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Diazepam usage in veterans with spinal cord injury
C P Broderick1, C L Radnitz, W A Bauman
1Psychology Service, Veterans Affairs Medical Center, Bronx, NY 10468, USA.
The Journal of Spinal Cord Medicine
|November 14, 1997
Summary
Many spinal cord injury (SCI) patients receive diazepam for spasticity, often long-term, with few discontinuation programs. Guidelines are needed for safer diazepam use and withdrawal in SCI care.
Area of Science:
- Neurology
- Pharmacology
- Rehabilitation Medicine
Background:
- Diazepam is commonly prescribed for managing spasticity in individuals with spinal cord injury (SCI).
- The Department of Veterans Affairs Medical Centers (DVAMCs) provide specialized SCI services, making them a key setting for evaluating medication practices.
Purpose of the Study:
- To assess the current prescription patterns and long-term usage of diazepam among patients with SCI within DVAMC specialized SCI Services.
- To identify existing policies and programs related to benzodiazepine use and discontinuation in this patient population.
Main Methods:
- A survey was distributed to all 23 DVAMCs with specialized SCI Services.
- The survey collected data on policies, routine prescription of benzodiazepines, duration of diazepam use, and discontinuation programs.
Main Results:
- No formal policy on benzodiazepine prescription existed at 65% of SCI Services.
- Diazepam or other benzodiazepines were routinely prescribed at 70% of SCI Services.
- One-third of patients used diazepam for over 10 years; 37% used it for 6-10 years. Only 10 services had discontinuation programs with a 20% success rate.
Conclusions:
- There is a significant lack of established policies and structured programs for diazepam management in SCI patients.
- Long-term diazepam use is prevalent, highlighting the need for better understanding and strategies for safe withdrawal.
- Development of appropriate guidelines for diazepam use in SCI spasticity is crucial.