Long Term Users of Benzodiazepine Attending the Department of Medicine in a Tertiary Care Hospital.

Abstract

Although comprehensive epidemiological data related to long term use and abuse of benzodiazepine (BZD) in our country is scarce, undocumented clinical observation suggests that the prevalence is quite high and constitutes a significant public health problem. This cross-sectional study was carried out in the Department of Medicine, Shaheed Ziaur Rahman Medical College hospital, Bogra, from 1st October 2015 to 31st March 2016. The objectives of the study were to evaluate the indication, dosage, duration and untoward effects of use of benzodiazepine for one month or longer among the patients attending the inpatient and outpatient departments of medicine. A total of 100 cases of long term benzodiazepine users aged between 18 to 72 years with mean age of 44.0±15.02 years were taken for the study. Male to female ratio of the cases was 1.08:1.00, 97.0% were Muslims, 96.0% were married; 77.0% were rural dwellers. Fifty four (54.0%) cases were from middle class society and 39.0% were housewives by occupation. The benzodiazepine dosage ranged from <5mg to 10mg equivalent to diazepam, with mean dose of 7.5±1.71 and the duration ranged from 1-60 months. Benzodiazepine tolerance was found in 21.0% and dependence in 18.0%. The common reason for taking was benzodiazepine for long duration was the different anxiety disorders in 63.0% followed sleep disturbance in 33.0%. Common cause of long term continuation reported by the respondents was rapid relief of symptoms (51.0%) and lack of awareness (21.0%). In 56.0% cases, the drugs were prescribed by providers other than registered physicians. Only 23.0% of patients were counseled beforehand regarding the probable hazards of long term use of the drugs and the counseling were provided only by registered physicians. In conclusion, it can be said that, large scale epidemiologic studies are warranted to evaluate the weight of burden of benzodiazepines abuse in our community and the needs for changes in clinical approach.