Long-term users of benzodiazepines in Colombia: Patterns of use and cessation of treatment

Drug Alcohol Depend. 2020 May 1:210:107962. doi: 10.1016/j.drugalcdep.2020.107962. Epub 2020 Mar 19.

Abstract

Background: Benzodiazepines have low abuse potential, but patients often develop physical dependence and neurological impairments. The objective of this study was to investigate treatment cessation and use of high doses in long-term benzodiazepine users in Colombia.

Methods: Retrospective study. Patients who used benzodiazepines for at least six months (long-term) were selected from a prescription database and followed from initiation of benzodiazepine treatment for up to 30 months. We investigated treatment duration and compared patients who received normal and high (≥2 mean prescribed daily dose) doses.

Results: Only 1255 (6.1 %) out of 20,567 patientsprescribed benzodiazepines became long-term users; their mean age was 60.6 years (SD=20.0) and 61.7 % were women. Mean high doses were used by 42.5 % (n=534) of the sample. Age under 20 years was a protector, whereas the long half-life benzodiazepines and use of other neurological medications were predictors of high dosage. Overall, 44.8 % (n=563) of the sample was still using benzodiazepines at the end of the study period. The use of antidepressants, antipsychotics, and anticonvulsants were negatively associated with cessation of benzodiazepine treatment.

Conclusions: A low proportion of patients starting benzodiazepines became long-term users. Nearly half of them used high doses and continued the medication for up to 30 months. Use of concomitant neurological drugs was associated with higher doses and less cessation.

Keywords: Benzodiazepines; Drug tolerance; Hypnotics and sedatives; Pharmacoepidemiology; Substance-related disorders.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Benzodiazepines / administration & dosage*
  • Benzodiazepines / adverse effects
  • Child
  • Child, Preschool
  • Colombia / epidemiology
  • Databases, Factual / trends
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Substance-Related Disorders / diagnosis*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology*
  • Withholding Treatment / trends*
  • Young Adult

Substances

  • Benzodiazepines