Do Spanish patients drink alcohol while undergoing treatment with benzodiazepines?

Abstract

In this study, we analyzed patterns of combined benzodiazepines and alcohol use among the Spanish general population over the age of 16 years. The study was based on information from the 1997 Spanish National Household Health Survey. A total of 6,396 persons over 16 years of age, a representative sample of noninstitutionalized Spaniards, were surveyed. One percent of the population are consumers of benzodiazepines and daily drinkers of alcohol; fundamentally, these consumers are men, of whom 15.4% drink alcohol at a high level (>50 units/week). Findings show the frequency of concurrent use of benzodiazepines and alcohol by the Spanish population.

Concurrent use of alcohol interactive medications and alcohol in older adults: a systematic review of prevalence and associated adverse outcomes

“…Consistent with those studies investigating psychotropic medications [14, 22, 25, 26, 28, 32, 34, 36], the following drug classes were classified as AI medications, sedatives/hypnotics [18–21, 24, 27, 30, 31], antidepressants [18–21, 27, 30, 31], opioids/narcotics [18–21, 27, 30, 31], anticonvulsants [19–21, 24, 27, 30, 31] and anti-psychotics [19–21, 27, 29, 30]. After CNS agents, cardiovascular medicines (CVS) were the most common AI medicines [18–21, 24, 27, 29–31], followed by antidiabetic drugs [18, 20, 21, 24, 27, 29–31], warfarin [18–21, 24, 27, 30, 31], gastrointestinal agents [18–21, 24, 30, 31], non-steroidal anti-inflammatory drugs (NSAIDs) [18–21, 29–31], antibiotics/anti-infectives [21, 24, 27, 29–31] and anti-histamines [19–21, 30].…”

“…For men 20–64 years moderate: >0–14 drinks/week & heavier >14drinks/weekCousins 2013 [21]Ireland, community dwelling older adults ≥60 years N  = 381546.6% males69.7 (±7.3 years)Range: 60–99 yearsCross sectional (Nurse led interviews in-home; medications reviewed & self-completed questionnaire)Current or regular use of medications with potential to interact with alcohol identified using Stockley’s Drug Interactions, British National Formulary and Irish Medicines Formulary: cardiovascular agents, CNS agents, antihistamines, blood agents, antidiabetic agents, anti-infectives, GI drugs, immunomodulators & muscle relaxantsQuantity-frequency, past 6 months: None,Light/moderate (≤ 4 drinks/day or 10 drinks/ week) and heavy drinkers (>4 drinks/day or 10 drinks/ week)1 drink = 10 g of alcoholDel Rio 1996 [23]Spain, community dwelling adults≥ 16 years≥66 years N  = 3003≥ 16 years N  = 21,08448% menNRCross sectional (survey with interview)Medication use, past 2 weeks. No reference source reportedBeverage specific quantity-frequency, past 2 weeksDel Rio 2002 [22]Spain, community dwelling adults≥ 16 years≥66 years = 1025≥16 years N  = 639648% menNRCross sectional (survey with interview)Benzodiazepine use, past 2 weeksBeverage specific quantity-frequency past 2 weeks: Low (men: ≤ 21 units/week, women: ≤ 14 units/week), moderate (men: 22–50 units/week, women: 15–35 units/week) & high consumption (men: >50 units/week & women: >35 units/week)1 unit = 10 g of alcoholDu 2008 [14]Germany, community dwelling older adults N  = 160545.2% menNRRange: 60–79 yearsCross sectional (survey & interview; prescriptions or original containers)Any psychotropic medication use in past 7 days: ATC nervous system drugs coded N00. (Excluded drugs coded N02B aspirin & paracetamol, except for N02BA71) Opiate codeines used as antitussives were merged with N02A & opiates for GI conditions (A07D) were not recordedBeverage specific quantity-frequency, past 12 months: Problem use (risky drinking): daily consumption ≥10 g for women & ≥ 20 g for menForster 1993 [24]US, community dwelling older adults N =66739.9% men74.1 (±6.6 years)NRCross sectional (survey & interview; medication containers)Prescription or OTC medications currently or past month: AI drugs defined by study clinical team: OTC painkillers, anti-hypertensives, diuretics, OTC cold preparations, arthritis medications, heart medications, antibiotics, mind altering medications, chest pain medications, pain medications, diabetes medications, ulcer medications, sleeping pills, OTC nasal sprays, steroids, blood agents, insulin, seizure medications & OTC asthma medicationFrequency: never, rarely, sometimes & regularlyIlomaki 2008 [25]Finland, community dwelling older adults N =1,77448.1% men63 years (NR)Range: 53-73 yearsCross sectional (mailed survey & interview; prescr...…”

“…Nine studies reported on a wide range of prescription and/or over the counter (OTC) medicines with potential to interact with alcohol [18–21, 24, 27, 29–31] . Three studies investigated any medication use during the recall period [23, 33, 35], and a further eight focused on psychotropic medications [14, 22, 25, 26, 28, 32, 34, 36]. Of the eight studies focusing on psychotropic medications, five investigated psychotropic medications alone [22, 25, 26, 34, 36] and three studies also included analgesics [14, 28, 32].…”

“…Ten studies were considered to have moderate external validity; five studies sampled random community dwelling older adults but with age restrictions which may have introduced selection bias [14, 19, 25, 26, 31] such as including adults aged between 53 and 75 years [25] or only including adults ≥75 years [19]. A further five studies reported on random population samples of community dwelling adults with subgroup analysis of older adults, however they did not report oversampling of older adults [22, 23, 28, 33, 34]. The six remaining studies were considered to have poor external validity, as the risk of selection bias is considered to be high [18, 29, 30, 32, 35, 36].…”

Motives and Simultaneous Sedative-Alcohol Use among Past 12-month Alcohol and Nonmedical Sedative Users

“…Multivariate logistic regression was used to identify the motives associated with past 12-month SSAU, adjusting for other covariates (age, gender, ethnicity, and education), selected based on prior literature suggesting their association with sedative misuse/combined use of sedatives and alcohol (18,19). Furthermore, it is possible that individuals may also have combined sedatives with other drugs.…”