Abuse of benzodiazepines in western European society--incidence and prevalence, motives, drug acquisition.

A nation-wide survey on the abuse of benzodiazepines in Switzerland showed an average morbidity (incidence) of 0.0006 per year for isolated abuse of benzodiazepines. The exposure risk was, independently of the benzodiazepine compound used. 0.00002 per prescription. The afflicted population differed demographically in no way from the population of "normal" benzodiazepine consumers, legitimate therapeutic use of a benzodiazepine being the only visible risk factor for development of an abuse. The motivation for abuse, too, was in about 90% of the case self-medication of anxiety and/or insomnia and related symptomatology. Main source of the drug was new prescriptions by the treating physician. The majority of patients were medically in a good state of health and socially well adjusted; 52 out of 180 patients, however, showed negative consequences. Withdrawal syndromes were reported in about one quarter of the detected cases, but detection was mostly due to the increased frequency of prescriptions of confession of the patient. Because of the low frequency of severe negative consequences and the mostly unobtrusive behaviour of the patients, differing in many ways from the accustomed picture of an "abuser of (illicit) drugs", the physician's attitude towards abuse of benzodiazepines was in many cases ambivalent, resulting in a tacit acquiescence and continued prescription. From the data presented it is concluded that the most appropriate measure against abuse of benzodiazepines would be, rather than international control, education of medical professionals and the public, according to internationally accepted medical knowledge and to national law and prescription regulations.