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CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
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Benzodiazepine Prescribing Patterns Following Mass Traumatic Events.

Ofer Rahamim1,2,3, Aviv Segev4,5, Dana Sinai2,6

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Following the October 7 attacks, benzodiazepine prescriptions surged, especially first-time use, highlighting a gap between guidelines and crisis care. This underscores the need for better support for frontline clinicians during mass trauma events.

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Area of Science:

  • Public Health
  • Pharmacology
  • Trauma Medicine

Background:

  • Clinical guidelines recommend caution with benzodiazepine use post-trauma.
  • Mass traumatic events present challenges to adhering to formal prescribing recommendations.
  • Frontline care delivery during crises often involves pragmatic decision-making.

Purpose of the Study:

  • To analyze changes in benzodiazepine prescribing patterns after the October 7, 2023, terrorist attacks in Israel.
  • To identify factors influencing benzodiazepine prescription decisions during this mass trauma event.

Main Methods:

  • Population-based retrospective cohort study using Clalit Health Services electronic database (Israel).
  • Comparison of benzodiazepine prescriptions in 7- and 30-day periods post-October 7, 2023, with the same periods in 2022.
  • Analysis of nearly 4 million individuals aged 18+ actively insured.

Main Results:

  • Total benzodiazepine prescriptions increased by 219% (7-day) and 57% (30-day) compared to 2022.
  • First-time prescriptions saw a 10-fold increase (7-day) and 268% increase (30-day).
  • Proximity to conflict zones and pre-existing anxiety diagnoses were associated with new prescriptions.

Conclusions:

  • The October 7 attacks led to a significant rise in benzodiazepine prescribing, particularly by primary care physicians.
  • This highlights a conflict between clinical guidelines and emergency response needs.
  • Enhanced clinician training and support systems are needed for managing prescribing during mass trauma.