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Michael Cucciare, Ph.D.
UAMS Research Shows Online Program Significantly Reduces Benzodiazepine Use in Adults
| LITTLE ROCK — A new study involving University of Arkansas for Medical Sciences (UAMS) research scientists offers hope for patients who are seeking to reduce their dependence on benzodiazepines, powerful drugs prescribed to relieve anxiety and insomnia and reduce seizures.
More than 30 million American adults are currently taking benzodiazepines. However, long-term use of these drugs carries significant risks, including drowsiness, confusion, memory impairment and slowed reaction time. When combined with alcohol or opioids, benzodiazepines can cause severe disorientation, coma and even death.
The UAMS study found that an online intervention program was significantly more effective in reducing benzodiazepine use compared to following provider recommendations about their use of the drugs.
Using an informational website, the UAMS researchers teamed up with a group from Stanford University to make participants in the study aware of the risks and potential harms of long-term benzodiazepine use. The website contains many of the components of a paper form typically given to users of the drugs, which include alprazolam, known commercially as Xanax, clonazepam (Klonopin) and diazepam (Valium).
“We personalized the online resource to meet the needs of the participants,” said Michael Cucciare, Ph.D., director of UAMS’ Center for Health Services Research.
The online resource includes first-person accounts of people who successfully discontinued their use of benzodiazepines along with resources (mobile apps, websites) for the treatment of stress, anxiety and sleep disorders.
“The website generates a customizable schedule for patients to follow for tapering off the drugs,” said Cucciare, a professor in the UAMS Department of Psychiatry. “We also had a physician on call 24 hours a day for the participants to call if they needed help, a failsafe, so to speak.”
Participants in the study, men and women chosen because they had a continuous prescription for benzodiazepines lasting three or more months, were randomly assigned to receive the intervention website or usual care. All participants were given access to the website at the end of the study.
“We found that the people who were given access to the website were five times more likely to stop using benzodiazepines completely than those who didn’t get the website,” said Cucciare, who reviewed the participants’ pharmacy records to determine if they were still receiving the medications.
He emphasized that the program would be highly beneficial in areas where medical care is limited, such as rural states like Arkansas, due to the fact there would be no cost to participants and limited impact on the workforce.
“It doesn’t cost anything once the website is created. It could be scaled up nationally for virtually nothing,” said Cucciare, who worked on the website’s content for two years along with UAMS’ Xiaotong Han and Misha Karr.
The results of the research study, funded by a grant from the U.S. Department of Veterans Affairs Health Services Research and Development Service, were printed in the January edition of the Journal of the American Medical Association Network Open.
Cucciare is exploring the possibility of implementing the online intervention in rural communities throughout Arkansas.
“We know that rural populations who have less access to care are more likely to be taking benzodiazepines long term and are at risk for combining them with opioids,” he said. “We hope to meet with them and show them the effectiveness of this new program.”
UAMS is the state’s only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and eight institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute, Institute for Digital Health & Innovation and the Institute for Community Health Innovation. UAMS includes UAMS Health, a statewide health system that encompasses all of UAMS’ clinical enterprise. UAMS is the only adult Level 1 trauma center in the state. UAMS has 3,553 students and 1,015 medical residents and fellows. It is the state’s largest public employer with about 12,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Children’s, the VA Medical Center and Baptist Health. Visit www.uams.edu or uamshealth.com. Find us on Facebook, X (formerly Twitter), YouTube or Instagram.
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