Skip to main content
Top
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Mood Disorders | Research article

Prevalence of prescribed benzodiazepine long-term use in the French general population according to sociodemographic and clinical factors: findings from the CONSTANCES cohort

Authors: Guillaume Airagnes, Cédric Lemogne, Adeline Renuy, Marcel Goldberg, Nicolas Hoertel, Yves Roquelaure, Frédéric Limosin, Marie Zins

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

Data are lacking regarding the prevalence of benzodiazepine long-term use in the general population. Our aim was to examine the prevalence of prescribed benzodiazepine long-term use (BLTU) according to sociodemographic and clinical factors in the French general population.

Methods

Data came from 4686 men and 4849 women included in 2015 in the French population-based CONSTANCES cohort. BLTU was examined using drug reimbursement administrative registries from 2009 to 2015. Analyses were weighted to provide results representative of the French general population covered by the general health insurance scheme. Weighted prevalence of BTLU and weighted Odds Ratios (OR) of having BTLU were computed with their 95% Confidence Interval (95% CI) according to age, education level, occupational status, occupational grade, household income, marital status, alcohol use disorder risk and depressive symptoms. All the analyses were stratified for gender.

Results

Weighted prevalence of BLTU were 2.8%(95% CI:2.3–3.4) and 3.8%(95% CI: 3.3–4.5) in men and women, respectively. Compared to men, women had an increased risk of having benzodiazepine long-term use with OR = 1.34(95% CI = 1.02–1.76). Aging, low education, not being at-work, low occupational grade, low income, being alone and depressive state were associated with increased risks of having BTLU.

