title: Long-term, high-dose benzodiazepine prescriptions in veteran patients with PTSD: influence of preexisting alcoholism and drug-abuse diagnoses.
abstract: Databases from the New England Veterans Integrated Service Network were analyzed to determine factors associated with long-term, high-dose anxiolytic benzodiazepine prescriptions dispensed to patients with posttraumatic stress disorder (PTSD) and existing alcoholism and/or drug abuse diagnoses. Among 2,183 PTSD patients, 234 received the highest 10% average daily doses for alprazolam, clonazepam, diazepam, or lorazepam, doses above those typically recommended. Highest doses were more commonly prescribed to patients with existing drug abuse diagnoses. Among patients with PTSD and alcoholism, younger age, drug abuse, and concurrent prescriptions for another benzodiazepine and oxycodone/acetaminophen independently predicted high doses. Results indicate that for veteran patients with PTSD, alcoholism alone is not associated with high-dose benzodiazepines, but existing drug abuse diagnoses do increase that risk.
authors.affiliation: Pharmacoepidemiology Research Group, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA 02130, USA. john.hermos@med.va.gov
authors.forename: John A
authors.initials: JA
authors.lastname: Hermos
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Young
authors.forename: Elizabeth V
authors.initials: EV
authors.lastname: Lawler
authors.forename: David
authors.initials: D
authors.lastname: Rosenbloom
authors.forename: Louis D
authors.initials: LD
authors.lastname: Fiore
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis*; D014151:Anti-Anxiety Agents / Q000008:administration & dosage*; D001569:Benzodiazepines / Q000008:administration & dosage*; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009511:New England; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000175:diagnosis*; D014728:Veterans
chemical_list: D014151:Anti-Anxiety Agents; D001569:Benzodiazepines