Managing benzodiazepines in primary care

Podcast

Season 6: Episode 5 - April 7 2026

Runtime: 33:47

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SHOW NOTES
Summary

In this episode, host David P. Ball dives into the topic of managing benzodiazepine use in primary care. He’s joined by Bill Nelles, a former AIDS nurse and counsellor with lived experience of benzodiazepine use, and Dr. Megan Hill, a family doctor who has worked in addiction medicine for over 10 years. Together, they offer practical insights for care providers supporting patients to manage or reduce benzodiazepine use. Through real-world examples and grounded clinical advice, the episode highlights how structured, compassionate care can make a meaningful difference.

Learning Objectives

  1. Identify how to approach meeting a new client in primary care who has been on benzodiazepines long-term for insomnia, anxiety, or other conditions.
  2. Examine and optimize underlying conditions and age-related factors.
  3. Employ best practices for a benzodiazepine taper, transitioning to alternative therapies, and supporting clients through dependency.

Lineup

In this episode, you’ll hear:

  • [2:00] – Bill Nelles, Guest – Former nurse and counsellor 
  • [15:13] – Dr. Megan Hill, Guest – Primary care family physician, sub-specializing in addiction medicine, Interior Health

Clinical Pearls

Here’s what listeners can take away from this episode:

  1. Utilize brief intervention each appointment to understand and collaborate on goals with the patient, allowing incremental progress with each interaction.
  2. A slow and steady taper is better than cutting the patient off abruptly. Any momentum is good, and a slow taper also allows relationship and trust to build over time.
  3. When preparing for a taper, optimize any concurrent conditions (such as anxiety, seizure or sleep disorders, etc.) first by referring to specialist care to help assure them that their underlying conditions will be addressed and that the taper is safe. Educate the patient that withdrawal from benzodiazepines can sometimes mimic the underlying condition.
  4. Differentiating between physiological dependence and a use disorder will help determine the course of treatment. There are some medications available to treat withdrawal while adjusting to lower dose and other remedies like CBT, mindfulness, meditation, etc.
  5. Prepare for appointments by having tools and resources that you can pull up quickly to share with the patient, such as referral sources for counsellors. This can help make a shorter appointment be more efficient.

Resources

Supports for care providers

Resources for patients, families, friends and loved ones

Reports, statistics, and guidance

Articles

  • Tannenbaum C, Martin P, Tamblyn R, Benedetti A, Ahmed S. Reduction of Inappropriate Benzodiazepine Prescriptions Among Older Adults Through Direct Patient Education: The EMPOWER Cluster Randomized Trial. JAMA Intern Med. 2014;174(6):890–898. doi:10.1001/jamainternmed.2014.949