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The findings, which were based on an analysis of data collected as part of a national survey in 2015 and 2016, suggest that annual benzodiazepine use among U.S. adults may be more than double estimates based on data collected in 2013 and 2014, but the differences may be due partly by different survey methodologies, the authors wrote. The findings also point to those most likely to take the medication without a prescription or in greater amounts or over longer periods of time than prescribed.
For the study, Donovan Maust, M.D., M.S., of the University of Michigan and colleagues analyzed data from the National Survey on Drug Use and Health (NSDUH). The NSDUH, which is an annual survey directed by the Substance Abuse and Mental Health Services Administration, asks participants aged 12 and older from across the country about substance use, mental health, and more. Maust and colleagues focused specifically on respondents aged 18 and over in the 2015 and 2016 survey years, who reported benzodiazepine use in response to queries about medications used for anxiety, insomnia, and more. Misuse was defined as “in any way doctor did not direct,” including without a prescription, in greater amounts or more often than prescribed, and longer than prescribed.
Based on their analysis, the researchers estimated that a total of 30.6 million adults (12.6%) reported past-year benzodiazepine use, including 25.3 million (10.4%) who took the medication as prescribed. Prior analyses of 2013-2014 surveys had previously estimated benzodiazepine use in adults to be between 4% and 6%, the authors noted. Adults aged 50 to 64 had the highest overall rate of prevalence of benzodiazepine use as prescribed, and adults 18 to 25 had the highest prevalence of misuse.
Among those who reported benzodiazepine misuse, most adults indicated that they did so to help them to relax and/or sleep, the study found.
“The presence of past-year mental illness was associated with increased odds of any use, as was worse self-rated health. In almost every instance, past-year use, misuse, or abuse of or dependence on tobacco, alcohol, marijuana, heroin, prescription opioids, or prescription stimulants was associated with any benzodiazepine use,” Maust and colleagues wrote. “Prescription drug monitoring programs are an important tool for clinicians to understand which of their patients may be misusing other medications and would thus be at high risk of benzodiazepine misuse.”
The authors also noted that “a significant proportion of NSDUH-defined ‘misuse’ could reflect use for untreated symptoms among those with poor access to care—specifically, for behavioral treatments for insomnia or anxiety disorders.” Increasing access to insurance coverage and treatment for mental illness and substance use disorder may help to reduce benzodiazepine use and misuse, they wrote.
For related information, see the Psychiatric News article “Benzodiazepine Prescriptions Found to Increase Substantially With Age.”
(Image: iStock/carterdayne)
