Inappropriate benzodiazepine medical and non-medical use: a neglected problem begging for prevention
Published |
January 1, 2025 |
Title |
Inappropriate benzodiazepine medical and non-medical use: a neglected problem begging for prevention |
Authors |
Giulia Collatuzzo, Alberto Gabbiadini, Silvia Martins, Paolo Boffetta. |
DOI |
10.62684/TIIK3824 |
Keywords |
benzodiazepine; anxiolytics; BDZ; drug abuse; drug addiction; non-medical use; accidental overdose; unintentional overdose. |
Downloads |
Giulia Collatuzzo(1), Alberto Gabbiadini(2), Silvia Martins(3), Paolo Boffetta(1,4)
(1) Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
(2) Azienda Unità Sanitaria Locale (AUSL) di Modena, Department of Psychiatry, 41121, Modena, Italy.
(3) Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, NY 10032, USA.
(4) Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA
Correspondence to: Giulia Collatuzzo, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. Stony Brook, email: giulia.collatuzzo3@unibo.it
Abstract
Aims
We aimed at providing an epidemiological overview on inappropriate use of benzodiazepines (BDZ) and its adverse outcomes.
Methods
We performed a narrative review of recent studies focused on the epidemiology of BDZ inappropriate use. We addressed prevalence of use, incidence and possible predictors of life-threatening events, mortality risk, barriers to monitoring their use and to good prescription practice, screening and prevention of inappropriate use of BDZ.
Results
Besides being good symptomatic medications, BDZ convey the risk of dependence and addiction, making their long-term use discouraged by the Food and Drugs Administration. BDZ prescription and long-term use are not systematically recorded, and therefore risky behaviors are scarcely documented. This prevents from attributing adverse events to BDZ use. While life-threatening events are well known in polysubstance intoxication, the specific effects of BZD non-medical use remain unrecognized. Ascertainment of cause of deaths often does not include BDZ, and does not distinguish between accidental or intentional overdose. Monitoring of BDZ use, preparedness of emergency departments, screening of at-risk subjects, sensitization of the general public and support for discontinuation treatments might help controlling BDZ inappropriate use. Further data are needed to characterize life-threatening events and deaths, and in turns help preventing a quote of the severe outcomes related to this medical problem.
Conclusions
The inappropriate use of BDZ requires public health attention. Effective monitoring systems are needed to record and characterize BDZ use, especially when chronic. Health education programs targeting patients and providers should be promoted to recognize and control inappropriate use of BDZ.
Declarations
Conflict of Interest
The authors declare there is no conflict of interest.
Author Contributions
Conceptualization: GC. Investigation: GC, SM, AG. Methodology: PB, GC. Writing the main draft: GC. Writing review and editing: all authors. SM provided important insight and expertise to this work. All authors reviewed and approved the final version of the manuscript.
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