Public health dimensions of benzodiazepine regulation

Benzodiazepines have been described historically as the latest and safest of a long list of popular sedative compounds. Despite well-known problems of dependence and misuse, they continue to be widely prescribed, even on an unlicensed long-term repeat basis, particularly to women, the elderly, the chronically ill and other groups of people who suffer social and educational disadvantage. Guidelines discouraging such prescribing have been relatively ineffective, and may not be based on a grounded assessment of the balance of risk in the management of community mental health problems. Effective benzodiazepine regulation is a complex multilevel process, requiring a grasp of the dynamics of drug prescribing, consumption and diversion. The urgent need for further quantitative and qualitative research is starkly illustrated in the deteriorating social environment of the modern inner-city ghetto.