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Psychiatrist Decision-Making Towards Prescribing Benzodiazepines: The Dilemma with Substance Abusers

Abstract  

Psychiatrists’ decision making about prescribing benzodiazepines (BZD) was evaluated in a community mental health center.
An anonymous survey of outpatient psychiatrists in an academic-affiliated public mental health center was conducted using
a 45-item questionnaire developed based on the results of a previous study. Sixty-six percent of responses indicate that,
at times, psychiatrists experienced requests for behaviors suspicious for abuse, including ‘lost/missing prescriptions’ and
‘use of BZD by others’. Patient characteristics such as ‘history of abuse’, ‘unknown patient’, and ‘patient use of illicit
substances’ were occasional or common reasons for NOT prescribing BZDs (75 %). The most common contexts in which the majority
of our sample was uncomfortable prescribing BZDs involved a patient history of substance abuse, fear of initiation of dependence,
diversion, and feeling manipulated by the patient. Time limitations were a dilemma for 20 %. Psychiatrist self-reported dilemma
and behavior in prescribing BZDs largely reflected concerns with substance abuse and less frequently workload or time issues.

  • Content Type Journal Article
  • Category Original Paper
  • Pages 1-9
  • DOI 10.1007/s11126-012-9220-8
  • Authors
    • Carla Beth Marienfeld, Department of Psychiatry, Yale University School of Medicine, 300 George St. Suite 901, New Haven, CT 06511, USA
    • Ece Tek, Department of Psychiatry, Yale University School of Medicine, 300 George St. Suite 901, New Haven, CT 06511, USA
    • Esperanza Diaz, Department of Psychiatry, Yale University School of Medicine, 300 George St. Suite 901, New Haven, CT 06511, USA
    • Richard Schottenfeld, Department of Psychiatry, Yale University School of Medicine, 300 George St. Suite 901, New Haven, CT 06511, USA
    • Marek Chawarski, Department of Psychiatry, Yale University School of Medicine, 300 George St. Suite 901, New Haven, CT 06511, USA
    • Journal Psychiatric Quarterly
    • Online ISSN 1573-6709
    • Print ISSN 0033-2720
Posted in: Journal Article Abstracts on 04/29/2012 | Link to this post on IFP |
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