Benzodiazepine Misuse: An Epidemic Within a Pandemic

Abstract

Coronavirus disease 2019 (COVID-19) had deleterious effects on patients with mental health problems and several studies have shown a spike in the rates of depression, insomnia, and post-traumatic stress disorder. Anxiety and insomnia rates have also increased among both the general public and health care professionals. Benzodiazepines are some of the most commonly used drugs in the treatment of anxiety and insomnia. However, benzodiazepines are also misused, abused alone, or abused in combination with other drugs. Lockdowns and social distancing have also had negative consequences on patients with mental health problems. We assessed the extent of benzodiazepine use during the pandemic and interpreted its effects in the future. We conducted a literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol and eight articles reviewed specifically reported worrying fluctuations in benzodiazepine use during the pandemic. We observed varied trends in the usage of benzodiazepines in various parts of the world. Some studies showed an increase in the consumption of benzodiazepine while others demonstrated a decrease in the prescription refills of benzodiazepine, which may be a result of gaps in mental health care. At this time, we can conclude that the current trend with benzodiazepine use is fluctuating and mental health professionals must continue to exercise caution before prescribing benzodiazepines. Future research is also warranted to be aware of the changing patterns and to avoid misuse and/or abuse at an epidemic level.

Chronic Pain-Induced Depression: A Review of Prevalence and Management

“…They are involved in the antihyperalgesic effect of the GABAA receptor that is a target for benzodiazepines in the spinal cord, along with which the GABAA receptors have been seen to play a role in the regulation of mood and antidepressant therapy [ 11 ]. Along with treating chronic pain-induced depression, benzodiazepines are also used for treating anxiety and insomnia, both of which can be seen in chronic pain patients [ 30 ].…”

“…Due to increased prescription of the drugs, misuse has become more prevalent, especially in the recent coronavirus disease 2019 (COVID-19) pandemic, which led to increased social distancing, isolation, and loneliness, all of which contribute to depression, anxiety, or insomnia [ 30 ]. The motivations for misusers have been to help with sleep, experimentation, and to get "high" [ 30 ]. The methods for obtaining benzodiazepines have been primarily from family or friends compared to doctors [ 30 ].…”

“…The motivations for misusers have been to help with sleep, experimentation, and to get "high" [ 30 ]. The methods for obtaining benzodiazepines have been primarily from family or friends compared to doctors [ 30 ]. Long-term cognitive disorders and addiction have been seen as the consequences of misuse [ 30 ].…”

Psychoactive Drugs in the Management of Post Traumatic Stress Disorder: A Promising New Horizon

“…In a study of extended-release venlafaxine, the response rate was 78% and the remission rate was 40% in patients with PTSD [ 31 ]. In addition to SSRIs and SNRIs, benzodiazepines (BZDs) have been utilized for patients with PTSD [ 32 ]. However, due to their anxiolytic, sedative, hypnotic, and skeletal muscle-relaxing effects, BZDs have become widely abused amongst this population [ 32 ].…”

“…In addition to SSRIs and SNRIs, benzodiazepines (BZDs) have been utilized for patients with PTSD [ 32 ]. However, due to their anxiolytic, sedative, hypnotic, and skeletal muscle-relaxing effects, BZDs have become widely abused amongst this population [ 32 ]. Studies have found that this trend of misuse has only increased with the recent COVID-19 global pandemic [ 32 ].…”