Chronic use of benzodiazepines among older adults

Abstract

OBJECTIVETo analyze the perception of and motivation for the chronic use of benzodiazepine among older adults.METHODSA qualitative study was conducted on 22 older adults living in Bambuí, MG, Southeastern Brazil, who were taking benzodiazepines and had the clinical and cognitive ability to respond to interview questions. The collected data were analyzed on the basis of the “signs, meanings, and actions” model.RESULTSThe main reasons pointed out for the use of benzodiazepines were “nervousness”, “sleep problems”, and “worry” due to family and financial problems, everyday problems, and existential difficulties. None of the interviewees said that they used benzodiazepines in a dose higher than that recommended or had been warned by health professionals about any risks of their continuous use. Different strategies were used to obtain the prescription for the medication, and any physician would prescribe it, indicating that a bond was established with the drug and not with the health professional or healthcare service. Obtaining and consuming the medication turned into a crucial issue because benzodiazepine assumes the status of an essential food, which leads users to not think but sleep. It causes a feeling of relief from their problems such as awareness of human finitude and fragility, existential difficulties, and family problems.CONCLUSIONSBenzodiazepine assumes the characteristics of polyvalence among older adults, which extrapolate specific clinical indications, and of essentiality to deal with life’s problems in old age. Although it relieves the “nerves”, the chronic use of benzodiazepines buffers suffering and prevents older adults from going through the suffering. This shows important difficulties in the organization and planning of strategies that are necessary for minimizing the chronic use in this population.

Prevalence of and Factors Related to Prescription Opioids, Benzodiazepines, and Hypnotics Among Medicare Home Health Recipients

“…BNZs are one of the most common class of prescription drugs in the world (Donoghue & Lader, 2010; Lucchetti & Lucchetti, 2016) and older adults are frequently prescribed these medications to treat general or acute anxiety (Alvarenga et al, 2014). Insomnia, a common complaint among older adults is often treated with non-benzodiazepine hypnotics (NBNZH); among our sample, NBNZH were prescribed to almost 7% of those 65 years of older, compared to general samples estimated at 4 – 5 % (Bertisch, et al, 2014).…”

The interplay of context factors in hypnotic and sedative prescription in primary and secondary care—a qualitative study

“…They are still frequently prescribed in both primary and secondary care, often as a “quick fix solution” for “nervousness,” “sleep problems,” and other life problems, especially in old age [2–4]. A recent European study [5] found that more than 36% of elderly patients received at least one benzodiazepine during hospitalization.…”

“…Hypnotics and sedatives, especially benzodiazepines and Z-drugs, have well-known adverse effects, such as withdrawal symptoms upon discontinuation, cognitive difficulties, impairment in activities and daily living, and increased risk of falls [ 1 ]. They are still frequently prescribed in both primary and secondary care, often as a “quick fix solution” for “nervousness,” “sleep problems,” and other life problems, especially in old age [ 2 – 4 ]. A recent European study [ 5 ] found that more than 36% of elderly patients received at least one benzodiazepine during hospitalization.…”

Prescrições em serviços de saúde mental: aspectos legais e indicadores do uso racional de medicamentos

“…No entanto, este resultado pode refletir um outro contexto inerente aos serviços de saúde mental, no qual o uso da medicação é um importante componente do tratamento e o acesso à terapia é um fator a ser considerado pelos prescritores para contribuir com a adesão do paciente ao tratamento. O número médio de medicamentos por prescrição dos CAPS, apesar de estar dentro da média encontrada em outros estudos realizados na Atenção Primária à Saúde (cerca de dois medicamentos) [9,13,20], poderá se elevar consideravelmente em condições de comorbidades agudas ou crônicas, visto que por muitas vezes são utilizados por um período prolongado ou mesmo na condição de uso crônico [23][24][25]. O crescimento do número médio de medicamentos prescritos ao longo das últimas décadas [3,20], o recente fenômeno de medicalização [26] e o uso pouco crítico de medicamentos psiquiátricos em serviços de saúde mental [24] despertam a necessidade iminente de inserção de práticas relacionadas ao uso racional de medicamentos nos CAPS.…”