The report, Examining the overprescribing of benzodiazepines, z drugs and gabapentinoids in Ireland, has been produced by a multi-agency working group established by the Medical Council.

The recommendations within the report aim to reduce the initiation and inappropriate prescribing of these medicines in the interests of patient and doctor safety, and to support prescribers.

Key recommendations of the working group include:

• Increase resources for primary care counselling supports and addiction services to reduce the number of people requiring prescriptions for benzodiazepines, z-drugs and gabapentinoids. Additionally, provision of appropriate resourcing of all prescribers to support patients to reduce their consumption of these drugs
• Further educational initiatives should be developed for doctors, pharmacists, and the public to increase awareness of the risks associated with benzodiazepine, z-drug and gabapentinoid use. Training and awareness around overprescribing matters should be a focus of pre-registration education and training
• The working group proposes that a central repository for data, which would be accessible to prescribers, should be established. The purpose of this is to enhance visibility of private prescribing of controlled drugs, to achieve greater accountability and improve prescribing practices
• The working group supports the idea of consideration being given to including pregabalin and gabapentin on the controlled drugs list. However, it acknowledges that this alone may not be enough. Additional improved service delivery is also crucial to ensuring this reclassification has the desired impact on prescription rates and adverse impacts of these drugs
• The successful implementation of these recommendations will require considerable stakeholder involvement across the Irish healthcare system to be effective. The working group recommends the establishment of an implementation group to assess progress on the implementation of the recommendations within this report.

Dr Margaret O’Riordan, chair of the working group and member of the Medical Council, said while benzodiazepines may have a role in the treatment of a patient on a time-limited basis, caution and strict monitoring are required when they are prescribed. The overprescribing of benzodiazepines, z-drugs, and gabapentinoids is an issue that affects patient safety and has significant implications for public health. 

“Our report highlights the importance of tailored approaches, the significance of services like pain clinics, mental health and addiction services, as well as the necessity of medicines reconciliation and review in primary and secondary care settings and during care transitions.”

Dr O’Riordan, a former Irish College of GPs president, said it is important to acknowledge that addressing the issues raised in the report demands a significant time commitment, especially in general practice. 

“Limited access to counselling and addiction services further strains both patients and health professionals’ efforts to address these needs.”

The full report is available on the website: www.medicalcouncil.ie