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Psychiatrist describes Medical Council views on benzodiazepines as 'utterly alarmist'

A leading psychiatrist has described as “utterly alarmist” and “frightening for doctors and patients” Medical Council advice that raises concerns about over-prescribing of benzodiazepines.

Ted Dinan, who recently retired as Professor of Psychiatry at University College Cork (UCC) said the view from the Council was that taking benzodiazepines “is a bit like taking opiates and that is simply not true”.

"Patients could be led to believe you might as well be taking crack cocaine,” Prof Dinan said.

“I believe they went seriously over the top in their threats, particularly in relation to GPs who do have a role to play in managing psychiatric illness.”

Prof Dinan was commenting on a recent Medical Council statement warning doctors to reduce over-prescribing of benzodiazepines, Z-drugs and pregabalin - or face potential investigation. The drugs are used to treat anxiety and insomnia.

The Council also warned that long term use of these drugs could lead to dependency.

Prof Dinan said while he was “all in favour of judicious prescribing of benzos and I have no truck with doctors who over-prescribe” he believed the majority of those prescribed benzos “do not develop a dependency just as the majority of those who drink alcohol do not become dependent on it”.

“What I find completely over-the-top is the inference that the overwhelming majority will become dependent on benzos,” Prof Dinan said.

“The implication is that most people who take benzos will become dependent, that is the message most reasonable people will take from the Medical Council statement.

“My concerns are that it’s a threat to doctors that they will end up before a Fitness to Practice Committee and that it frightens patients as well."

He said he knows GPs in the city who won’t prescribe benzos largely because of Medical Council concerns.

“Patients with severe depression and anxiety disorder have enough on their plate without being frightened [of taking benzos],” Prof Dinan said.

The Medical Council’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners says doctors “must be aware of the dangers of drug dependency when prescribing benzodiazepines, opiates and other drugs with addictive potential”.

Prof Dinan said he believed putting both drugs in the same sentence equated benzos to opioids and he questioned whether a psychopharmacologist or pharmacologist had any input in drafting the guideline.

In response, the Medical Council said its statement “related to inappropriate prescribing practices” and that it acknowledged benzodiazepines “may have a role in the treatment of a patient on a time-limited basis, but that caution and strict monitoring are required when they are prescribed”.

A spokesperson said in drafting its Guide to Professional Conduct and Ethics, published in 2016, the process “included engagement and consultation with the profession”.

Asked specifically if this extended to pharmacologists, psychopharmacologists or psychiatrists, the spokesperson said it extended to all registered medical practitioners.