title: Benzodiazepine use among adults residing in the urban settlements of Karachi, Pakistan: a cross sectional study.
abstract: BACKGROUND
  There are hardly any studies carried out in Pakistan on the usage of benzodiazepines at the level of community. This research was aimed to determine the frequency of benzodiazepine use, along with its associations with socio-demographic and clinical characteristics among community dwelling adults, residing in two urban settlements of Karachi, Pakistan.
  
  
  METHODS
  We performed a cross sectional study from August 2008 to December 2009, in 2 areas of Karachi, namely Garden and Sultanabad. We followed the systematic sampling strategy to randomly select the households, with an adult of either sex and of age 18 years or more. Data collection was carried out through interview, using a pre-tested questionnaire, with items on socio-demographic position, medical history and benzodiazepine use. Student's t-test and χ2 test was employed to determine the associations between socio-demographic and clinical characteristics, and their relationship with benzodiazepine use was determined using applied logistic regression.
  
  
  RESULTS
  The overall percentage of benzodiazepine consumption was estimated to be 14%. There were significantly more benzodiazepine users in the peri-urban Sultanabad community to the urban community of Garden (p-value = 0.001). The mean age (± SD) for users was 51.3 (± 15.6) years compared to 37.1 (± 14.4) years among non-users. Bromazepam was the most widely used benzodiazepine (29%); followed by diazepam, with a median duration on primary use being 144 weeks (IQR = 48-240). The adjusted logistic regression model revealed that increasing age, location, female sex, unemployment and psychiatric consultation were associated with increased likelihood of benzodiazepine use.
  
  
  CONCLUSIONS
  We believe the unregulated over-the-counter sales of benzodiazepines and social conditions might be playing a role in this high consumption of benzodiazepines in the community.
authors.affiliation: Department of Pediatrics & Child Health, Aga Khan University, Stadium Road, Karachi, Pakistan. saleem.iqbal@aku.edu
authors.forename: Saleem P
authors.initials: SP
authors.lastname: Iqbal
authors.forename: Syed
authors.initials: S
authors.lastname: Ahmer
authors.forename: Salima
authors.initials: S
authors.lastname: Farooq
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Parpio
authors.forename: Ambreen
authors.initials: A
authors.lastname: Tharani
authors.forename: Rashid A M
authors.initials: RA
authors.lastname: Khan
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zaman
mesh_terms: D000328:Adult; D001569:Benzodiazepines / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D012307:Risk Factors; D012651:Self Medication / Q000523:psychology; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D001569:Benzodiazepines