Awareness and Use of Benzodiazepines in Healthy Volunteers and Ambulatory Patients Visiting a Tertiary Care Hospital: A Cross Sectional Survey

Abstract

BackgroundIndiscriminate prescription of Benzodiazepines in Pakistan and subsequent availability over-the-counter without prescription is a major public health problem, requiring systematic inquiry through research. Additionally, there is limited data on the awareness and use of Benzodiazepines from developing countries making it impossible to devise meaningful health policies.Methodology/Principal FindingsThis was an Observational, Cross-Sectional study. conducted at Aga Khan University. A total of 475 (58.5% males, 41.5% females) people visiting a tertiary care hospital were interviewed by means of a structured questionnaire. The results showed that majority of population was aware of one or more Benzodiazepines (80.4%) and 30.4% had used them at some point in life. 42.4% of the users had been using it for more than a year. Commonest reason for use was sleep disturbance. Frequency of usage was higher for females, married individuals, educated (>Grade12), high socioeconomic status and housewives. More (59%) were prescribed than not and of them most by GP (58.5%). Only 36.5% of them were particularly told about the long-term addiction potential by the use of these drugs.ConclusionEasy availability, access to re-fills without prescription and self prescription compounded with the lack of understanding of abuse potential of benzodiazepines constitutes a significant problem demanding serious consideration from health policy makers.

Self-medications with potential abuse in the Middle East: a systematic literature review

“…Female sex was associated with increased likelihood of benzodiazepine use. 24,26 However, the percentage of tramadol consumption was higher in males (78%) than in females (22%) in the Iraqi community. 29 Abuse of analgesics is considered as risky behaviour and is initiated during early adolescence, particularly between 12 and 16 years.…”

“…24 The frequency of psychotropic medications abuse was mostly related to low educational level and socioeconomic status. 17,26 Cigarette or water pipe smoking was associated with increased odds ratio of sedatives/tranquilizer use and sleeping medication use. 19,21 Abuse is also related to occupation, where housewives have more risk for abuse than employed individuals.…”

“…OTC medications implicated in misuse and abuse belong to different groups: Psychoactive medications including: tramadol [20][21][22] , Benzodiazepines 1,8,[24][25][26] , Tramadol 9,10 and Psychoactive medications. [17][18][19]27 Codeine based products 28 , Anabolic steroids 11,14,15 , and cough medications 1,12,28 or laxatives.…”

“…8,25 In Pakistan, the life time prevalence of benzodiazepine use was reported to be 30.4%; 42.4% of the users had been using it for more than a year. 26 Bromazepam was the most widely used benzodiazepine (29%). Rates of lifetime and daily use of prescription sedatives (mostly benzodiazepines) were 2.7% and 3.8%, respectively, in high school boys and 4.4% and 0.44%, respectively, in girls in the Kerman study.…”

“…17 Only 36.5% of patients in Pakistan were told about the long-term addiction potential of these drugs. 26 Friends are an important source for such misuse, where peer pressure from friends, or having a family member who used them, stood out as the most common reason to start and continue using substances. 10,17,18 Gender differences were observed in abuse of psychotropic medications.…”