Conclusions

BLTU is widespread in the French general population, however this issue may particularly concern vulnerable subgroups. These findings may help in raising attention on this public health burden as well as targeting specific at-risk subgroups in preventive intervention.
Appendix
Available only for authorised users
Literature
1.
go back to reference Airagnes G, Pelissolo A, Lavallee M, Flament M, Limosin F. Benzodiazepine misuse in the elderly: risk factors, consequences, and management. Curr Psychiatry Rep. 2016;18(10):89.CrossRef Airagnes G, Pelissolo A, Lavallee M, Flament M, Limosin F. Benzodiazepine misuse in the elderly: risk factors, consequences, and management. Curr Psychiatry Rep. 2016;18(10):89.CrossRef
2.
go back to reference Ait-Daoud N, Blevins D, Khanna S, Sharma S, Holstege CP. Women and addiction. Psychiatr Clin N Am. 2017;40(2):285–97.CrossRef Ait-Daoud N, Blevins D, Khanna S, Sharma S, Holstege CP. Women and addiction. Psychiatr Clin N Am. 2017;40(2):285–97.CrossRef
3.
go back to reference AFSSAPS: Etat des lieux de la consommation de benzodiazépines en France. Rapport d'expertise. 2012. AFSSAPS: Etat des lieux de la consommation de benzodiazépines en France. Rapport d'expertise. 2012.
4.
go back to reference Brett J, Murnion B. Management of benzodiazepine misuse and dependence. Aust Prescr. 2015;38(5):152–5.CrossRef Brett J, Murnion B. Management of benzodiazepine misuse and dependence. Aust Prescr. 2015;38(5):152–5.CrossRef
5.
6.
go back to reference Donoghue J, Lader M. Usage of benzodiazepines: a review. Int J Psychiatry Clin Pract. 2010;14(2):78–87.CrossRef Donoghue J, Lader M. Usage of benzodiazepines: a review. Int J Psychiatry Clin Pract. 2010;14(2):78–87.CrossRef
7.
go back to reference Lader M. Benzodiazepine harm: how can it be reduced? Br J Clin Pharmacol. 2014;77(2):295–301.CrossRef Lader M. Benzodiazepine harm: how can it be reduced? Br J Clin Pharmacol. 2014;77(2):295–301.CrossRef
8.
go back to reference Nordfjærn T. A population-based cohort study of anxiety, depression, sleep and alcohol outcomes among benzodiazepine and z-hypnotic users. Addict Behav. 2012;37(10):1151–7.CrossRef Nordfjærn T. A population-based cohort study of anxiety, depression, sleep and alcohol outcomes among benzodiazepine and z-hypnotic users. Addict Behav. 2012;37(10):1151–7.CrossRef
9.
go back to reference Kurko TA, Saastamoinen LK, Tahkapaa S, Tuulio-Henriksson A, Taiminen T, Tiihonen J, Airaksinen MS, Hietala J. Long-term use of benzodiazepines: definitions, prevalence and usage patterns - a systematic review of register-based studies. Eur Psychiatry. 2015;30(8):1037–47.CrossRef Kurko TA, Saastamoinen LK, Tahkapaa S, Tuulio-Henriksson A, Taiminen T, Tiihonen J, Airaksinen MS, Hietala J. Long-term use of benzodiazepines: definitions, prevalence and usage patterns - a systematic review of register-based studies. Eur Psychiatry. 2015;30(8):1037–47.CrossRef
10.
go back to reference Micallef J, Frauger E, Lapeyre-Mestre M. Chapter 102 - misuse of benzodiazepines in France A2 - Preedy, victor R. In: Neuropathology of Drug Addictions and Substance Misuse. Edn. San Diego: Academic Press; 2016. p. 1101–11.CrossRef Micallef J, Frauger E, Lapeyre-Mestre M. Chapter 102 - misuse of benzodiazepines in France A2 - Preedy, victor R. In: Neuropathology of Drug Addictions and Substance Misuse. Edn. San Diego: Academic Press; 2016. p. 1101–11.CrossRef
11.
go back to reference Orriols L, Salmi LR, Philip P, Moore N, Delorme B, Castot A, Lagarde E. The impact of medicinal drugs on traffic safety: a systematic review of epidemiological studies. Pharmacoepidemiol Drug Saf. 2009;18(8):647–58.CrossRef Orriols L, Salmi LR, Philip P, Moore N, Delorme B, Castot A, Lagarde E. The impact of medicinal drugs on traffic safety: a systematic review of epidemiological studies. Pharmacoepidemiol Drug Saf. 2009;18(8):647–58.CrossRef
12.
go back to reference Konopka A, Pełka-Wysiecka J, Grzywacz A, Samochowiec J. Psychosocial characteristics of benzodiazepine addicts compared to not addicted benzodiazepine users. Prog Neuro-Psychopharmacol Biol Psychiatry. 2013;40:229–35.CrossRef Konopka A, Pełka-Wysiecka J, Grzywacz A, Samochowiec J. Psychosocial characteristics of benzodiazepine addicts compared to not addicted benzodiazepine users. Prog Neuro-Psychopharmacol Biol Psychiatry. 2013;40:229–35.CrossRef
13.
go back to reference Tapiainen V, Taipale H, Tanskanen A, Tiihonen J, Hartikainen S, Tolppanen AM. The risk of Alzheimer's disease associated with benzodiazepines and related drugs: a nested case-control study. Acta Psychiatr Scand. 2018;138(2):91–100.CrossRef Tapiainen V, Taipale H, Tanskanen A, Tiihonen J, Hartikainen S, Tolppanen AM. The risk of Alzheimer's disease associated with benzodiazepines and related drugs: a nested case-control study. Acta Psychiatr Scand. 2018;138(2):91–100.CrossRef
