Use and abuse of benzodiazepines in Norway and determinants of drug dependency

Benzodiazepiner (BZD) er en gruppe beroligende medisiner som virker på sentralnervesystemet. BZD brukes spesielt i forbindelse med angst og søvnløshet. I følge retningslinjene bør BZD kun brukes i korte perioder, og avhengighetsproblemer kan oppstå etter relativt kort tid. Vi har studert risikoen for at tidligere BZD-naive pasienter blir storbrukere av BZD ved å se på en Cox proporsjonal hasard regresjonsmodell. Vi har uthentet innløsningsdata over flere år fra Reseptregisteret koblet med data fra Statistisk Sentralbyrå. Risikofaktorer er, sammen med alder og kjønn, hvilket BZD man startet med, forskrivers spesialitet, tidligere medisinbruk av diverse relevante medikamenter, utdannelse, lønn, type arbeid og tidligere mottatte visse sosialstønader.

The time it takes to form a physical dependency on a given benzodiazepine (BDZ) varies widely; regularity with which one consumes a dose and the average dose consumed per day, are important. Some say that the consumer's "personal body chemistry"is most im portant, others that psychic premorbid instability is decisive. Dependencies can occur 14 days of regular use and the probability of dependency is 50 % after daily use for 6 months. It is unclear whether certain benzodiazepines are associated with a more rapid onset of dependency than others. Since the establishment of the Norwegian Prescription Database (NorPD) insight can be brought to this question. The consumption of BDZ in Norway is considerable. In 2007 altogether 56 individuals per 1000 inhabitants received at least one prescription for this drug group. Methods: Extraction of data from the NorPD, first finding prescriptions with ATC-numbers N05B Anxiolytics and N05C Hypnotics and sedative drugs dispensed through one year, and extract a cohort that will be followed for 3 years. This cohort will be supplied with data from the NorPD concerning consumption of other drugs (antabus, opioids) and with information from other database: Dødsårsaksregisteret, the Road Accident Registry (NRAR) and the Central Population Registry (NCPR). Collaborating centres: Department of Community Health, Department of Pharmacology, both University of Oslo, and Norsk Regnesentral, Oslo. Contact will be tried established with the Danish Drug prescription register trough Dani sh colleagues. Distribution of results: The findings will be published in peer reviewed international journals. The cooperation with the organization "Medisin mot piller" will secure that any important findings from a Norwegian study will be distributed in Norway and through special contacts also in Scandinavia. That the investigation includes as partner a general practitioner will secure that the results will be known among colleagues.