Benzodiazepine use among adults residing in the urban settlements of Karachi, Pakistan: A cross sectional study

Abstract

BackgroundThere are hardly any studies carried out in Pakistan on the usage of benzodiazepines at the level of community. This research was aimed to determine the frequency of benzodiazepine use, along with its associations with socio-demographic and clinical characteristics among community dwelling adults, residing in two urban settlements of Karachi, Pakistan.MethodsWe performed a cross sectional study from August 2008 to December 2009, in 2 areas of Karachi, namely Garden and Sultanabad. We followed the systematic sampling strategy to randomly select the households, with an adult of either sex and of age 18 years or more. Data collection was carried out through interview, using a pre-tested questionnaire, with items on socio-demographic position, medical history and benzodiazepine use. Student's t-test and χ2 test was employed to determine the associations between socio-demographic and clinical characteristics, and their relationship with benzodiazepine use was determined using applied logistic regression.ResultsThe overall percentage of benzodiazepine consumption was estimated to be 14%. There were significantly more benzodiazepine users in the peri-urban Sultanabad community to the urban community of Garden (p-value = 0.001). The mean age (± SD) for users was 51.3 (± 15.6) years compared to 37.1 (± 14.4) years among non-users. Bromazepam was the most widely used benzodiazepine (29%); followed by diazepam, with a median duration on primary use being 144 weeks (IQR = 48-240). The adjusted logistic regression model revealed that increasing age, location, female sex, unemployment and psychiatric consultation were associated with increased likelihood of benzodiazepine use.ConclusionWe believe the unregulated over-the-counter sales of benzodiazepines and social conditions might be playing a role in this high consumption of benzodiazepines in the community.

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.…”

“…22 However, Iqbal found that benzodiazepine users were older compared to the non-users. 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.…”

“…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.…”

Remote consequences of the long-term uncontrollable consumption of anxiolytics and hypnotics in elderly: a problem of drug dependence

“…Первично токсикоманический вариант, обычно не вызывая разногласий исследователей, квалифицирует-ся как болезнь зависимости от психоактивных веществ (ПАВ). Для него характерны первично поисковое поведе-ние и выбор бензодиазепинов в качестве препаратов, вы-зывающих или усиливающих эйфорию, первая их проба редко связана с назначением врача, употребление начина-ется с высоких доз, которые затем быстро повышаются, больные оказывают предпочтение высокопотентным анк-сиолитикам (альпразолам, клоназепам, лоразепам), при-бегают к сочетанию отдельных препаратов, в том числе с барбитуратами, алкоголем, реже психостимуляторами, опиатами, каннабиноидами, в структуре синдрома отме-ны ярко проявляется симптоматика патологического вле-чения [1- 17,32,[38][39][40][41][42][43][44][45][46].…”

“…К факторам риска развития зависимости от бензоди-азепинов относят также большую длительность непре-рывного приема бензодиазепинов, применение высоких доз, предпочтение высокопотентных анксиолитиков (аль-празолам, клоназепам, лоразепам), препаратов с медлен-ной элиминацией и активными метаболитами (клоназе-пам, нитразепам, диазепам, феназепам), сочетание с дру-гими ПАВ [1- 17,32,[38][39][40][41][42][43][44].…”