The article by Lucie Baillargeon and associates1 serves more to critique what is going on in medical practice than to contribute to medical knowledge. The use of benzodiazepines should be restricted to the treatment of status epilepticus;2 because of their highly addictive nature, they should not be used for habitual sedation. Even the manufacturers caution against use of benzodiazepines in elderly patients or in combination with alcohol. In a health care system that is strapped for money, it is astounding that such profligate expenditure on bad medical practice is allowed and that resources are being used to support costly withdrawal practices in a situation that should not have been initiated and supported in the first place. The publication of an article such as this one, upholstered with a sufficiency of the elegant though irrelevant algebra that so delights editors, may still do some good if it leads to action against bad medical practice and waste. Is nobody minding the shop?
Myre Sim Psychiatrist (retired) Victoria, BC
Footnotes
Competing interests: None declared.
References
- 1.Baillargeon L, Landreville P, Verreault R, Beauchemin JP, Grégoire JP, Morin CM. Discontinuation of benzodiazepines among older insomniac adults treated with cognitive-behavioural therapy combined with gradual tapering: a randomized trial. CMAJ 2003;169(10):1015-20. [PMC free article] [PubMed]
- 2.Beers MH, Berkow R, eds. The Merck manual of diagnosis and therapy. 17th ed. Whitehouse Station (NJ): Merck and Co. Inc.; 1999. p. 1405-8.