14.
go back to reference Kapil V, Green J, Le Lait C, Wood D, Dargan P. Misuse of benzodiazepines and Z-drugs in the UK. Br J Psychiatry. 2014;205(5):407–8.CrossRef Kapil V, Green J, Le Lait C, Wood D, Dargan P. Misuse of benzodiazepines and Z-drugs in the UK. Br J Psychiatry. 2014;205(5):407–8.CrossRef
15.
go back to reference Manthey L, van Veen T, Giltay EJ, Stoop JE, Neven AK, Penninx BWJH, Zitman FG. Correlates of (inappropriate) benzodiazepine use: the Netherlands study of depression and anxiety (NESDA). Br J Clin Pharmacol. 2011;71(2):263–72.CrossRef Manthey L, van Veen T, Giltay EJ, Stoop JE, Neven AK, Penninx BWJH, Zitman FG. Correlates of (inappropriate) benzodiazepine use: the Netherlands study of depression and anxiety (NESDA). Br J Clin Pharmacol. 2011;71(2):263–72.CrossRef
16.
go back to reference Ten Wolde GB, Dijkstra A, Van Empelen P, Knuistingh Neven A, Zitman FG. Psychological determinants of the intention to educate patients about benzodiazepines. Pharm World Sci. 2008;30(4):336–42.CrossRef Ten Wolde GB, Dijkstra A, Van Empelen P, Knuistingh Neven A, Zitman FG. Psychological determinants of the intention to educate patients about benzodiazepines. Pharm World Sci. 2008;30(4):336–42.CrossRef
17.
go back to reference Glintborg B, Olsen L, Poulsen H, Linnet K, Dalhoff K. Reliability of self-reported use of amphetamine, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone, and opiates among acutely hospitalized elderly medical patients. Clin toxicol (Philadelphia, Pa). 2008;46(3):239–42.CrossRef Glintborg B, Olsen L, Poulsen H, Linnet K, Dalhoff K. Reliability of self-reported use of amphetamine, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone, and opiates among acutely hospitalized elderly medical patients. Clin toxicol (Philadelphia, Pa). 2008;46(3):239–42.CrossRef
19.
go back to reference Jutte DP, Roos LL, Brownell MD. Administrative record linkage as a tool for public Health Research. Annu Rev Public Health. 2011;32(1):91–108.CrossRef Jutte DP, Roos LL, Brownell MD. Administrative record linkage as a tool for public Health Research. Annu Rev Public Health. 2011;32(1):91–108.CrossRef
20.
go back to reference Demyttenaere K, Bonnewyn A, Bruffaerts R, De Girolamo G, Gasquet I, Kovess V, Haro JM, Alonso J. Clinical factors influencing the prescription of antidepressants and benzodiazepines:: results from the European study of the epidemiology of mental disorders (ESEMeD). J Affect Disord. 2008;110(1):84–93.CrossRef Demyttenaere K, Bonnewyn A, Bruffaerts R, De Girolamo G, Gasquet I, Kovess V, Haro JM, Alonso J. Clinical factors influencing the prescription of antidepressants and benzodiazepines:: results from the European study of the epidemiology of mental disorders (ESEMeD). J Affect Disord. 2008;110(1):84–93.CrossRef
21.
go back to reference Van der Heyden JHA, Gisle L, Hesse E, Demarest S, Drieskens S, Tafforeau J. Gender differences in the use of anxiolytics and antidepressants: a population based study. Pharmacoepidemiol Drug Saf. 2009;18(11):1101–10.CrossRef Van der Heyden JHA, Gisle L, Hesse E, Demarest S, Drieskens S, Tafforeau J. Gender differences in the use of anxiolytics and antidepressants: a population based study. Pharmacoepidemiol Drug Saf. 2009;18(11):1101–10.CrossRef
22.
go back to reference Fride Tvete I, Bjørner T, Skomedal T. Risk factors for excessive benzodiazepine use in a working age population: a nationwide 5-year survey in Norway. Scand J Prim Health Care. 2015;33(4):252–9.CrossRef Fride Tvete I, Bjørner T, Skomedal T. Risk factors for excessive benzodiazepine use in a working age population: a nationwide 5-year survey in Norway. Scand J Prim Health Care. 2015;33(4):252–9.CrossRef
23.
go back to reference Redonnet B, Chollet A, Fombonne E, Bowes L, Melchior M. Tobacco, alcohol, cannabis and other illegal drug use among young adults: the socioeconomic context. Drug Alcohol Depend. 2012;121(3):231–9.CrossRef Redonnet B, Chollet A, Fombonne E, Bowes L, Melchior M. Tobacco, alcohol, cannabis and other illegal drug use among young adults: the socioeconomic context. Drug Alcohol Depend. 2012;121(3):231–9.CrossRef
24.
go back to reference Lugoboni F, Mirijello A, Faccini M, Casari R, Cossari A, Musi G, Bissoli G, Quaglio G, Addolorato G. Quality of life in a cohort of high-dose benzodiazepine dependent patients. Drug Alcohol Depend. 2014;142:105–9.CrossRef Lugoboni F, Mirijello A, Faccini M, Casari R, Cossari A, Musi G, Bissoli G, Quaglio G, Addolorato G. Quality of life in a cohort of high-dose benzodiazepine dependent patients. Drug Alcohol Depend. 2014;142:105–9.CrossRef
