URGENT! We Need Your Help by July 19! Draft Benzo Deprescribing Guidelines!

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Today, we sent ASAM a letter outlining our organization’s top concerns with their draft Clinical Practice Guideline on Benzodiazepine Tapering. These concerns are ranked by priority and supported by medical professionals, researchers, and patients both within and outside our organization. Do you agree with us?

Our Top Concerns, Ranked By Priority 

1. Inpatient tapers are too heavily recommended. 
2. The issue of protracted benzodiazepine withdrawal syndrome, especially from rapid cessation, should be recognized in this guidance.
3. The 5-25% starting taper rate is too broad to be meaningful and allows for a taper starting at 25%—the likely default for the expeditious clinician—which will harm certain patients.
4. Patients should be advised to reduce at 5-10% of the current dose, as opposed to the starting dose, per month so that reductions become smaller and smaller as total dose becomes lower.
5. Recommending that requiring older adults taper off benzodiazepines completely is over-emphasized.
6. Tapering with very long-acting agents like phenobarbital is typically not managed appropriately in an inpatient setting.
7. Shared decision making requires full informed consent, including the risks and benefits of both continuing as well as discontinuing benzodiazepines.
8. The tapering strategies outlined in this guideline are not sufficient to provide meaningful guidance to clinicians. 
9. The guideline does not help clarify the difference between relapse and withdrawal.
10. “Long-term” should be defined as “>2-4 weeks” and used consistently throughout the guideline.

Click the link to read the full letter, see the rest of our comments, find out who signed it, and get all the supporting details:  https://www.benzoinfo.com/2024/07/19/voicing-concerns-asam/

 

[[Ka...]]

Encourage all BB members to read the full letter - it is excellent. @[...] and all contributors have worked so hard on this. 

Concern 5. is really important. Interesting to see adults in age range 50-64 have the highest prescription rates, prevention of older adult benzodiazepine prescribing should start much earlier with more judicious prescribing in younger populations. 

Concerns 7. & 8. for me go together. Everyone deserves informed consent and clinical guidance on how to taper - if that is best way forward for the individual. Sadly, my experience of both here in UK under NHS is negative.  

The timeframe and process for submissions has been short and technically difficult. Heres hoping concerns from BIC, and others, really are a catalyst for change and guidelines fit for purpose. 

 

Edited July 19 by [Ka...]
edit concern 5.

[[Ch...]]

I believe you can just submit your story. It's very emotional for me to talk about my story after all these years and I can't currently deal with all the lines and things. But I believe you can just submit your story and your comments as Line 0 Page 0...or that's what I did. It was a little difficult being super professional and not telling them to eff off...to type anything at all, but submitting it is probably part of my healing. I believe we can submit comments until the end of today. I hope everyone will try and do this.

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The form is still available on the ASAM website. We're not entirely sure what this means, but if you would like to leave any comments, please feel free to do so! https://www.asam.org/quality-care/clinical-guidelines/benzodiazepine-tapering

[[Li...]]

@[...]I just tried to submit another comment and got the “You have already taken this survey” message.  I hope someone who has not previously submitted comments will let us know if they can create a new ‘account’ and submit comments.

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2 minutes ago, [[L...] said:

@[...]I just tried to submit another comment and got the “You have already taken this survey” message.  I hope someone who has not previously submitted comments will let us know if they can create a new ‘account’ and submit comments.

Clear your cookies. We've been able to comment. 

[[Li...]]

[[...]]

Did you clear your cache, too? That could help

 

[[Li...]]

Yes I cleared my cache.  No luck.

I then tried switching to a different device and browser (from iPad/Safari to MacBook/Firefox).

I was able to submit another comment using my original username.  However, I was also asked to submit the Disclosure Form again so I am now uncertain if my new comment will be linked to my old comments.  Fingers crossed that ASAM will reconcile the data.

[[Li...]]

Benzo survivor and advocate Angie Peacock shares her perspective on the ASAM draft tapering guideline after helping 53+ people submit comments.

 

 

 

 

[[Ka...]]

@[Li...]  thank you for posting.

ASAM kinda need to rethink how they approached this and it would have been helpful to make allowance for how so many of us are cognitively affected through benzodiazepine use. Writing and commenting on the subject matter is deeply personal, potentially draining and likely to be triggering. Yet it's such an important issue and opportunity.

BIC and all contributors have worked so incredibly hard. For Angie Peacock to devote time, energy and commitment to help with submissions in a short timeframe is incredible and she is truly advocating for the benzo harmed community. 

Edited July 22 by [Ka...]