Benzodiazepines Get Stronger Boxed Warning on Misuse Risk

By Kelly Young

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

The FDA is requiring that boxed warnings for benzodiazepines be updated to emphasize the risks for misuse, addiction, physical dependence, and withdrawal symptoms, even when the drugs are taken at the recommended dosages.

Overdose and death can occur when taking benzodiazepines, particularly in combination with opioids, alcohol, or illicit drugs. Physical dependence can occur after only a few days. Ceasing use suddenly or lowering the dosage too quickly can lead to withdrawal symptoms, including life-threatening seizures. In some patients, withdrawal symptoms may last many months.

When prescribing benzodiazepines, clinicians should assess the patient's risk for abuse, misuse, and addiction — and consider other medications the patient is taking. When stopping a benzodiazepine or lowering the dosage, they should use a patient-specific plan to gradually taper treatment.