How do individuals in the UK experience recovery from prescribed benzodiazepine dependence and what helped?

Background: Benzodiazepines are a class of drug prescribed mainly for anxiety and insomnia. Since 1988, UK guidelines have warned not to prescribe benzodiazepines for longer than 2-4 weeks, because they cause dependence and withdrawal symptoms that can last months to years. Despite this, an estimated 72% of prescriptions between 2015-18 in England exceeded 4 weeks. There is a lack of services available in the UK to support individuals struggling with dependence and withdrawal, and limited scientific literature available on the experience of, and how to support individuals with, recovery from benzodiazepine dependence.

Aims: This study aims to explore the experience of recovery from prescribed benzodiazepine dependence, what individuals found helpful during the recovery process, and their views on what future services should look like.

Methods: Qualitative data was collected through semi structured interviews with seven participants who were prescribed benzodiazepines for at least 4 weeks, struggled with stopping or withdrawal symptoms, and stopped taking benzodiazepines at least one year ago. Interview transcripts were analysed using Reflexive Thematic Analysis within a phenomenological framework.

Results: Four themes were developed, which cover: (1) facing disbelief and failures in the healthcare system and consequent calls for improved education; (2) receiving and providing peer support; (3) the changing relationship to withdrawal symptoms during recovery, strategies used to cope with symptoms, and the persistence of post-withdrawal symptoms long after stopping; (4) severe suffering that can impact many different areas of life, can lead to enduring trauma, and requires holistic support.

Conclusion: This study demonstrates how some benzodiazepine patients endure severe suffering that can be unnecessarily exacerbated by disbelief and failures in the healthcare system, resulting in trauma and distrust of healthcare professionals. This situation could be improved by believing and validating patient experiences, so appropriate care can be received and further harm avoided. Counselling Psychologists may particularly need to focus on establishing trust, providing validation, and advocating for this client group. The findings further point to a need for improved education, commissioning of specialist services and a national helpline, updated NICE guidance, and improved monitoring of prescribing behaviour.