Benzodiazepine use by chronic pain patients

Of 114 patients presenting to the Pain Management Service at the Mount Sinai School of Medicine with chronic pain, 38% (N = 43) were taking one or more benzodiazepine drugs at the time of the initial assessment. The majority of patients were chronic users, with 14% (N = 6) having taken the medications for 1-2 years and 46% (N = 20) for 2 years or longer. Ninety-three percent (N = 40) of those given a benzodiazepine drug stated that it was initiated after the onset of pain. Although 86% (N = 37) were using the medication (all or in part) to improve sleep, they continued to report as many problems with sleep as the nonbenzodiazepine group did. Other drugs prescribed concurrently with the benzodiazepine drugs were narcotic drugs (58% of patients), antidepressant drugs (32%), nonsteroidal antiinflammatory agents (26%), and others (16%). Benzodiazepines have been reported to provide little therapeutic benefit to chronic pain patients, and may even exacerbate their symptoms. We have shown that benzodiazepine drugs are frequently prescribed for long-term use, for sleep, and in conjunction with narcotic drugs. Such use is contrary to generally accepted guidelines.