Current Situation and Clinical Characteristics of Sedative-Related Disorder Patients in Japan: Comparison with Methamphetamine-Related Disorder Patients

Abstract

The purpose of the present study is to examine the current situation of sedative-related disorders (mainly benzodiazepines) in Japan and the clinical characteristics of Japanese patients with this disorder. Subjects were 671 drug-related disorder patients diagnosed according to the ICD-10 classification as "F1: mental and behavioural disorders due to psychoactive substance use," who abused psychoactive substances other than alcohol. Of all the psychiatric hospitals in Japan between September and October 2010, these drug-related disorder patients had consecutively consulted or were admitted to 153 psychiatric hospitals. The present study was conducted by means of a mail survey. Subjects' clinical information, including history of psychoactive substance use, means of access to the primary drug of abuse, other ICD-10 diagnoses including F1 subcategory and comorbid psychiatric disorders, and recent history of self-destructive behavior, were collected from the attending psychiatrists of each subject. The data thus gathered concerning sedative-related disorder patients were compared with those patients with methamphetamine-related disorder, which has been the most serious drug-related problem in Japan since the 1950s. Out of the 671 subjects, 119 patients mainly abusing sedatives (the SRD group) were identified, while 361 patients were identified as mainly abusing methamphetamine (the MRD group). The MRD group was the largest population (53.8% of the total subjects), followed by the SRD group (17.7%), the inhalant-related disorder group with 56 patients (8.3%), and so on. Compared with the MRD group, the SRD group was younger, contained more female patients, and had a lower incidence of history of involvement with anti-social societies and anti-social behavior. Patients of the SRD group were more likely to have started abusing drugs with the intention of reducing the unpleasant symptoms of insomnia (42.9%), anxiety (26.1%), and depression (16.0%), and to acquire the drugs they abused from medical institutions such as psychiatric or primary care clinics (82.1%), while patients of the MRD group were more likely to have started out of curiosity (35.1%) or in response to peer pressure (47.1%), and to acquire their drugs from a "pusher" (32.8%). Additionally, in the SRD group, the ICD-10 Neurology and Psychiatry,4-1-1 OgawaHigashi, Kodaira, Tokyo 187-8553, Japan; Tel: +81-42-341-2711; Fax: +81-42-346-1944; email: tmatsu@ncnp.go.jp [Translated with permission from Seishinshinkeigaku-zasshi (Psychiatria et Neurologia Japonica), vol. 113, 1184-1198, 2011] Received May 16, 2013 accepted September 15, 2014; Act Nerv Super 57(1), 12-28; ISSN-1802-9698 F1 subcategory diagnoses that were clinically most important were "dependence syndrome" (64.0%), "harmful use" (16.2%) and "acute intoxication" (16.2%), while the most important subcategory diagnosis in the MRD group was "psychotic disorder" (34.3%) and "residual disorder and late-onset psychotic disorder" (32.9%). Further, comorbid psychiatric disorders were more fr...

Clinical features of patients with designer‐drug‐related disorder in Japan: A comparison with patients with methamphetamine‐ and hypnotic/anxiolytic‐related disorders

“…This study also confirmed that the educational background of DDRD patients was higher and the relationships with antisocial groups lower than MARD patients and, as such, this type of lifestyle background has more in common with HARD patients. These findings are consistent with our previous study . The above suggests the possibility that designer‐drug abuse has spread from the center of a class with a relatively general lifestyle background of young men who are also not antisocial.…”

“…At first, DDRD patients were younger than both MARD and HARD patients and the proportion of men was higher. This study has also confirmed our previous report 13 that the proportion of men was overwhelmingly higher among MARD than HARD patients. However, the proportion of men was even higher among the DDRD patients than the MARD patients.…”

“…We previously established that abusers of hypnotics/anxiolytics tend to include more women, fewer people with criminal records or relationships with antisocial groups, more among the dependence syndrome group and fewer among the psychotic disorders group compared with methamphetamine drug abuse patients. In addition, abusers of hypnotics/anxiolytics are more likely to use drugs with the intention of alleviating the unpleasant symptoms of insomnia and anxiety rather than because of a desire for stimulation or because of peer pressure, as is the case with stimulant abusers . However, it is unclear whether the same features as these are recognized in abusers of the similarly unregulated designer drugs.…”

“…In addition, abusers of hypnotics/anxiolytics are more likely to use drugs with the intention of alleviating the unpleasant symptoms of insomnia and anxiety rather than because of a desire for stimulation or because of peer pressure, as is the case with stimulant abusers. 13 However, it is unclear whether the same features as these are recognized in abusers of the similarly unregulated designer drugs.…”

Clinical behavior of Japanese community pharmacists for preventing prescription drug overdose

“…Furthermore, drug dependence caused by abuse of prescription drugs is increasing in Japan. According to a nationwide psychiatric hospital survey, the proportion of patients with sedative (mainly benzodiazepine)‐related disorders has more than doubled in the last decade …”