title: Psychoactive drug consumption: performance-enhancing behaviour and pharmacodependence in workers.
abstract: OBJECTIVE
  The aim of this study was to investigate factors associated to psychoactive medication use and dependence in working environment during a 1-year period.
  
  
  METHODS
  We performed a 1-year-follow-up cohort study including workers from Toulouse metropolitan area. During their annual compulsory examination to assess their aptitude to work, subjects were asked to fill in an anonymous questionnaire at 1 year interval, in May 2000 and May-June 2001.
  
  
  RESULTS
  Among a study sample of 1273 subjects (47.4% of men, mean age 39.2 +/- 9.2 years), the prevalence of psychoactive medication use at baseline was 9.1% (4.3% anxiolytic, 1.9% hypnotic, 1.7% antidepressant, 2.1% opiate analgesic and 0.5% antipsychotic drugs, according to ATC classification). Dependence on these drugs was found in 3.5% of workers. This consumption was associated with professional categories (higher in employees versus senior executive, Odds Ratio: 1.80; 95% Confidence Interval [1.04-3.11]), low job satisfaction and outside workplace (1.92; [1.30-2.84] and 3.40; [2.27-5.09] respectively), and patterns of medication use at workplace: for sleeping disorders related to job (18.27; [11.81-28.26]), for enhancing performance at work (28.13; [12.00-65.92]), for relieving unpleasant symptoms at work (22.98; [9.59-55.01]). The risk of psychoactive medication chronic use (psychoactive drug users in 2000 and 2001), and dependence at 1 year were both strongly associated with nicotine dependence (5.99 and 6.23, respectively) and performance-enhancing behaviour with drugs and/or alcohol (8.35 and 3.32 respectively), whereas current use (psychoactive drug users only in 2001) was strongly associated with performance-enhancing behaviour.
  
  
  CONCLUSIONS
  Among workers using psychoactive drugs, one out of three are dependent on psychoactive medications. Performance-enhancing behaviour and coping strategies might be a determinant of psychoactive drug use and could lead to dependence in the workplace.
authors.affiliation: Department of Clinical Pharmacology, Research Unit of Pharmacoepidemiology, EA 3696, Toulouse, France.
authors.forename: T B
authors.initials: TB
authors.lastname: Ngoundo-Mbongue
authors.forename: M
authors.initials: M
authors.lastname: Niezborala
authors.forename: P
authors.initials: P
authors.lastname: Sulem
authors.forename: D
authors.initials: D
authors.lastname: Briant-Vincens
authors.forename: Y
authors.initials: Y
authors.lastname: Bancarel
authors.forename: P
authors.initials: P
authors.lastname: Jansou
authors.forename: E
authors.initials: E
authors.lastname: Chastan
authors.forename: J L
authors.initials: JL
authors.lastname: Montastruc
authors.forename: M
authors.initials: M
authors.lastname: Lapeyre-Mestre
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D017132:Workplace
chemical_list: D011619:Psychotropic Drugs