25.
go back to reference Holm E, Fosbol E, Pedersen H, Jensen TB, Nielsen M, Weeke P, Brinth L, Torp-Pedersen C. Benzodiazepine use in Denmark 1997–2008. Eur Geriatr Med. 2012;3(5):299–303.CrossRef Holm E, Fosbol E, Pedersen H, Jensen TB, Nielsen M, Weeke P, Brinth L, Torp-Pedersen C. Benzodiazepine use in Denmark 1997–2008. Eur Geriatr Med. 2012;3(5):299–303.CrossRef
26.
go back to reference Morel A, Grall-Bronnec M, Bulteau S, Chauvin-Grelier P, Gailledrat L, Pinot ML, Jolliet P, Victorri-Vigneau C. Benzodiazepine dependence in subjects with alcohol use disorders: what prevalence? Expert Opin Drug Saf. 2016;15(10):1313–9.CrossRef Morel A, Grall-Bronnec M, Bulteau S, Chauvin-Grelier P, Gailledrat L, Pinot ML, Jolliet P, Victorri-Vigneau C. Benzodiazepine dependence in subjects with alcohol use disorders: what prevalence? Expert Opin Drug Saf. 2016;15(10):1313–9.CrossRef
27.
go back to reference Zins M, Goldberg M. The French CONSTANCES population-based cohort: design, inclusion and follow-up. Eur J Epidemiol. 2015;30(12):1317–28.CrossRef Zins M, Goldberg M. The French CONSTANCES population-based cohort: design, inclusion and follow-up. Eur J Epidemiol. 2015;30(12):1317–28.CrossRef
28.
go back to reference Santin GHE, Guéguen A, Carton M, Cyr D, Genreau M, et al. Estimation de prévalences dans Constances : premières explorations. Bull Epidémiol Hebd. 2016;35(36):622–9. Santin GHE, Guéguen A, Carton M, Cyr D, Genreau M, et al. Estimation de prévalences dans Constances : premières explorations. Bull Epidémiol Hebd. 2016;35(36):622–9.
29.
go back to reference Bezin J, Duong M, Lassalle R, Droz C, Pariente A, Blin P, Moore N. The national healthcare system claims databases in France, SNIIRAM and EGB: powerful tools for pharmacoepidemiology. Pharmacoepidemiol Drug Saf. 2017;26(8):954–62.CrossRef Bezin J, Duong M, Lassalle R, Droz C, Pariente A, Blin P, Moore N. The national healthcare system claims databases in France, SNIIRAM and EGB: powerful tools for pharmacoepidemiology. Pharmacoepidemiol Drug Saf. 2017;26(8):954–62.CrossRef
30.
go back to reference Cloos JM, Bocquet V, Rolland-Portal I, Koch P, Chouinard G. Hypnotics and Triazolobenzodiazepines - best predictors of high-dose benzodiazepine use: results from the Luxembourg National Health Insurance Registry. Psychother Psychosom. 2015;84(5):273–83.CrossRef Cloos JM, Bocquet V, Rolland-Portal I, Koch P, Chouinard G. Hypnotics and Triazolobenzodiazepines - best predictors of high-dose benzodiazepine use: results from the Luxembourg National Health Insurance Registry. Psychother Psychosom. 2015;84(5):273–83.CrossRef
31.
go back to reference Airagnes G, Lemogne C, Olekhnovitch R, Roquelaure Y, Hoertel N, Goldberg M, Limosin F, Zins M. Work-related stressors and increased risk of benzodiazepine long-term use: findings from the CONSTANCES population-based cohort. Am J Public Health. 0(0):e1–7. Airagnes G, Lemogne C, Olekhnovitch R, Roquelaure Y, Hoertel N, Goldberg M, Limosin F, Zins M. Work-related stressors and increased risk of benzodiazepine long-term use: findings from the CONSTANCES population-based cohort. Am J Public Health. 0(0):e1–7.
32.
go back to reference Schneider SL: The International Standard Classification of Education 2011. In: Class and Stratification Analysis (Comparative Social Research, Volume 30) Emerald Group Publishing Limited. Edn. Edited by Birkelund GE; 2013: 365–379. Schneider SL: The International Standard Classification of Education 2011. In: Class and Stratification Analysis (Comparative Social Research, Volume 30) Emerald Group Publishing Limited. Edn. Edited by Birkelund GE; 2013: 365–379.
33.
go back to reference Morin AJ, Moullec G, Maiano C, Layet L, Just JL, Ninot G. Psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in French clinical and nonclinical adults. Revue d'epidemiologie et de sante publique. 2011;59(5):327–40.CrossRef Morin AJ, Moullec G, Maiano C, Layet L, Just JL, Ninot G. Psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in French clinical and nonclinical adults. Revue d'epidemiologie et de sante publique. 2011;59(5):327–40.CrossRef
34.
go back to reference Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT: the alcohol use disorders identification test: guidelines for use in primary health care, 2 edn. Geneva: World Health Organization; 2001. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT: the alcohol use disorders identification test: guidelines for use in primary health care, 2 edn. Geneva: World Health Organization; 2001.
