National Trends in Benzodiazepine Dispensing

OBJECTIVE: Benzodiazepines (BZDs) are commonly prescribed medications in the United States. Up-to-date BZD dispensing trends can inform whether and where improvements in prescribing practices are needed. The objective of this study was to evaluate national changes in BZD dispensing from 2013 to 2024 by patient age and prescriber type. METHODS: A repeated, cross-sectional analysis using the IQVIA Longitudinal Prescription dataset was conducted to examine trends in BZD prescription dispensing between 2013 and 2024 (a total of 1,100,233,787 prescription fills). BZD prescription fill counts, prevalence, and mean total dose dispensed per BZD prescription were reported annually, stratified by patient age and prescriber type. RESULTS: From 2013 to 2024, the annual U.S. prevalence of BZDs dispensed declined by 26.7%, from 7.5% to 5.5%. Net decreases in prevalence occurred across age groups, with the largest relative reduction among young adults ages 18-29 (-44.8%). Primary care physicians dispensed the most BZD prescriptions, followed by advanced practice providers and psychiatrists/mental health specialists. There were sharp relative declines in the number of BZDs dispensed by pain medicine specialists (-62.5%), primary care physicians (-44.3%), and psychiatrists/mental health specialists (-38.3%), with an increase observed among advanced practice providers (+101.5%). The mean total dose dispensed per BZD prescription decreased across all patient ages and prescriber types, with large declines in doses prescribed by pain medicine specialists (-65.3%). CONCLUSIONS: National declines in BZD prescription fills and total dose dispensed over the past decade may indicate greater caution or selectiveness in BZD dispensing, potentially related to safety considerations and drug labeling changes. Shifts in dispensing patterns among select patient and prescriber populations warrant ongoing monitoring.