title: Unconventional indicators of drug dependence among elderly long-term users of benzodiazepines.
abstract: A quarter of the elderly population is prescribed benzodiazepines (BZD). This has led to growing concerns about drug dependence and the validity of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for dependence to a substance. This study aimed to understand how dependence was experienced by long-term BZD users. Interviews were conducted with 45 elderly persons who had been using BZDs for an average of nine years. These users' comments suggest six indicators of dependence: self-identifying as a dependent user, invoking multiple stressors to justify BZD use, using BZD to cope with anticipated stressors, trivializing the dangers of BZDs, keeping a supply in reserve, having previously tried and failed to stop, and reducing the dosage. Our results stress the need to take a more elaborate, person-centered view of dependence.
authors.affiliation: Faculty of Nursing Sciences, Laval University, Cite Universitaire, Quebec City, Quebec, Canada. philippe.voyer@fsi.ulaval.ca
authors.forename: Philippe
authors.initials: P
authors.lastname: Voyer
authors.forename: Michael
authors.initials: M
authors.lastname: McCubbin
authors.forename: David
authors.initials: D
authors.lastname: Cohen
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lauzon
authors.forename: Johanne
authors.initials: J
authors.lastname: Collin
authors.forename: Caroline
authors.initials: C
authors.lastname: Boivin
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged / Q000523:psychology*; D014151:Anti-Anxiety Agents / Q000009:adverse effects*; D001294:Attitude to Health; D001569:Benzodiazepines / Q000009:adverse effects*; D003717:Denial, Psychological; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007406:Interview, Psychological / Q000592:standards; D008297:Male; D020380:Needs Assessment; D011792:Quebec; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards; D013997:Time Factors
chemical_list: D014151:Anti-Anxiety Agents; D001569:Benzodiazepines