Determinants of Quality of Life in High-Dose Benzodiazepine Misusers

Abstract

Benzodiazepines (BZDs) are among the most widely prescribed drugs in developed countries, but they have a high potential for tolerance, dependence and misuse. High-dose BZD misuse represents an emerging addiction phenomenon, but data on quality of life (QoL) in high-dose BZD misusers are scant. This study aimed to explore QoL in high-dose BZD misuse. We recruited 267 high-dose BZD misusers, compared the QoL scores in those who took BZD only to poly-drug misusers, and explored the role of demographic and clinical covariates through multivariable analysis. Our data confirmed worse QoL in high-dose BZD misusers and showed that (a) QoL scores were not negatively influenced by the misuse of alcohol or other drugs, or by coexisting psychiatric disorders; (b) demographic variables turned out to be the most significant predictors of QoL scores; (c) BZD intake significantly and negatively influenced QoL. Physical and psychological dimensions of QoL are significantly lower in high-dose BZD misusers with no significant effect of comorbidities. Our data suggest that the main reason for poor QoL in these patients is high-dose BZD intake per se. QoL should be considered among outcome measures in these patients.

Screening for adult attention deficit/hyperactivity disorder in high-dose benzodiazepine dependent patients

“…We prospectively recruited 167 consecutive patients aged >18 years, who were seen from June 2014 to June 2016 at the Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Italy for detoxification from high‐dose BZD dependence. High‐dose BZD dependence was defined as BZD dependence according to DSM‐IV‐TR criteria with abuse lasting >6 months, daily BZD intake exceeding at least five times the maximum daily recommended dose (ie, >50 mg diazepam/day), and/or an otherwise problematic use, such as mixing BZDs, escalating dosage, using BZDs for recreational purposes, or obtaining BZDs illegally . The dosage of BZD was based on self‐report and standardized as daily diazepam dose equivalent (DDDE, mg) according to previous studies .…”

“…High‐dose BZD dependence was defined as BZD dependence according to DSM‐IV‐TR criteria with abuse lasting >6 months, daily BZD intake exceeding at least five times the maximum daily recommended dose (ie, >50 mg diazepam/day), and/or an otherwise problematic use, such as mixing BZDs, escalating dosage, using BZDs for recreational purposes, or obtaining BZDs illegally . The dosage of BZD was based on self‐report and standardized as daily diazepam dose equivalent (DDDE, mg) according to previous studies . Zolpidem, which is an imidazopyridine chemically distinct from BZDs, has been included in the present study, since it binds to the alpha‐1 subtype of BZD receptor and its effect is similar to that of BZDs …”

“…High‐dose benzodiazepine (BZD) dependence represents an emerging and under‐reported addiction phenomenon, which is associated with reduced QoL, multifocal cognitive dysfunction, and difficult treatment . Data on the association between ADHD and high‐dose BZD dependence are lacking.…”

Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users

“…The estimated prevalence of higher-thanrecommended dose of anxiolytics and hypnotics was reported to be 0.14 and 0.06%, respectively, in Europe [7], and that of high-dose BZD use to be 0.16% in Switzerland [8]. We have previously found that high-dose BZD use is associated with worse quality of life (QoL) [9,10] and multifocal cognitive dysfunction [11].…”

Beyond Prescriptions Monitoring Programs: The Importance of Having the Conversation about Benzodiazepine Use

“…Since that time evidence of broad-ranging harms resulting from long-term BDZ use has continued to grow, including cognitive deficits [8][9][10], reductions in quality of life [11][12][13], depression [14][15][16], risk of suicide [17], risk for road accidents [18,19], and specific to older adults-the risk of falls [20][21][22], developing dementia [23][24][25], and of mortality [26][27][28]. Short-term, paradoxical effects such as increased anxiety, agitation, disinhibition, and aggression have also been observed [29,30].…”