New regulations regarding e-prescriptions may increase the risk of acute withdrawal syndromes in patients dependent on benzodiazepines or non-benzodiazepine hypnotics

Abstract

The implementation of solutions in the area of e-health and use of electronically issued prescription obligations meets the modern requirements of the healthcare system. A digital record of the issued prescriptions aims at preventing prescriptions from being traded without a physician's name in patient medical records. Access to the system may in turn reveal doctors' bad practices, and fear of the professional and legal consequences may force a change in the prescription of benzodiazepines or non-benzodiazepine hypnotics. The effect of these activities may be the disclosure of many cases of ‛hidden' dependence and adverse phenomena and increase in the number of effects of cases of sudden dose reduction or discontinuation of benzodiazepines or non-benzodiazepine hypnotics. It is recommended to develop integrated, central information and train Emergency Department staff. Awareness of the phenomenon and appropriate diagnostic and therapeutic procedures can significantly increase the chance of improving the quality and safety of services provided in the acute intervention mode (Emergency Department). A rational solution may be to urgently develop standards of conduct in cases of acute withdrawal syndromes from benzodiazepines or non-benzodiazepine hypnotics. It seems reasonable to introduce preventative programs enabling early recognition and treatment of cases where large and very large doses of drugs have been taken (high dose tolerance). Under no circumstances should medication be stopped abruptly. An information campaign, raising awareness also among the personnel of psychiatric wards, may increase the chances of systemic preparation for admission of the currently unknown population of patients at risk.