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Practice Guideline
. 2025 Sep;40(12):2814-2859.
doi: 10.1007/s11606-025-09499-2. Epub 2025 Jun 17.

Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits

Emily Brunner  1 , Chwen-Yuen A Chen  2 , Tracy Klein  3 , Donovan Maust  4 , Maryann Mazer-Amirshahi  5 , Marcia Mecca  6 , Deanna Najera  7 , Chinyere Ogbonna  8 , Kiran F Rajneesh  9 , Elizabeth Roll  10 , Amy E Sanders  11 , Brett Snodgrass  12 , Amy VandenBerg  13 , Tricia Wright  14 , Maureen Boyle  15 , Amanda Devoto  15 , Sarah Framnes-DeBoer  15 , Bethea Kleykamp  16 , Janette Norrington  15 , Dawn Lindsay  17 ; Clinical Guideline Committee (CGC) Members; ASAM Staff and Contractors
Collaborators, Affiliations
Practice Guideline

Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits

Emily Brunner et al. J Gen Intern Med. 2025 Sep.

Abstract

Description: The American Society of Addiction Medicine (ASAM) has partnered with nine other medical societies and professional associations representing a wide range of clinical settings and patient populations to provide guidance on evidence-based strategies for tapering benzodiazepine (BZD) medication across a variety of settings.

Methods: The guideline was developed following modified GRADE methodology and clinical consensus process. The process included a systematic literature review as well as several targeted supplemental searches. The clinical practice guideline was revised based on external stakeholder review.

Recommendations: Key takeaways included the following: Clinicians should engage in ongoing risk-benefit assessment of BZD use/tapering, clinicians should utilize shared decision-making strategies in collaboration with patients, clinicians should not discontinue BZDs abruptly in patients who are likely to be physically dependent and at risk of withdrawal, clinicians should tailor tapering strategies to each patient and adjust tapering based on patient response, and clinicians should offer patients adjunctive psychosocial interventions to support successful tapering.

Keywords: Benzodiazepine tapering; Clinical guideline; Shared decision-making.

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Conflict of interest statement

Declarations:. Conflict of Interest:: The authors declare that they do not have a conflict of interest. All authors completed Disclosure of Interest forms, which can be found in Supplementary Material 4.

Figures

Figure 1
Figure 1
Determining whether and where to taper
Figure 2
Figure 2
Outpatient taper management
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Multiple Cause of Death Data 2000-2020 on CDC WONDER Online Database. December 2021 ed. CDC WONDER: Centers for Disease Control and Prevention, National Center for Health Statistics; 2021.
    1. Soyka M. Treatment of benzodiazepine dependence. N Engl J Med. 2017;376(12):1147-1157. 10.1056/NEJMra1611832 - PubMed
    1. Lader M. Benzodiazepines revisited--will we ever learn? Addiction. 2011;106(12):2086-2109. 10.1111/j.1360-0443.2011.03563.x - PubMed
    1. US Food and Drug Administration. FDA Drug Safety Communication. Updated 09-23-2020. Accessed August 1, 2024. https://www.fda.gov/media/142368/download
    1. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. National Survey on Drug Use and Health 2023 Detail Files. Retrieved from https://datafiles.samhsa.gov. 2024.

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