• Joan M Cook, Tatyana Biyanova, Christina Masci, and James C Coyne.
• New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit #69, New York, NY 10032, USA. jc2676@columbia.edu
• J Gen Intern Med. 2007 Aug 1; 22 (8): 109411001094-100.

ObjectiveThe objective of the study is to understand patient factors contributing to the chronicity of benzodiazepine use by older adults as a first step in the development of acceptable intervention strategies for taper/discontinuation or prevention of chronic use.DesignThe design of the study consists of qualitative semi-structured patient interviews.Setting And ParticipantsThe participants were 50 anxiolytic benzodiazepine users, 61-95 years of age, recruited through referrals from primary care physicians who practiced in the general Philadelphia, Pennsylvania area.ResultsMany older chronic users have come to rely and psychologically depend on benzodiazepines for their unique soothing properties, attributing to these medications characteristics that extend beyond an ordinary medication, i.e., affording control over daily stress, bringing tranquility, and even prolonging life. Most of the patients denied or minimized side effects and expressed resistance to taper or discontinuation, ranging from subtle reluctance to outright refusal and fear of being left suffering without these medications.ConclusionsThe reluctance of older chronic benzodiazepine users to taper or discontinue use highlights the importance of prevention and early intervention strategies to avoid the development of chronic use. Suggestions for curbing chronic use are presented.

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