Benzodiazepine prescribing for older adults has declined 18% overall from 2015 to 2024, but prescribing reductions have stalled since the COVID-19 pandemic, according to a study issued yesterday by Annals of Internal Medicine.Why It’s Relevant
Benzodiazepine use—particularly long-term use (≥6 months)—poses risks for older adults including falls, cognitive decline, dependence, and motor vehicle crashes. Yet prescribing trends for this population are not well characterized, particularly among long-term care residents.
By the Numbers
- Between 2015 and 2024, overall benzodiazepine prescribing to older adults (≥65 years) decreased from 14.1 to 11.5 fills per 100 persons. However, after reaching a low in 2020, prescribing rates plateaued through 2024.
- Dispensing of benzodiazepines to older adults by long-term care pharmacies increased from 0.46 to 0.85 fills per 100 persons from 2015 to 2024, with the sharpest rise occurring after 2020. Benzodiazepine prescribing also increased among adults aged 75 and older after 2020.
- Prescribing by advanced practice clinicians such as nurse practitioners or physician assistants more than doubled during the study period (from 14% to 30%), while prescribing by primary care physicians dropped from 68% to 57%. Prescribing by psychiatrists remained relatively flat at 7%.
- Overall, 43% of older adults prescribed benzodiazepines were in the South, whereas 18%, 19%, and 20% were living in the West, Northeast, and Midwest, respectively.
The Other Side
The researchers relied on information about filled prescriptions among older adults and didn’t have data about clinical indications, comorbidities, co-prescribed medications, and potential adverse outcomes.
Takeaway Message
Increases in benzodiazepine prescribing for those in long-term care facilities may reflect pandemic-related disruptions, including social isolation, staffing shortages, reduced access to behavioral therapies, and greater reliance on medications with rapid effects, the researchers wrote. In addition, prescribing oversight may have been deprioritized.
“Adults aged 75 years or older and those served by [long-term care] pharmacies remain priority populations for medication safety initiatives,” the researchers wrote. “Structured medication review, nonpharmacologic therapies, and alignment of quality incentives may help sustain reductions in benzodiazepine prescribing.”
Related Information
Source
Mark Olfson et al. Benzodiazepine prescriptions to older adults in the United States, 2015 to 2024. Annals of Internal Medicine. Published July 7, 2026. doi: 10.1159/000485800.
(Image: Getty Images/iStock/Andrii Dodonov)
