A leading Spanish university and healthcare provider are working together to reduce long-term dependency on anxiety and sleep medications through a new behavioral intervention.
Benzodiazepines, commonly prescribed for anxiety and insomnia, are widely used throughout Spain. While these medications can provide relief, their overuse has become a growing public health issue. Many people end up taking these pills every day, often for much longer than intended, which can lead to dependence and other health problems. Now, a new project aims to change how these medications are prescribed and used, making care safer and more focused on individual needs.
Behind the Numbers Something More Is Happening
Benzodiazepines, known by brand names like Valium and Xanax, are taken by a large number of people in Spain. A 2024 study by the Spanish Organization of Consumers and Users found that 22% of Spaniards regularly use these medications, and four out of ten take them daily. This high rate of use brings risks like memory problems, increased risk of falls, and a strong chance of dependence, especially for older adults.
One key reason for this overuse is how often benzodiazepines are prescribed in primary care. Doctors often have very limited time with each patient, which leads to quick decisions and repeat prescriptions. Manuel Armayones, a professor of behavioral design and project lead, notes, “The causes of these practices include factors relating to healthcare settings themselves, such as short appointments and overworked practitioners. Practitioners sometimes may feel that benzodiazepines are the only available tool to relieve patients’ discomfort. There’s also an understandable fear on the part of both healthcare practitioners and patients that symptoms will get worse if the medication is withdrawn, especially in cases of physical and psychological dependence.”
Many patients fear that stopping these medications will make their symptoms worse, especially if they have developed a physical or psychological dependence. This cycle can be difficult to break, both for healthcare providers and for patients themselves.
A Fresh Strategy Is Quietly Taking Shape
The Universitat Oberta de Catalunya, together with Badalona Serveis Assistencials, has started the “Don’t get stuck” project to address this problem. The project targets both healthcare providers and patients, using behavioral design tools to help change habits and attitudes around benzodiazepine use.
Since April, a proof-of-concept program has been underway at the CAP Martí i Julià primary care center in Badalona. This is the third phase of a larger initiative funded by the Spanish Ministry of Science and Innovation. Earlier research by the team showed that the most effective interventions combine education, pharmacist involvement, and clear communication about risks.
Manuel Armayones explains, “We’re aiming to change not just the volume of drugs prescribed, specifically benzodiazepines, but also deep-rooted patterns of prescription, dispensing and use. Research shows that the most effective interventions are those that combine clear information about the risks involved, changes in the environment, support in decision-making and opportunities for dialogue. Using theoretical frameworks enables us to choose and combine these elements in a coherent way rather than through trial and error.”
He also adds, “Combining BSA’s clinical practice with the UOC’s behavioural design and applied research makes it possible to effectively address the shared concern of benzodiazepine overuse through interventions that are concrete, assessable and, above all, designed with and for professionals.”
Inside the Clinic New Tools Are Making a Difference
Over three months, healthcare professionals at the Badalona clinic are taking part in practical sessions where they can ask questions and share their experiences. They also receive scripts to help guide conversations about reducing benzodiazepine use, along with guides on alternatives and tools for reviewing prescriptions.
Patients Are Finding New Ways Forward
Patients get easy-to-read materials that explain the risks of long-term benzodiazepine use, as well as tips on better sleep and managing anxiety without medication. Posters throughout the clinic encourage open conversations about how to reduce these drugs safely. Community resources and non-drug options, such as therapy and support groups, are also available.
Reminders are added to patients’ medical records to prompt a review of any benzodiazepine treatment after four weeks. Àlex Escosa Farga, head of the Primary Care Service at BSA, says, “This project allows us to advance towards safer, more person-centered care. We work to reduce risks for citizens, but also to offer professionals who facilitate more informed and coherent clinical decisions.”
What Comes Next Could Change More Than One Clinic
Once the intervention ends, researchers will measure its impact using both numbers and personal feedback to see if it reduces benzodiazepine prescriptions. If it works, the model will be adapted and expanded to other primary care centers managed by BSA. The approach is designed to be flexible, so it can be adjusted for different teams and settings.
This project is part of a broader movement in Catalonia and internationally to cut back on low-value medical practices. It lines up with initiatives like the Essencial project and Choosing Wisely, which aim to improve care by reducing unnecessary treatments. The research also supports global health goals, including the United Nations’ focus on good health and well-being.
Manuel Armayones states, “We’re confident that this project will reduce the number of patients using benzodiazepines on a long-term basis and lead to fewer unnecessary prescriptions. We also hope that professionals will feel more in control and better supported when it comes to broaching this issue with patients.”
Source: News Medical