title: Heavy drinking and use of sedative or anxiolytic drugs among aging men: an 11-year follow-up of the FinDrink study.
abstract: BACKGROUND
  Most studies on heavy drinking and sedative/anxiolytic drug use have been cross-sectional, and evidence for a possible temporal association is lacking.
  
  
  OBJECTIVE
  To prospectively investigate whether heavy drinking predicts initiation, continuation, or discontinuation of sedative/anxiolytic drugs at 4 and 11 years and, conversely, whether sedative/anxiolytic drug use predicts heavy drinking.
  
  
  METHODS
  This was a longitudinal population-based study conducted in Kuopio, Finland. An age-stratified random sample of 1516 men aged 42, 48, 54, and 60 years received a structured clinical examination at baseline (August 1986-December 1989). Follow-up clinical examinations were conducted at 4 (n = 1038) and 11 (n = 854) years. Multinomial logistic regression was used to compute odds ratios and 95% confidence intervals for the association between sedative/anxiolytic drug use and initiation, continuation, and discontinuation of heavy drinking (≥ 14 drinks/wk). The reverse association between heavy drinking and sedative/anxiolytic drug use was also investigated. Regression models were adjusted for age, working status, smoking, and depressive symptoms.
  
  
  RESULTS
  At baseline 12.9% (134/1038) of participants were heavy drinkers and 4.0% (41/1030) used sedative/anxiolytic drugs. In multivariate analyses, baseline heavy drinking predicted initiation of sedative/anxiolytic drug use at 4 years (OR 2.96; 95% CI 1.23 to 7.15). Conversely, baseline sedative/anxiolytic drug use predicted continuation of heavy drinking at 11 years in unadjusted analysis (OR 3.30; 95% CI 1.19 to 8.44). However, the association was not statistically significant in adjusted analyses (OR 2.69; 95% CI 0.86 to 8.44).
  
  
  CONCLUSIONS
  The main finding of this study was the association between heavy drinking and subsequent initiation of sedative/anxiolytic drugs that was not fully explained by baseline depressive symptoms. This may inform strategies to optimize the use of sedative/anxiolytic drugs, and assist in the early identification of patients at risk of heavy drinking. Clinicians should consider a patient's alcohol consumption prior to prescribing or dispensing sedative/anxiolytic drugs. Clinicians should also monitor patients prescribed sedative/anxiolytic drugs for subsequent heavy drinking.
authors: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia. jenni.ilomaki@unisa.edu.au
authors: Jenni
authors: J
authors: Ilomäki
authors: J Simon
authors: JS
authors: Bell
authors: Jussi
authors: J
authors: Kauhanen
authors: Hannes
authors: H
authors: Enlund
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D000435:Alcoholic Intoxication / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D014151:Anti-Anxiety Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D013287:Illicit Drugs; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000008:administration & dosage; D012044:Regression Analysis; D012306:Risk; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D013287:Illicit Drugs; D011619:Psychotropic Drugs