Main Article Content
Epidemiology, cross-sectional surveys, sedative-hypnotic medications, mood disorders, anxiety disorders, population studies
Benzodiazepines (BDZs) and related sedative-hypnotic drugs can be used as symptomatic treatments for anxiety, insomnia, and agitation. Often, they are used as adjunctive treatments for mood or anxiety disorders. The frequency of use of antidepressant medications has been increasing in Canada, suggesting that effective management of mood and anxiety disorders may be occurring more often in the population. Potential adverse effects of BDZs have also been more clearly defined. It seems reasonable to hypothesize that the frequency of use of these medications may be decreasing over time, but existing published reports are dated.
To describe the frequency of sedative-hypnotic medication use in a general population sample. The longitudinal National Population Health Survey (NPHS) cohort between 1994 and 2000 was the data source for this study.
The frequency of use of BDZs and zopiclone in the NPHS was evaluated at four survey iterations: 1994/1995, 1996/1997, 1998/1999, and 2000/2001.
No decline in the frequency of use over time was evident. The pattern of use resembled that previously described in Canada: there is a higher frequency in women, and the frequency of use increases with age.
Survey data of the type reported here cannot differentiate appropriate from inappropriate use. However, these results do indicate that the frequency of use of these medications is not declining, as might have been expected.
2. Busto U, Lanctot KL, Isaac P, Adrian M. Benzodiazepine use and abuse in Canada. CMAJ Canadian Medical Association Journal 1989 Nov 1;141:917-21.
3. Neutel CI, Walop W, Patten SB. Can continuing benzodiazepine use be predicted? Canadian Journal of Clinical Pharmacology 2003;10(4):202-6.
4. Patten SB, Beck CA. Major depression and mental health care utilization in Canada: 1994-2000. Can J Psychiatry 2004;49:303-9.
5. Statistics Canada Health Statistics Division. National Population Health Survey Cycle 4 (2002 - 2003), Household Component Longitudinal Documentation. Section 5, Pages 6-10. Ottawa, Ontario: Statistics Canada; 2004. http://www.statcan.ca/english/sdds/document/3225_D5_T1_V2_E.pdf
6. Ray WA, Griffin MR, Downey W. Benzodiazepines of long and short elimination half-life and the risk of hip fracture. JAMA 1989
7. Neutel CI, Walop W. Comparing two different approaches to measuring drug use within the same survey. Chron Dis Can 2000;21:150-6.
8. Statistics Canada Health Statistics Division. National Population Health Survey, 1994-95, Public Use Microdata Files. User's Guide. Ottawa, Canada: Minister of Industry; 1995.
9. Kessler RC, Andrews G, Mroczek D, Ustun B, Wittchen HU. The World Health Organization Composite International Diagnostic Interview Short-Form (CIDI-SF). Int J Methods Psychiatr Res 1998;7:171-85.
10. Statistics Canada Health Statistics Division. National Population Health Survey Cycle 4 (2002-2003), Household Component Longitudinal Documentation. Section 10, Pages 41-45. Ottawa, Ontario: Statistics Canada; 2004. http://www.statcan.ca/english/sdds/dcoument/32 25/_D5_T1_V2_E.pdf
11. Busto U, Lanctot KL, Isaac P, Adrian M.Benzodiazepine use and abuse in Canada. CMAJ Canadian Medical Association Journal 1989 Nov 1;141(9):917-21.
12. Isacson D. Long-term benzodiazepine use: factors of importance and the development of individual use patterns over time - a 13-year follow-up in a Swedish community. Soc Sci Med 1997;44:1871-80.
13. van Hulten R, Teeuw KB, Bakker A, Leufkens HG. Initial 3-month usage characteristics predict long-term use of benzodiazepines: an 8-year follow-up study. Eur J Clin Pharmacol 2003;58:689-94.