Benzodiazepine Prescribing Patterns Following Mass Traumatic Events

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.