1
|
Srithumsuk W, Thummapol O, Bhatarasakoon P. Social Determinants of Health Inequities for Older LGBT Adults: A Scoping Review. J Transcult Nurs 2024:10436596241253866. [PMID: 38767232 DOI: 10.1177/10436596241253866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Despite the research on a health-disparate population, less is known about the social determinants of health (SDOH) inequities among older lesbian, gay, bisexual, and transgender (LGBT) adults. This scoping review aimed to explore and summarize what is known in the literature regarding the SDOH among older LGBT adults. METHODS The Joanna Briggs Institute's (JBI) approach guided this scoping review, which examined 31 articles that included quantitative, qualitative, and mixed-method studies. Data were analyzed by three independent reviewers through a predesigned process of data charting, descriptive summary, and thematic analysis. RESULTS Older participants were primarily LGBT and LGB. The findings identified four intersecting dimensions of individuals, social, economic, and health care system, contributing to health inequities and poor health outcomes. CONCLUSION Given the importance of SDOH for older LGBT adults, stakeholders including health care providers need to better understand the multiple intersecting influences, provide culturally congruent health care, and integrate sources of support into the care of these sexual- and gender-minority older adults.
Collapse
|
2
|
Sun Y, Tsai MK, Wen CP. Association of sleep duration and sleeping pill use with mortality and life expectancy: A cohort study of 484,916 adults. Sleep Health 2023; 9:354-362. [PMID: 37045661 DOI: 10.1016/j.sleh.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 01/15/2023] [Accepted: 01/31/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES To compare mortality risk and life expectancy among individuals with different sleep durations and sleeping pill use. METHODS A cohort of 484,916 community-dwelling adults in Taiwan was recruited into a health screening program from 1994 to 2011. Subjects were categorized by daily sleep duration into 4 groups: extremely short (<4 hours), short (4-6 hours), medium (6-8 hours), and long (>8 hours). Cox proportional hazards models were used to investigate the associations of mortality risk with sleep duration and sleeping pill use. Models were adjusted for sociodemographic characteristics, lifestyle, and comorbidities. Life expectancy tables were calculated among sleeping pill users and nonusers with different sleep durations. RESULTS With 6- 8 hours of daily sleep, sleeping pill nonusers had the lowest mortality risk. Sleeping pill users, even with this optimal amount of sleep, had a 55% (p < .001, 95% CI, 1.38-1.73) higher mortality risk than nonusers. The life expectancy of 30-year-old male sleeping pill users with extremely short or long sleep durations was 12-13 years shorter than sleeping pill nonusers who had 6-8 hours of sleep. On average, life expectancy in individuals using sleeping pills (vs. nonusers) was shorter by 5.3 (95% CI, 4.10-6.32) years in men and 5.7 (95% CI, 5.28-7.98) years in women. CONCLUSIONS This study suggests that the use of sleeping pills is associated with an increased risk of mortality and shortened life expectancy, especially in extreme sleepers. Regular users should be aware of potential harms from sleeping pills.
Collapse
Affiliation(s)
- Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan; Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Min-Kuang Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Chi-Pang Wen
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; China Medical University, Taichung, Taiwan.
| |
Collapse
|
3
|
Ricciardulli S, Lattanzi L, Barbuti M, Ceravolo R, Perugi G. Occurrence of involuntary movements after prolonged misuse of zolpidem: a case report. Int Clin Psychopharmacol 2023; 38:117-120. [PMID: 36719339 DOI: 10.1097/yic.0000000000000443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Zolpidem is a non-benzodiazepine agent used for short-term treatment of insomnia. Several cases of dependence and withdrawal from zolpidem are reported in the literature. Furthermore, involuntary movements after prolonged zolpidem misuse have been described. In this case report, a 69-year-old Italian woman with no history of diagnosed psychiatric or neurologic diseases developed uncontrolled movements and a depressive-anxious syndrome after twelve-year zolpidem misuse. The underlying mechanisms of involuntary movements occurring after long-term zolpidem intake are unknown; yet, we suggest that zolpidem might induce an increase in dopamine release through inhibition of gamma-aminobutyric acid neurons tonically suppressing dopamine cells. Future studies on the occurrence of persistent disorders after long-term benzodiazepine or Z-drug abuse are needed and clinicians should pay attention to the risk of tardive syndromes related to zolpidem misuse, especially in the case of long-term intake of over-therapeutic dosages.
