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Issue 1: March, 2022

Message from the Registrar – Prescribing Benzodiazepines and Z-Drugs

Physicians are aware of the harmful effects of Benzodiazepines and Z-drugs when used long-term or in combination with opioids.

The profession has achieved significant improvement in prescribing Benzodiazepines and Z-Drugs, with a significant reduction in co-prescribing these medications with opioids. Prescribing is particularly challenging when caring for legacy patients and when attempting to taper dosages.  

To offer support and direction to physicians, our Council has recently approved a new Professional Standard Regarding Benzodiazepines and Z-Drugs. The standard was developed to provide physicians with direction on the ethical and practice requirements for physicians in relation to prescribing these medications. The standard addresses the challenges of initiating benzodiazepines or Z-drugs with older patients. This new guidance was developed in consultation with stakeholders including Nova Scotia Health, Doctors NS, and CMPA.

The Nova Scotia Prescription Monitoring Program expanded the scope of its monitoring services to include benzodiazepines with the goal of collecting data to improve prescribing practices and patient care. As such, Benzodiazepine prescribing histories of patients are available via NSPMP’s e-Access.

Physicians are also encouraged to review the College’s Professional Standards and Guidelines Regarding Care for Legacy Patients. The purpose of this document is to guide physicians on the challenges of caring for legacy patients. Physicians must both manage the expectations of legacy patients and independently assess the risks and benefits of their existing treatment plan. These challenges are particularly difficult when involving medication regimes that do not conform to current best practice standards or guidelines.

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