Managing benzodiazepines in primary care

Managing benzodiazepines in primary care

How do people find strength in their journey to sobriety when prescribed drugs like benzodiazepines are in the mix? This episode of Addiction Practice Pod focuses on the tricky realities of benzo use in primary care, with a strong emphasis on safety, compassion, and honesty. Host David Ball talks with two guests who bring both sides of the desk to the table.

Former AIDS nurse and counsellor Bill Nelles shares how he was first prescribed diazepam at 16 for severe anxiety, describing that first tablet as giving him “one of the best relaxing sleeps” he’d ever had. Decades later, he’s tapering slowly with his doctor and stresses the importance of shared power, tiny dose changes, and knowing when a clinician needs to pull back to protect trust.

Family physician and addiction specialist Dr Megan Hill offers a practical, clinic-ready approach for GPs and other prescribers. She challenges the reflex to “just stop” benzos, arguing that “we do more harm from undertreating” when patients are cut off abruptly. Instead, she outlines slow tapers that may take one to three years, frequent brief check-ins, and careful planning around life stressors, all grounded in harm reduction.

You’ll hear clear tips on assessing dependence versus use disorder, managing withdrawal, and supporting patients whose anxiety and sleep problems are tangled up with the effects of the medication itself. There’s also a frank look at stigma, family dynamics, and how even well-meaning prescribers can fuel fear if they rush the process. If you’re a clinician working with people who use benzos—or you’re personally affected and curious what thoughtful, respectful care can look like—this conversation offers steady, realistic hope.

What could change for your patients if benzo tapers became a long-term partnership instead of a one-sided demand?