Prospective cohort study into post-disaster benzodiazepine use demonstrated only short-term increase.
OBJECTIVE
Benzodiazepines are typically prescribed for anxiety and insomnia, two complaints often reported after disasters. Benzodiazepines can cause mental or physical dependence, especially when taken for a long time. This study aims at evaluating benzodiazepine use in a disaster-stricken community with the help of computer-based records.


METHODS
This prospective cohort study covers a period of 4 years. For every patient, predisaster baseline data are available. Multilevel regression is applied to study differences in benzodiazepine use in 496 patients whose children were involved in the Volendam café fire on January 1, 2001 compared with 1,709 community controls, and 4,530 patients from an unaffected cohort.


RESULTS
In community controls and patients from the unaffected cohort, benzodiazepine use remained stable in the course of the years. In the first year postfire, parents of disaster victims were 1.58 times more likely to use benzodiazepines than community controls (95% confidence interval 1.13-2.23). With regard to long-term use, differences between community controls and parents were statistically nonsignificant.


CONCLUSIONS
In the studied community, benzodiazepines were predominantly prescribed as a short-term intervention. Clinical guidelines that advocate a conservative prescription policy were well adhered to.
Dorn
T
T
Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, P.O. Box 1568, 3500 BN Utrecht, the Netherlands. t.dorn@nivel.nl
Yzermans
C J
CJ
van der Zee
J
J
D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy*; D001569:Benzodiazepines / Q000627:therapeutic use*; D016022:Case-Control Studies; D016001:Confidence Intervals; D003625:Data Collection / Q000379:methods; D004334:Drug Administration Schedule; D005260:Female; D005390:Fires; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents; D011446:Prospective Studies; D012044:Regression Analysis; D012306:Risk; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000517:prevention & control
D014151:Anti-Anxiety Agents; D001569:Benzodiazepines