Benzodiazepine and “Z-Drug” Dependence

Shukla, Lekhansh; Bokka, Spandana; Shukla, Tulika; Kandasamy, Arun; Chand, Prabhat; Benegal, Vivek; Murthy, Pratima

doi:10.4088/pcc.16br02025

Cited by 15 publications

(4 citation statements)

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“…In India, a retrospective study of 950 patients who were admitted from 2007 to 2014 in a tertiary addiction centre revealed that alprazolam (50.6%), nitrazepam (23.5%) and zolpidem (11.2%) were the most commonly reported drugs of abuse. 28 High misuse prevalence of benzodiazepines and Z-drugs in this study of patients with drug dependence may suggest that there are significant problems with the misuse of benzodiazepines and Z-drugs in India, which is similar to the findings of the UNODC report on prescription medicine misuse in South Asia. 13…”

Section: Prescription Medicine Misuse In Indiasupporting

confidence: 85%

Prescription medicine misuse in the Asia–Pacific region: An evolving issue?

Chan

Wood

Dargan

2020

Brit J Clinical Pharma

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Prescription medicine misuse, especially misuse of opioids has become a major public healthcare issue in many developed countries such as the USA and Australia where this is associated with significant morbidity (Emergency Department visits due to acute toxicity) and mortality. In this review, we looked at the available data obtained from peer‐reviewed articles and population surveys to gain an insight into the current situation in the Asia–Pacific region. There is currently limited information available, but data from subpopulation surveys in a number of countries suggests that prescription medicine misuse is likely to be an issue of concern from a public health perspective in the Asia–Pacific region. The available data suggest that misuse prevalence rates and the medicines that are commonly misused are similar to countries such as the USA and UK. Further studies are required to determine the overall prevalence of misuse, the harms associated with this and the sources of drugs being misused so that appropriate interventions can be implemented to tackle issues related to prescription medicine misuse in this region.

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Section: Prescription Medicine Misuse In Indiasupporting

confidence: 85%

Prescription medicine misuse in the Asia–Pacific region: An evolving issue?

Chan

Wood

Dargan

2020

Brit J Clinical Pharma

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“…The present study was a proof-of-concept comparison of LCA with PLA, applied to prescription claims data for 3 medications: alprazolam, the benzodiazepine with the greatest abuse liability; [ 14 , 15 ] opioids, which are a top public health concern because of an epidemic of misuse and overdose deaths; [ 1 , 16 ] and gabapentin, a noncontrolled substance recently identified as a medication of abuse [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Use of power-law analysis to predict abuse or diversion of prescribed medications: proof-of-concept mathematical exploration

Fairman

Peckham

Rucker³

et al. 2018

BMC Res Notes

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ObjectiveTo conduct a proof-of-concept study comparing Lorenz-curve analysis (LCA) with power-law (exponential function) analysis (PLA), by applying segmented regression modeling to 1-year prescription claims data for three medications—alprazolam, opioids, and gabapentin—to predict abuse and/or diversion using power-law zone (PLZ) classification.ResultsIn 1-year baseline observation, patients classified into the top PLZ groups (PLGs) were demographically and diagnostically similar to those in Lorenz-1 (top 1% of utilizers) and Lorenz-25 (top 25%). For prediction of follow-up (6-month post-baseline) Lorenz-1 use of alprazolam and opioids (i.e., potential abuse/diversion), PLA had somewhat lower sensitivity compared with LCA (83.5–95.4% vs. 99.5–99.9%, respectively) but better specificity (98.2–98.8% vs. 75.5%) and much better positive predictive value (PPV; 34.5–45.3% vs. 4.0–4.6%). Of top-PLG alprazolam- and opioid-treated patients, respectively, 20.7 and 9.9% developed incident (new) Lorenz-1 in followup, compared with < 3% of Lorenz-25 patients. For gabapentin, neither PLA nor LCA predicted incident Lorenz-1 (PPV = 0.0–1.4%). For all three medications, PLA sensitivity for follow-up hospitalization was < 5%, but specificity was better for PLA (97.3–99.2%) than for LCA (74.3–75.4%). PLA better identified patients at risk of future controlled substance abuse/diversion than did LCA, but the technique needs refinement before widespread use.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3632-y) contains supplementary material, which is available to authorized users.

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“…Out of the 6307 patients who initiated benzodiazepine or Z-drug treatment, 3.5% used clonazepam or alprazolam, both of which are among the most common drugs of abuse worldwide. [31][32][33] Alprazolam has long been known for causing more severe physical dependence than other benzodiazepines, due to its high potency. 34 Similarly, warnings about the highly addictive properties of clonazepam have emerged in recent years, 35,36 indicating that the high rates of longterm use of these drugs may be due to patients becoming dependent.…”

Section: Discussionmentioning

confidence: 99%