REVIEW OF: Humphreys K et al, JAMA Netw Open 2026;9(1):e2551807
STUDY TYPE: RCT

Long-term benzodiazepine (BZD) tapering is challenging. Patients resist, withdrawals can be dangerous, and clinician time is limited. A free self-guided website may help.

Building on the EMPOWER study, which showed that printed educational materials plus a consultation visit could help support BZD tapering (Tannenbaum C et al, JAMA Intern Med 2014;174:890), this VA trial tested whether the approach could work as a self-guided website alone.

The trial enrolled 161 veterans on BZDs for at least three months at two VA primary care systems, randomizing them to the website or usual care. The site covered the risks of long-term BZD use, offered peer vignettes from others who had successfully quit, suggested alternatives for anxiety and sleep, and provided a personalized schedule slowly tapering BZDs over several months.

At 6 months, complete cessation was 5 times more likely in the website group than controls (12% vs 3%; odds ratio [OR] 5.31). A trend toward a ≥ 25% dose reduction was seen with the intervention as well (17.1% vs 7.6%), though the confidence interval (CI) was wide and it did not quite reach statistical significance (OR 2.51, 95% CI: 0.91–6.90). Anxiety, sleep, and quality of life were similar between groups, providing reassuring evidence that tapering didn’t trigger symptom rebound.

CARLAT TAKE
A simple, patient-directed website increased BZD cessation without worsening anxiety or sleep. The study’s generalizability has limits given its sample of mostly older male veterans, but the basic mechanism should translate broadly. The website is freely available at https://veteranlearning.com/empower/rwd/alpha/index.html.