- Design
- Repeated cross-sectional analysis of national dispensing data, 2013 to 2024
- Population
- About 1.1 billion US benzodiazepine prescription fills
- Primary outcome
- Annual prevalence of benzodiazepine dispensing
- Effect
- 7.5% to 5.5% (−26.7%); ages 18–29 −44.8%; advanced practice providers +101.5%
A repeated cross-sectional analysis of US retail prescription data covered about 1.1 billion benzodiazepine fills from 2013 to 2024. Published in the American Journal of Psychiatry on 30 September 2026.
The share of people receiving a benzodiazepine fell from 7.5% to 5.5%, a relative drop of 26.7%. The largest fall was in adults aged 18 to 29 (−44.8%). Dispensing by pain specialists fell 62.5%, by primary care physicians 44.3% and by psychiatrists 38.3%, while dispensing by advanced practice providers rose 101.5%. The average total dose per prescription fell across every age group and prescriber type.
The data describe dispensing, not appropriateness: they cannot say whether the remaining prescriptions are the right ones, or whether patients who stopped were moved to safer care. But the rise among non-physician prescribers is a clear signal of where prescribing support and audit now need to reach. The pattern is US-specific; Indian dispensing data of comparable scope are not available.
- Review long-term benzodiazepine prescriptions at each renewal and record the indication
- Plan a gradual taper with the patient rather than stopping abruptly after long use
- Extend prescribing guidance and audit to nurse practitioners and physician assistants, where fills rose
- Check for concurrent opioids or other sedatives before issuing a new prescription
Why it matters
Caution has spread unevenly: the prescriber group growing fastest is the one least often reached by stewardship work.
Don't overread it
Falling dispensing is not proof of better care; the data hold no clinical outcomes.
The statistics, in plain English
A drop from 7.5% to 5.5% is two percentage points in absolute terms, which the authors express as a 26.7% relative fall. Relative changes in small groups, such as pain specialists, can look dramatic even when few prescriptions are involved.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for psychiatry, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free