Collapse
Affiliation(s)
- Sara Ricciardulli
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa
| | - Lorenzo Lattanzi
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa
| | - Margherita Barbuti
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa
| | - Roberto Ceravolo
- Neurology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Giulio Perugi
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa
| |
Collapse
|
4
|
Validation of the Arabic and French Versions of a Knowledge, Attitudes and Practices (KAP) Questionnaire on Tranquilizer Misuse. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111144. [PMID: 34769663 PMCID: PMC8582760 DOI: 10.3390/ijerph182111144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022]
Abstract
Tranquilizer misuse is an emerging international public health concern. The psychosocial determinants of this misuse remain understudied. Instruments to measure the Knowledge, Attitudes and Practices (KAP) of tranquilizer misuse are unavailable, except for a recently published questionnaire validated in the Spanish language. We translated the KAP questionnaire into Arabic and French, adapted it and undertook a complete validation procedure in the general adult population in Lebanon. The content validity indicators were good: item content validity index ranged between 0.89 and 1.00, the content validity index scale average was ≥0.95 and the modified Kappa statistic for each of the KAP items was equal to I-CVI. The intra-class correlation coefficient values (n = 100) were ≥0.62 for all Knowledge and Attitudes items, demonstrating the item reliability. Confirmatory factorial analysis (n = 1450) showed that the selected model of Knowledge and Attitude constructs has adequate fit indicators and encompassed three factors that showed acceptable internal reliability: Knowledge (Cronbach’s alpha = 0.72), personal Attitudes towards tranquilizers (Cronbach’s alpha = 0.79) and Attitudes towards healthcare providers (Cronbach’s alpha = 0.65). The Arabic/French questionnaire was highly accepted, with a response rate of 95.72% and item non-response rate ≤3.6%. The availability of a cross-cultural adapted and multilingual validated questionnaire would stimulate research on tranquilizer misuse.
Collapse
|
5
|
Comparison of Longitudinal and Cross-Sectional Approaches in Studies on Knowledge, Attitude and Practices Related to Non-Medical Tranquilizer Use. J Clin Med 2021; 10:jcm10214827. [PMID: 34768347 PMCID: PMC8584824 DOI: 10.3390/jcm10214827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
Research about the association of knowledge and attitudes with practices (KAP) of non-medical tranquilizer use is scarce. We compared findings from cross-sectional and longitudinal approaches in a KAP-based study on non-medical tranquilizer use in Spain using data collected from the same population. Eight-hundred forty-seven participants completed a validated KAP questionnaire at baseline and were then followed-up bimonthly for one year for episodes of non-medical tranquilizer use. Non-medical use was defined as unprescribed use, non-adherence to treatment, storage/sharing of tranquilizers, or a combination of those practices. Adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated using logistic regression from cross-sectional data and generalized linear mixed models for repeated measures in the longitudinal approach. Only the longitudinal approach showed that limited knowledge about the effect of tranquilizers on behaviour [OR: 3.24 (95% CI: 1.12–9.38)] and about the negative effect of their excessive consumption [OR: 4.12 (95% CI: 1.5–11.33)] is associated with storing/sharing tranquilizers. Both cross-sectional and longitudinal analyses indicated that personal attitudes towards tranquilizers and attitudes towards healthcare providers are associated with non-medical tranquilizer use, yet with different magnitude of associations. Differences between the two approaches were also observed for individual types of non-medical use. Certain discrepancies exist between findings from longitudinal and cross-sectional approaches on KAP of non-medical tranquilizer use. KAP studies are the backbone for designing and evaluating prevention programs on non-medical tranquilizer use, and hence choosing a proper study design, scrutinizing the associated biases, and carefully interpreting findings from those studies are required.
Collapse
|
6
|
Orsolini L, Chiappini S, Grandinetti P, Bruschi A, Testa R, Provenzano A, Berardis DD, Volpe U. 'Z-trip'? A Comprehensive Overview and a Case-series of Zolpidem Misuse. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:367-387. [PMID: 33888666 PMCID: PMC8077048 DOI: 10.9758/cpn.2021.19.2.367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 01/28/2023]
Abstract
Although believed safer compared to short-acting benzodiazepines (BZD), in the past few years a growing concern has developed relating to the abuse of Z-drugs, and specifically of zolpidem. Here we aim to review the evidence for the misuse of zolpidem and describe several related cases collected in Italy. A comprehensive overview is here carried by using several databases, and by combining the search strategy of free text terms and exploding a range of MESH headings relating to the topics of Zolpidem and Abuse and/or Misuse as follows: ((Zolpidem[Title/Abstract]) AND (Abuse[Title/Abstract]) OR (Misuse[Title/Abstract])), without time and/or language restrictions. Furthermore, a case series of 8 cases of zolpidem misuse and/or abuse, collected in different Italian psychiatric settings (psychiatric public hospital, psychiatric private rehabilitation clinic, and private practice), have been here described. According to our findings, zolpidem should be prescribed with the same caution as BZDs, especially in patients with a history of drug abuse or in the elderly. Behavioural modifications, including bizarre behaviours, psychomotor agitation, sleep-related complex behaviours have been reported. Monitoring of zolpidem use in selected populations is warranted. Psychiatrists and physicians should be aware of the misuse potential of zolpidem and adopt measures restricting its use.
