PRESCRIPTION AND LONG-TERM USE OF BENZODIAZEPINES IN PRIMARY HEALTH CARE: IMPLICATIONS FOR PUBLIC HEALTH

Abstract

This article aimed to analyze the implications related to the prescription and long-term use of benzodiazepines (BZDs) in primary health care (APS), considering aspects regarding safety, dependence, therapeutic monitoring, and the rational use of these medications. This is an integrative review conducted between August and September 2026 using the PubMed/MEDLINE, BVS, and SciELO databases, including studies published between 2021 and 2026 on the prescription and long-term use of benzodiazepines in APS. DeCS/MeSH descriptors and pre-defined inclusion and exclusion criteria were applied, followed by the selection, categorization, and synthesis of the studies. Eleven studies were selected, featuring diverse designs and levels of evidence, covering aspects related to long-term use, safety, dependence, and deprescribing of benzodiazepines in APS. Findings indicated a significant prevalence of long-term use, an association with adverse events, and a need for greater attention regarding the elderly and patients on polypharmacy. Deprescribing strategies particularly those involving gradual tapering, health education, and patient participation yielded favorable results, albeit with variations across studies. Long-term BZD use remains prevalent in APS and is associated with dependence, withdrawal, and adverse events, underscoring the need for monitoring and rational use. Deprescribing can be facilitated by gradual tapering, health education, and shared decision-making, and should be tailored to the individual. Further research within the Brazilian context is needed to evaluate deprescribing strategies and multiprofessional monitoring.