Benzodiazepines, zolpidem and zopiclone

There is no role for benzodiazepines, zolpidem or zopiclone for chronic noncancer pain. Co-administration with an opioid significantly increases the risk of death from opioid-induced ventilatory impairment. Unless indicated for another condition, benzodiazepines, zolpidem and zopiclone should be deprescribed in all patients with chronic noncancer pain.

In adults, benzodiazepines, zolpidem and zopiclone should be reduced by 25% of the original dose every 1 to 4 weeks. Slower weaning can be considered for the final dose reductions or if troublesome discontinuation symptoms are reported.

Long-term benzodiazepine use in children is very rare; seek specialist advice for deprescribing benzodiazepines, zolpidem or zopiclone in children.