Collapse
Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy.,Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Paolo Grandinetti
- NHS, Department of Territorial Assistance, Service for Addictions (SerD), Teramo, Rome
| | - Angelo Bruschi
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Belcolle Hospital, Viterbo, Rome.,Catholic University of the Sacred Heart, Rome.,Istituto di Psicopatologia, Rome
| | - Roberta Testa
- NHS, Department of Mental Health, AUSL Reggio Emilia, Reggio Emilia, Rome
| | | | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, G. Mazzini Hospital, Teramo, Rome.,Department of Neuroscience, Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy
| |
Collapse
|
7
|
McHugh RK, Peckham AD, Björgvinsson T, Korte FM, Beard C. Benzodiazepine misuse among adults receiving psychiatric treatment. J Psychiatr Res 2020; 128:33-37. [PMID: 32516628 PMCID: PMC7483788 DOI: 10.1016/j.jpsychires.2020.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/18/2020] [Accepted: 05/23/2020] [Indexed: 12/21/2022]
Abstract
Benzodiazepines are among the most commonly prescribed psychiatric medications and have the potential for misuse. People with psychiatric disorders may have a heightened liability to the reinforcing effects of benzodiazepines. Yet, the prevalence of benzodiazepine misuse in psychiatric care settings is not well characterized. The aim of the current study was to characterize the prevalence and correlates of benzodiazepine misuse in a sample of adults receiving psychiatric treatment (N = 589). The majority of participants reported a lifetime history of benzodiazepine prescription (68%) and 26% reported a lifetime history of misuse (defined as use without a prescription or at a dose or frequency higher than prescribed). Multivariable analyses indicated that history of a benzodiazepine prescription and drug use problems were significantly associated with lifetime benzodiazepine misuse. People with a history of benzodiazepine prescription had four times higher odds of misusing benzodiazepines and the primary source of misused benzodiazepines was from family or friends. Results suggest that benzodiazepine misuse is not exclusive to substance use disorder populations. The misuse of benzodiazepines should be assessed in psychiatric settings. Further research is needed to understand the impact of benzodiazepine misuse in this population and to develop tools to identify those at risk for misuse.
Collapse
Affiliation(s)
- R. Kathryn McHugh
- McLean Hospital, 115 Mill Street, Belmont, MA, USA 02478,Department of Psychiatry, Harvard Medical School, 25 Shattuck St., Boston MA, USA 02115
| | - Andrew D. Peckham
- McLean Hospital, 115 Mill Street, Belmont, MA, USA 02478,Department of Psychiatry, Harvard Medical School, 25 Shattuck St., Boston MA, USA 02115
| | - Thröstur Björgvinsson
- McLean Hospital, 115 Mill Street, Belmont, MA, USA 02478,Department of Psychiatry, Harvard Medical School, 25 Shattuck St., Boston MA, USA 02115
| | | | - Courtney Beard
- McLean Hospital, 115 Mill Street, Belmont, MA, USA 02478,Department of Psychiatry, Harvard Medical School, 25 Shattuck St., Boston MA, USA 02115
| |
Collapse
|
8
|
Machado FV, Louzada LL, Cross NE, Camargos EF, Dang-Vu TT, Nóbrega OT. More than a quarter century of the most prescribed sleeping pill: Systematic review of zolpidem use by older adults. Exp Gerontol 2020; 136:110962. [PMID: 32360985 DOI: 10.1016/j.exger.2020.110962] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/14/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022]
Abstract
Zolpidem is widely used to treat insomnia of older adults despite that few randomized controlled studies were conducted in this group. We systematically reviewed the relevant literature on efficacy/effectiveness and safety of zolpidem use by elderly individuals in relevant databases completed with a manual search of key journals. Studies were required to include individuals aged ≥60 years under intervention with zolpidem compared to placebo or other hypnosedatives. Outcomes were either objectively- or subjectively-assessed improvements in specific sleep parameters and safety for clinical use. The 31 reports selected for review were mostly of low-quality. The evidence suggests that zolpidem is useful typically by reducing sleep latency and episodes of wake after sleep onset, and increasing total sleep time and sleep efficiency. Regarding safety and tolerability, analyses suggest a low risk of daytime sleepiness and of deleterious effects on memory or psychomotor performance, provided that recommended dosage and precautions are followed. Few retrospective studies associate zolpidem use with risk of falls, fractures, dementia, cancer, and stroke. Zolpidem appears effective at lower doses and for short-term treatment among the elderly. Rigorous, new clinical trials are warranted to further document the specific effects of zolpidem in older individuals.