35.
go back to reference Newgard CD, Haukoos JS. Advanced statistics: missing data in clinical research--part 2: multiple imputation. Acad Emerg Med Off J Soc Acad Emerg Med. 2007;14(7):669–78. Newgard CD, Haukoos JS. Advanced statistics: missing data in clinical research--part 2: multiple imputation. Acad Emerg Med Off J Soc Acad Emerg Med. 2007;14(7):669–78.
36.
go back to reference Boudes P. Drug compliance in therapeutic trials: a review. Control Clin Trials. 1998;19(3):257–68.CrossRef Boudes P. Drug compliance in therapeutic trials: a review. Control Clin Trials. 1998;19(3):257–68.CrossRef
38.
go back to reference Kan CC, Breteler MH, Zitman FG. High prevalence of benzodiazepine dependence in out-patient users, based on the DSM-III-R and ICD-10 criteria. Acta Psychiatr Scand. 1997;96(2):85–93.CrossRef Kan CC, Breteler MH, Zitman FG. High prevalence of benzodiazepine dependence in out-patient users, based on the DSM-III-R and ICD-10 criteria. Acta Psychiatr Scand. 1997;96(2):85–93.CrossRef
39.
go back to reference Neutel CI, Walop W. Drug utilization by men and women: why the differences? Drug Inf J. 2005;39(3):299–310.CrossRef Neutel CI, Walop W. Drug utilization by men and women: why the differences? Drug Inf J. 2005;39(3):299–310.CrossRef
40.
go back to reference Kan C, Hilberink S, Breteler M: Determination of the Main Risk Factors for Benzodiazepine Dependence Using a Multivariate and Multidimensional Approach, vol. 45; 2004.CrossRef Kan C, Hilberink S, Breteler M: Determination of the Main Risk Factors for Benzodiazepine Dependence Using a Multivariate and Multidimensional Approach, vol. 45; 2004.CrossRef
41.
go back to reference Ngoundo-Mbongue TB, Niezborala M, Sulem P, Briant-Vincens D, Bancarel Y, Jansou P, Chastan E, Montastruc JL, Lapeyre-Mestre M. Psychoactive drug consumption: performance-enhancing behaviour and pharmacodependence in workers. Pharmacoepidemiol Drug Saf. 2005;14(2):81–9.CrossRef Ngoundo-Mbongue TB, Niezborala M, Sulem P, Briant-Vincens D, Bancarel Y, Jansou P, Chastan E, Montastruc JL, Lapeyre-Mestre M. Psychoactive drug consumption: performance-enhancing behaviour and pharmacodependence in workers. Pharmacoepidemiol Drug Saf. 2005;14(2):81–9.CrossRef
42.
go back to reference Valenstein M, Taylor KK, Austin K, Kales HC, McCarthy JF, Blow FC. Benzodiazepine use among depressed patients treated in mental health settings. Am J Psychiatr. 2004;161(4):654–61.CrossRef Valenstein M, Taylor KK, Austin K, Kales HC, McCarthy JF, Blow FC. Benzodiazepine use among depressed patients treated in mental health settings. Am J Psychiatr. 2004;161(4):654–61.CrossRef
43.
go back to reference ANSM: Point d'information. Plan d’actions de l’ANSM visant à réduire le mésusage des benzodiazépines. 2012. ANSM: Point d'information. Plan d’actions de l’ANSM visant à réduire le mésusage des benzodiazépines. 2012.
44.
go back to reference HAS: Modalités d'arrêt des benzodiazépines et médicaments apparentés chez le patient âgé. 2007. HAS: Modalités d'arrêt des benzodiazépines et médicaments apparentés chez le patient âgé. 2007.
45.
go back to reference HAS: Arrêt des benzodiazépines et médicaments apparentés: démarche du médecin traitant en ambulatoire. 2015. HAS: Arrêt des benzodiazépines et médicaments apparentés: démarche du médecin traitant en ambulatoire. 2015.
46.
go back to reference Panes A, Lassalle R, Bernard M-A, Dureaud-Pournin C, Pariente A, Fourrier-Réglat A. Misuse of benzodiazepines in the French population: a cohort study in the Échantillon Genéraliste de Bénéficiaires between 2007 and 2012. Revue d'epidemiologie et de sante publique. 2016;64:S132–3.CrossRef Panes A, Lassalle R, Bernard M-A, Dureaud-Pournin C, Pariente A, Fourrier-Réglat A. Misuse of benzodiazepines in the French population: a cohort study in the Échantillon Genéraliste de Bénéficiaires between 2007 and 2012. Revue d'epidemiologie et de sante publique. 2016;64:S132–3.CrossRef
47.
go back to reference Soyka M. Treatment of benzodiazepine dependence. N Engl J Med. 2017;376(12):1147–57.CrossRef Soyka M. Treatment of benzodiazepine dependence. N Engl J Med. 2017;376(12):1147–57.CrossRef
Metadata
Title
Prevalence of prescribed benzodiazepine long-term use in the French general population according to sociodemographic and clinical factors: findings from the CONSTANCES cohort
Authors
Guillaume Airagnes
Cédric Lemogne
Adeline Renuy
Marcel Goldberg
Nicolas Hoertel
Yves Roquelaure
Frédéric Limosin
Marie Zins
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-6933-8

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue