Global trends in the consumption of benzodiazepines and Z-drugs in 67 countries and regions from 2008 to 2018: a sales data analysis

Abstract

Study objectives To investigate the trends in the consumption of benzodiazepines (BZDs) and Z-drugs at global, regional, and national levels from 2008 to 2018, across 67 countries and regions. Methods This cross-sectional descriptive study investigated the consumption of BZDs and Z-drugs analysed by global pharmaceutical sales data from the IQVIA-Multinational Integrated Data Analysis System database between 2008 and 2018. Consumption was measured in defined daily dose per 1,000 inhabitants per day (DDD/TID). The global, regional, and national trends were estimated using linear mixed models. Additional analyses were conducted by grouping countries by income levels. The association between consumption and Gross Domestic Product (GDP) and the prevalence of different medical conditions was explored in univariable linear models. Results BZD consumption decreased annually by -1.88% (95% CI: -2.27%, -1.48%), and Z-drugs increased by +3.28% (+2.55%, +4.01%). In 2008, the top ten countries for BZD and Z-drug consumption were all European, ranging from 63.69 to 128.24 DDD/TID. Very low levels were found in Russia, Kuwait, United Arab Emirates, Saudi Arabia, French West Africa, and the Philippines, with DDD/TID <1. The consumption in high-income countries was much higher than in middle-income countries. The results showed that increased consumption of BZDs and Z-drugs was statistically associated (P<0.05) with higher GDP and increased prevalence of anxiety, self-harm, neurological disorders, chronic respiratory diseases, cardiovascular diseases and cancers. Conclusions Distinct differences in consumption and trends of BZDs and Z-drugs were found across different countries and regions. Further exploration is needed to understand the association and safety of the use of BZDs and Z-drugs in patients with comorbidities.

Long-term use of benzodiazepines in chronic insomnia: a European perspective

“…Our pilot study methodology was not structured to determine factors which might explain differences in the pattern of BZD use between the countries surveyed. However, a recent global analysis of BZD and ZD sales data found that increased consumption of these drugs in countries was statistically associated ( p < 0.05) with several factors including increased prevalence of anxiety, self-harm and neurological disorders ( 44 ). Other factors, such as differences in prescribers’ attitudes to the risks and benefits of long-term use of BZDs between countries may also be involved.…”

Association Between Hypnotics and Dementia: A Mini Narrative Review

“…For this reason, difficulty in sleep can significantly comprises public health including psychiatric diseases, posing challenges for a substantial portion of the population [ 2 ]. In response to these sleep-related issues, the widespread use of hypnotics, especially benzodiazepines (BZDs), and Z-drug (ZD), has emerged as a common treatment [ 3 ]. Nevertheless, ongoing debates persist regarding the potential long-term consequences of prolonged hypnotics use on health [ 4 - 6 ].…”