Benzodiazepines are widely prescribed in Australia, despite concerns about their potential for abuse and dependence. Paradoxical reactions, disinhibition and amnesia are all associated with benzodiazepine use, misuse and intoxication. While violent and aggressive behaviour may be a consequence of such disinhibition, there is limited information available regarding the links between benzodiazepine use and violence.
This article aims to examine the existing evidence on the relationship between benzodiazepines, violence and aggression.
While current evidence suggests that benzodiazepines rarely induce violence, it is important to note that the available literature is limited in its scope and that benzodiazepine related violence is often severe and of potential concern to frontline workers. Mediating risk factors for benzodiazepine related violence include concurrent alcohol use, benzodiazepine dose, a history of aggression and underlying impulsivity. Comprehensive assessment and alternate nonpharmacological treatment options should be considered before prescribing benzodiazepines within primary care.
Each year over 5 million prescriptions for benzodiazepines are subsidised through the Pharmaceutical Benefits Scheme (PBS),1 accounting for approximately 4–5% of all prescriptions written by general practitioners.2 Although not recommended as first line treatment for anxiety disorders, and despite significant risks of abuse and dependence with continued use, benzodiazepines are widely prescribed for managing anxiety, panic disorders and insomnia.
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