Benzodiazepine dependence — structured clinical viva

Reject the junior plan. Abrupt stop after 12 years risks severe withdrawal including seizures. Flumazenil is not community detox. Zolpidem/zopiclone are not safe long-term elderly substitutes — they act at related GABA-A sites and carry falls/cognition risk. Vitamins alone are not a taper.^[3][1][6]

Elderly harm frame. Falls, fractures, cognitive adverse events, delirium risk; Glass meta-analysis shows modest sleep benefit versus harm; Markota review summarises dangers and alternatives.^[1][2]

Plan. Shared deprescribing: education (EMPOWER logic), Canadian BRZA-style conversation, convert/combine to a single taperable regimen, gradual reductions, CBT-I/sleep hygiene, review polypharmacy, involve daughter as support not as enforcer of cold turkey, monitor mobility and cognition.^[4][5][7][3]

Interactions. Counsel against alcohol and future opioid co-use because of synergistic depression.^[6]