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Benzodiazepine dependence common among community-dwelling seniors; DSM-IV criteria may underestimate prevalence, researchers report

Wednesday, December 12 2007 | Comments
Evidence Grade 0 What's This?
Nearly half of all community-dwelling seniors who have a prescription for a benzodiazepine may be dependent, although few meet DSM-IV criteria for dependence, suggesting that these criteria may underestimate the true prevalence of benzodiazepine dependence among this population, new findings reveal.

Researchers in Quebec conducted a quantitative, population-based, descriptive study among community-dwelling seniors to determine the prevalence of benzodiazepine use and dependence in this population. Nurses performed face-to-face, computer-assisted interviews in the homes of 2,333 participants aged >=65 years.

Of those interviewed, 598 individuals used benzodiazepines, of whom 54 (9%) were designated as drug-dependent based on DSM-IV criteria. These participants were significantly more likely to be female (P=.003) and to have less education relative to nondependent individuals (P=.03).

However, when asked if they thought they were addicted to their medication, 42% of the participants responded affirmatively, and when asked whether it would be a good thing if they were to stop taking the medication, 32.6% responded affirmatively.

Further, 69.7% of the respondents said even if they were to stop taking their medication, they thought it would be important to keep some in reserve, just in case. Philippe Voyer, the study's lead researcher, told VerusMed this finding suggests that these seniors engage in drug-hoarding behaviors.

A majority of participants (86.6%) believed their drug was "not very strong or powerful," yet 21.4% responded affirmatively when asked if their drug brought about certain problems, such as interpersonal conflicts.

In another study conducted by Voyer and colleagues, many more participants responded affirmatively when asked if they would choose to discontinue dosing if they were aged <=50 years. According to Voyer, this suggests that patients and physicians perpetuate these prescriptions beyond the recommended 30 days primarily on the basis of the patient's age.

"DSM-IV-TR criteria of drug dependency may underestimate the true prevalence of this problem among seniors," the study authors wrote. "Clinical examination of mental health in the context of elderly addiction should include screening for typical and atypical signs of [benzodiazepine] dependency." (Poster NR423.)

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