Background: Because of their potential for abuse and their high level of use in the general population, benzodiazepines and related substances (BZD) remain in the scope of the French Addictovigilance Network. This study aimed to evaluate the patterns of use and diversion of BZD, through the analysis of data collected in the OSIAP Survey from 2011 to 2015. Methods: The OSIAP (Ordonnances Suspectes Indicateur d'Abus Possible) Survey is conducted within a national network of community pharmacies collecting suspect prescription forms each year. The citations of BZD reported on these prescription forms are analyzed. The national sales data are computed to estimate the level of BZD consumption in France, using the number of defined daily doses per 1,000 inhabitants per day (DID). These data are used to estimate a diversion rate for each drug. Results: In 2015, BZD were reported in 84.9% of suspicious prescription forms, corresponding to a decrease (90.8% in 2014 and 93.3% in 2013), alongside with a decrease in the sales data. Flunitrazepam and tetrazepam remained reported despite their withdrawal from the French market in 2013. In 2015, clonazepam remained the substance with the highest diversion rate (64.3/DID), followed by zolpidem (28.2/DID), corresponding to a decrease compared with the previous year. Conclusions: These results suggest that regulatory measures have a significant impact on the consumption of BZD. For example, the high diversion rate of clonazepam observed from 2011 and its significant reduction in 2015 can be explained by the national regulatory measures implemented to strengthen its dispensing conditions. Besides, when a BZD is restricted, it is substituted by another one after a while (e.g. in France with flunitrazepam and clonazepam). To finish, the persistence of drug requests after their market withdrawal may be due to a "hoarding behaviour" before it became impossible to obtain them.

The growing need of dietary supplements, self-medication and patients' non-disclosure of herbal supplements use to doctors, the possible occurrence of adverse effects and the interaction with prescribed and over the counter drugs are among the reasons that require more rigorous assessment of the usefulness and safety of herbal supplements in order to best integrate them into common regimens. Lax control of production and distribution, and the lack of uniform legislation determine the need for changes in the regulation and harmonization of legislation in this area. Developing an appropriate postmarketing quality, efficacy and safety surveillance program will be a useful step, allowing the generation of important and relevant information for optimizing the risk-benefit ratio.

The growing use of dietary supplements, often combined with conventional drugs, creates a possibility of adverse reactions and interactions and asks for their safe application. The majority of patients do not disclose the use of dietary supplements to doctors; physicians are not always informed about the adoption of supplements and are often reluctant to initiate discussion on this topic. This lack of physician-patient comunication leads to an increased risk of the dietary supplements use. PURPOSE: То еstablish some of physician-patient communication problems on the use of dietary supplements. METHODS: This is a pilot study on the use of dietary supplements among the population of the town Stara Zagora. The pilot study was conducted by self-administrated questionnaire on people aged 19 to 59 years (n = 24). RESULTS: The opinion of 45.8% of all respondents in this pilot study is that when visiting doctors they have never been asked about the use of dietary supplements.78.8% of users of dietary supplements in the study did not tend to spontaneously share with their physicians that they accept food supplements. CONCLUSION: The low level of communication on the use of dietary supplements highlights the need for a new type of physician-patient relationships in order to reduce the risks associated with the use of dietary supplements.