Benzodiazepines, z-drugs, and gabapentinoids are all medications commonly prescribed to alleviate symptoms associated with various neurological and psychological conditions which can improve the quality of life for patients. Benzodiazepines, such as diazepam and alprazolam, belong to a class of drugs known for their sedative and anxiolytic properties. These drugs are primarily used for short periods of time. The overprescribing of benzodiazepines, z-drugs, and gabapentinoids is a critical issue that affects patient safety and has significant implications for public health. As identified in this report, prescribing patterns of benzodiazepines, z-drugs, and gabapentinoids are significantly influenced by wider societal issues, leading to substantial consequences in healthcare. While the majority of the drugs examined in this report are on the controlled drugs list, Pregabalin and Gabapentin are not and while not a solution to all issues, the working group felt consideration of adding these drugs to the controlled drugs list would be an additional safeguard. One of the key issues identified is the lack of prescribing data. Prescribing data is only available for medications prescribed to public patients and as such there is no centrally held data from private prescribing. Legislative options may need to be considered to address this. The importance of development of a national prescribing solution for Ireland would be a useful step. Current legislation would allow for this development to occur. The development of the National Shared Care Record1 programme, which will be another project that will provide greater visibility to health professionals on use of these medicines, thereby helping to better monitor and control overprescribing.

Additional publicly funded counselling services available in Primary Care and increased resourcing of pain management clinics and addiction services (particularly around benzodiazepine, z-drug and gabapentinoid dependence) would reduce the number of people requiring prescriptions for these medications. Patients who become dependent upon these drugs should be offered a referral to appropriate drug treatment services and provided with appropriate supports where available. Additionally, there should be appropriate resourcing of all prescribers to support patients to reduce their consumption of these drugs. Awareness of the dangers of these drugs needs to be increased amongst prescribers, patients and the wider public. Further educational initiatives should be developed for doctors, pharmacists, and the public to increase awareness of the risks associated with benzodiazepine, z-drug and gabapentinoid use. This report contains a number of recommendations which the working group believes will reduce the dependence on these drugs, while reducing the prescribing of them. There should be an oversight or implementation group which will require considerable stakeholder involvement across the Irish healthcare system in order to be effective.