocol for service, as long as they comply with the general criteria agreed by scientific societies, professional associations, etc.