Collapse
Affiliation(s)
- Flávio V Machado
- Graduation Program in Medical Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil
| | - Luciana L Louzada
- Graduation Program in Medical Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil; Geriatric Medical Centre, Brasilia University Hospital, SGAN 605 Av. L2 Norte, Brasilia, DF 70840-901, Brazil
| | - Nathan E Cross
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 chemin Queen-Mary, Montreal, Qc H3W 1W5, Canada; Center for Studies in Behavioral Neurobiology and PERFORM Center, Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, Qc H4B 1R6, Canada
| | - Einstein F Camargos
- Graduation Program in Medical Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil; Geriatric Medical Centre, Brasilia University Hospital, SGAN 605 Av. L2 Norte, Brasilia, DF 70840-901, Brazil
| | - Thien Thanh Dang-Vu
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 chemin Queen-Mary, Montreal, Qc H3W 1W5, Canada; Center for Studies in Behavioral Neurobiology and PERFORM Center, Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, Qc H4B 1R6, Canada
| | - Otávio T Nóbrega
- Graduation Program in Medical Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 chemin Queen-Mary, Montreal, Qc H3W 1W5, Canada.
| |
Collapse
|
9
|
Liu L, Jia L, Jian P, Zhou Y, Zhou J, Wu F, Tang Y. The Effects of Benzodiazepine Use and Abuse on Cognition in the Elders: A Systematic Review and Meta-Analysis of Comparative Studies. Front Psychiatry 2020; 11:00755. [PMID: 33093832 PMCID: PMC7527532 DOI: 10.3389/fpsyt.2020.00755] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/16/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Benzodiazepines (BZD) are one of the most frequently prescribed drugs worldwide. However, the cognitive effects of benzodiazepines in the elderly are highly debated. This systematic review and meta-analysis aims to explore the following two questions in the elderly population: (i) Do BZD lead to any impairments in cognitive functions in elderly users? and (ii) Which specific cognitive domains are most affected by BZD use and abuse? METHODS First, we performed a literature search following the PRISMA guidelines. Electronic databases, including PubMed, PsycINFO, EMBASE, Cochrane Library, and Web of Science were searched until May 14th, 2020. After selecting the relevant articles, we integrated the results of the selected studies with a standardized cognitive classification method. Next, we performed meta-analyses with the random-effects model on the cognitive results. Finally, we specifically examined the cognitive impairments of BZD in the abuse subgroup. RESULTS Of the included studies, eight of the thirteen had meta-analyzable data. Compared to the controls, elderly BZD users had significantly lower digital symbol test scores (n=253; SMD: -0.61, 95% CI: -0.91 to 0.31, I² = 0%, p < 0.0001). There was no significant difference in Mini-Mental State Examination, Auditory Verbal Learning Test, and Stroop Color and Word Test scores between BZD users and controls. According to the subgroup analyses, BZD abusers performed significantly worse than controls in Mini-Mental State Examination (n=7726; SMD: -0.23, 95% CI: -0.44 to -0.03, I² = 86%, p = 0.02), while there was no significant difference between the regular BZD users and the controls (n=1536; SMD: -0.05, 95% CI: -0.59 to 0.48, I² = 92%, p =0.85). CONCLUSION In the elderly population, the processing speed (digital symbol test scores) was significantly impaired in BZD users; global cognition (Mini-Mental State Examination scores) was significantly impaired in BZD abusers but not in BZD regular users. This study provides insight into the factors that interact with BZD cognitive effects, such as aging, testing tools, and abuse. Clinicians should be cautious when prescribing BZD for the elderly. SYSTEMATIC REVIEW REGISTRATION PROSPERO, identifier CRD42019124711.
