title: Use of benzodiazepines and related drugs in Manitoba: a population-based study.
abstract: BACKGROUND
  Despite their favourable toxicology profile, benzodiazepines and the related Z-drugs (zopiclone, zolpidem and zaleplon) have been associated with physiological tolerance, dependence and addiction. Evidence of harm (e.g., falls, motor vehicle collisions and cognitive disturbances) has been reported in older populations. The aim of this study was to determine the relation between users' characteristics and the use of benzodiazepines and Z-drugs in Manitoba over a 16-year period.
  
  
  METHODS
  This time-series analysis was based on prescription data from Apr. 1, 1996, to Mar. 31, 2012, obtained from the Drug Product Information Network database of Manitoba. We obtained sociodemographic information on benzodiazepine and Z-drug users from the Population Registry and determined changes in utilization rates over time using generalized estimating equations.
  
  
  RESULTS
  Overall, the prevalence of benzodiazepine use remained stable at about 61.0 per 1000 population between 1996/97 and 2011/12; however, the prevalence of Z-drug use increased steadily from 10.9 to 37.0 per 1000 over the same period. In older people (≥ 65 years), the incidence of benzodiazepine use decreased from 55.5 to 30.3 users per 1000, whereas the incidence of Z-drug use increased from 7.3 to 20.3 users per 1000 over the study period. Among those 18-64 years of age, the incidence of benzodiazepine use decreased from 30.1 to 27.6 users per 1000, but the increase in incidence of Z-drug use was more than 2-fold. The youngest population (≤ 17 years) showed the lowest rates of use of these drugs. The highest rates of use were observed among older women and the low-income population.
  
  
  CONCLUSIONS
  Over the study period, benzodiazepines have been prescribed less frequently to older patients in Manitoba; however, zopiclone prescribing has continued to increase for all age groups. The reasons for this increase remain to be determined.
authors.affiliation: Faculty of Pharmacy, University of Manitoba, Winnipeg, Man.
authors.forename: Silvia
authors.initials: S
authors.lastname: Alessi-Severini
authors.affiliation: Department of Psychiatry, Faculty of Medicine, University of Manitoba, Winnipeg, Man. ; Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Man. ; Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, Man.
authors.forename: James M
authors.initials: JM
authors.lastname: Bolton
authors.affiliation: Department of Psychiatry, Faculty of Medicine, University of Manitoba, Winnipeg, Man. ; Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Man. ; Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, Man.
authors.forename: Murray W
authors.initials: MW
authors.lastname: Enns
authors.affiliation: Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Man.
authors.forename: Matthew
authors.initials: M
authors.lastname: Dahl
authors.affiliation: Faculty of Pharmacy, University of Manitoba, Winnipeg, Man.
authors.forename: David M
authors.initials: DM
authors.lastname: Collins
authors.affiliation: Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Man. ; Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Man.
authors.forename: Dan
authors.initials: D
authors.lastname: Chateau
authors.affiliation: Department of Psychiatry, Faculty of Medicine, University of Manitoba, Winnipeg, Man. ; Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Man. ; Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, Man.
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen