title: Dependence on prescription benzodiazepines and Z-drugs among young to middle-aged patients in France.
abstract: BACKGROUND
  Benzodiazepines (BZD) and nonbenzodiazepines hypnotics (z-drugs) are recognized as one of the most widely prescribed medications in the world.
  
  
  OBJECTIVE
  The purpose of the study was to assess the BZD and z-drugs dependence in young to middle-aged outpatients who were taking BZD/z-drugs on a chronic basis, and to characterize their profile.
  
  
  METHODS
  This is a forward-looking cross-sectional epidemiological study. Data were collected through a semi-structured interview within a network of partner pharmacies from the Nantes area, in France. All data were obtained exclusively through patients' declarations. 212 patients (19-64 years old) were included: they were considered dependent when they answered positively to at least three items of the DSM IV. A multivariate logistic regression and a principal component analysis (PCA) were carried out to determine their profile.
  
  
  RESULTS
  Almost half of the patients met criteria for BZD/z-drugs dependence. The risk to develop BZD/z-drugs dependence is significantly associated with psychiatric history and with the quantity of BZD/z-drugs that is taken. A two factor concept of dependence could be identified according to the PCA: one axis with items of "tolerance" and "long term administration or higher doses", and a second axis with "concerned by treatment" and "somatic consequences". Conclusions/Importance: Among this BZD/z-drug dependent population, the two axes identified in the PCA represent two profiles of dependence: being in positive conditioning or suffering from negative consequences. Clinicians need to know them: these two clinical profiles may have an influence in terms of decision-making, especially to manage discontinuation.
authors.affiliation: 1CHU de Nantes, Clinical Pharmacology department, Institut de Biologie, 9 quai Moncousu, Nantes, France.
authors.forename: Marylène
authors.initials: M
authors.lastname: Guerlais
authors.forename: Marie
authors.initials: M
authors.lastname: Grall-Bronnec
authors.forename: Fanny
authors.initials: F
authors.lastname: Feuillet
authors.forename: Marie
authors.initials: M
authors.lastname: Gérardin
authors.forename: Pascale
authors.initials: P
authors.lastname: Jolliet
authors.forename: Caroline
authors.initials: C
authors.lastname: Victorri-Vigneau
mesh_terms: D000328:Adult; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D004338:Drug Combinations; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D010594:Pharmacies; D010865:Pilot Projects; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D055553:Prescription Drugs; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D006993:Hypnotics and Sedatives; D055553:Prescription Drugs; D001569:Benzodiazepines
keywords: benzodiazepine; dependence; middle-aged; substance-related disorders; z-drug