Collapse
Affiliation(s)
- Linzi Liu
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Linna Jia
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Peiying Jian
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Yifang Zhou
- Department of Geriatrics, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Jian Zhou
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Feng Wu
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang, China.,Department of Geriatrics, The First Affiliated Hospital, China Medical University, Shenyang, China
| |
Collapse
|
10
|
Bajaj V, Kalra I, Bajaj A, Sharma D, Kumar R. A case of zolpidem dependence with extremely high daily doses. Asia Pac Psychiatry 2019; 11:e12356. [PMID: 31044518 DOI: 10.1111/appy.12356] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/19/2019] [Accepted: 03/25/2019] [Indexed: 11/29/2022]
Abstract
The human population has been witnessing an increase in the number of diseases which are a consequence of progressively increasing physical and mental stress. Insomnia is one such condition whose prevalence is rising all over the world. Apart from the conventional behavioral interventions and use of benzodiazepines, the use of non-benzodiazepine drugs has seen a surge in recent times. The various adverse effects associated with benzodiazepines, dependence potential being one of them, led to an ever increasing use of non-benzodiazepine sedatives like zolpidem and zopiclone all over the world. But with their continuous and ever increasing use, it is seen that even these drugs carry dependence potential. Numerous cases of zolpidem abuse have been reported in literature until now. Here, we are presenting the case of a zolpidem-dependent patient who consumed it in quantities of 2400 mg/day, a quantity not reported anywhere in literature and around 240 times more than its usual prescribed daily dosage.
Collapse
Affiliation(s)
- Vikrant Bajaj
- Institute of Mental Health, Government Mental Hospital, Amritsar, India
| | - Ishat Kalra
- Institute of Mental Health, Government Mental Hospital, Amritsar, India
| | - Arushi Bajaj
- Institute of Mental Health, Government Mental Hospital, Amritsar, India
| | - Devasheesh Sharma
- Institute of Mental Health, Government Mental Hospital, Amritsar, India
| | - Rohit Kumar
- Institute of Mental Health, Government Mental Hospital, Amritsar, India
| |
Collapse
|
11
|
Votaw VR, Geyer R, Rieselbach MM, McHugh RK. The epidemiology of benzodiazepine misuse: A systematic review. Drug Alcohol Depend 2019; 200:95-114. [PMID: 31121495 PMCID: PMC6639084 DOI: 10.1016/j.drugalcdep.2019.02.033] [Citation(s) in RCA: 209] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 02/22/2019] [Accepted: 02/27/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Benzodiazepine misuse is a growing public health problem, with increases in benzodiazepine-related overdose deaths and emergency room visits in recent years. However, relatively little attention has been paid to this emergent problem. We systematically reviewed epidemiological studies on benzodiazepine misuse to identify key findings, limitations, and future directions for research. METHODS PubMed and PsychINFO databases were searched through February 2019 for peer-reviewed publications on benzodiazepine misuse (e.g., use without a prescription; at a higher frequency or dose than prescribed). Eligibility criteria included human studies that focused on the prevalence, trends, correlates, motives, patterns, sources, and consequences of benzodiazepine misuse. RESULTS The search identified 1970 publications, and 351 articles were eligible for data extraction and inclusion. In 2017, benzodiazepines and other tranquilizers were the third most commonly misused illicit or prescription drug in the U.S. (approximately 2.2% of the population). Worldwide rates of misuse appear to be similar to those reported in the U.S. Factors associated with misuse include other substance use, receipt of a benzodiazepine prescription, and psychiatric symptoms and disorders. Benzodiazepine misuse encompasses heterogeneous presentations of motives, patterns, and sources. Moreover, misuse is associated with myriad poor outcomes, including mortality, HIV/HCV risk behaviors, poor self-reported quality of life, criminality, and continued substance use during treatment. CONCLUSIONS Benzodiazepine misuse is a worldwide public health concern that is associated with a number of concerning consequences. Findings from the present review have implications for identifying subgroups who could benefit from prevention and treatment efforts, critical points for intervention, and treatment targets.
Collapse
Affiliation(s)
- Victoria R. Votaw
- Department of Psychology, University of New Mexico, MSC 03-2220, Albuquerque, NM, USA,Corresponding author: Victoria R. Votaw, Clinical Psychology Ph.D. Student Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, Albuquerque, NM 87131,
| | - Rachel Geyer
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA, USA
| | - Maya M. Rieselbach
- Department of Psychiatry, McLean Hospital, 115 Mill Street, Belmont, MA, USA
| | - R. Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, USA
| |
Collapse
|
12
|
Transnational trends in prescription drug misuse among women: A systematic review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 63:56-73. [DOI: 10.1016/j.drugpo.2018.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 09/14/2018] [Accepted: 10/09/2018] [Indexed: 12/21/2022]
|
13
|
Schonmann Y, Goren O, Bareket R, Comaneshter D, Cohen AD, Vinker S. Chronic hypnotic use at 10 years—does the brand matter? Eur J Clin Pharmacol 2018; 74:1623-1631. [PMID: 30090968 DOI: 10.1007/s00228-018-2531-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
|