Benzo Abuse Appeared Uncommon

Benzodiazepines not linked to long term use or increased dose in recent study

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) While certain medications can be valuable treatment options, they also may come with a risk of dependence and abuse. A recent study looked at the risks related to a type of medication used to treat anxiety and insomnia.

Researchers identified people who had been prescribed benzodiazepines and followed them for three years to see how long the patients took the medications and whether they began taking more of them over time.

The researchers found that the vast majority of participants only used benzodiazepines for a short period of time. Only a small percentage of people used benzodiazepines for the full three years and increased their daily amount.

According to the researchers, this study showed that benzodiazepine use did not frequently lead to abuse. They also said that people who had a history with certain drugs like opioids were more likely to abuse benzodiazepines as well.

"Take your medication as prescribed."

Ingunn Fride Tvete of The Norwegian Computing Center and other medical researchers conducted this study to see if there was a risk of medication misuse and dependency for people taking benzodiazepines.

Benzodiazepines are psychoactive medications that are commonly prescribed for anxiety, insomnia and restless legs syndrome (RLS). They sedate the user and reduce anxiety.

According to the article, long-term use of these medications can result in dependence and tolerance. The researchers stated that 50 percent of long-term benzodiazepine users claim they are dependent.

This study looked at people who redeemed benzodiazepine prescriptions at pharmacies for three years. The researchers wanted to see how the dose and frequency of use changed during this time for long-term users.

The study used data from the Norwegian Prescription Database, or NorPD. The study subjects had redeemed benzodiazepine prescriptions but had not been prescribed benzodiazepines prior to July 2004. The researchers looked at the dose of the prescriptions the patients redeemed over time.

The researchers followed each patient for three years, or for 12 three-month periods.

Overall, the study included 81,945 patients, 51.3 percent of whom received their first benzodiazepine prescription from a general practice specialist.

A total of 33.7 percent of these patients redeemed only one prescription during the first three-month period.

During the second three-month period, 1,315 patients began taking between one and two prescribed doses per day, and 133 patients took over two doses per day.

During the last three-month period of the study, 4.5 percent of participants were taking more than their prescribed daily dose, and 0.9 percent were taking more than twice their daily dose.

Certain patients were more likely than others to begin upping their doses. The researchers found that people who had previously been taking antidepressants, antiasthmatics, antipsychotics, opioids, antialcohol medications and smoking cessation treatments were more likely to regularly take more than twice their prescribed daily dose.

The study also found that people who were prescribed oxazepam or nitrazepam/flunitrazepam had a higher risk of increasing their dose than patients taking other benzodiazepines.

People who had used opioids or medications for alcohol or smoking cessation were about twice as likely to increase their daily dose than those who hadn't taken those medications before.

The researchers concluded that the vast majority of people who received benzodiazepine prescriptions only used them for a short, three-month period. A small number of people (less than 1 percent) became excessive, long-term users.

According to the authors, this study suggests that long-term benzodiazepine abuse is rare. They suggested that doctors who prescribe benzodiazepine have a plan for stopping treatment.

"When prescribing benzodiazepines, physicians should have a plan for stopping treatment, since there is a certain segment of the population that will tend to take more than their prescribed dose and may find the need to continue therapy, when therapeutically not necessary. Specifically, patients who have psychiatric or addictive conditions are much more likely to be susceptible to this problem," Nario Rene Cantu, RPh, pharmacist at Cantu's Pharmacy in Edinberg, Texas, told dailyRx News.

This study was published in BMJ Open on October 4.

The research was funded by the Norwegian Research Council. The authors declared no conflicts of interest.

Review Date: 
October 15, 2013
Last Updated:
December 30, 2013