Non‐medical use of benzodiazepines and GABA analogues in Europe

Abstract

We investigated the prevalence of non-medical use (NMU) of benzodiazepines and GABA analogues in Europe. Methods: Data were collected using the online Non-Medical Use of Prescription Drugs (NMURx) survey from France, Germany, Italy, Spain and the UK. Results: The study included 55 223 eligible surveys which, after post-stratification weights were applied, represented approximately 260 million European adults. Lifetime NMU of benzodiazepines was highest in Spain (6.5%, 95% CI: 6.07.0) and lowest in Germany (1.7%, 1.52.0). Lifetime NMU of GABA analogues was highest in Germany (5.4%, 5.05.7) and lowest in France (2.2%, 1.92.5) and the UK (2.2%, 1.92.6) While no notable difference was observed for France or the UK, there was a higher prevalence of last 12-month NMU of benzodiazepines compared to GABA analogues in Italy (2.4 times higher) and Spain (3.0 times higher) and a higher prevalence of NMU of GABA analogues compared to benzodiazepines in Germany (2.6 times higher). Conclusion: This study shows that there is variation in NMU of benzodiazepines and GABA analogues among countries. Of particular interest is the high incidence of GABA analogue NMU in Germany and benzodiazepine NMU in Spain. Further research to identify factors and motivations responsible for the higher prevalence observed are essential to inform public health policies in those countries. K E Y W O R D S addiction, drug abuse, public health 1 | INTRODUCTION Non-medical use (NMU) of prescription medicines is a global issue and, while much of the attention is focused on NMU of prescription opioids, there are other drug classes that warrant investigation. 1,2 A previous study by Novak et al. investigating NMU of prescription drugs in Denmark, Germany, Great Britain, Spain and Sweden found that, while opioids were the most commonly reported medication for lifetime NMU (13.5% of respondents after weighting, compared to 10.9% for sedative drugs [benzodiazepines and tranquilisers]), sedative drugs were most commonly reported for past-year NMU (5.8% compared to 5.0% for opioids). 3 Benzodiazepines have been widely used for their sedative and anxiolytic properties globally for decades, while more recently the

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“…In Italy, benzodiazepines are among the most prescribed drugs. An estimated 15-20% of the adult population reported being users of benzodiazepines in their lives [13]. In Italy, benzodiazepines are only available by prescription and are subject to strict regulations designed to ensure their safe and appropriate use.…”

GABAA receptor subtypes and benzodiazepine use, misuse, and abuse

“…In 2015, one in eight US adults reported BDZ use within the past year, further illuminating the widespread use of BDZs. Studies from other countries indicate comparable rates of prescribed or non-medical BDZ use despite some variation in rates and in the specific subpopulations (e.g., the elderly) where BDZ use is most common (2)(3)(4)(5)(6)(7)(8).…”

Nonmedical use of prescription drugs

“…The authors report interesting findings with respect to the misuse of these drugs, both alone and in combination with other drugs of abuse such as opioids and how the average user actually acquires these drugs. Finally, these authors also report data on the abuse of benzodiazepines and GABA analogues in various European countries using the NMURx survey from France, Germany, Italy, Spain, and the United Kingdom 11 . There are interesting differences between countries, with highest abuse of GABA‐analogues in Germany and highest abuse of benzodiazepines in Spain.…”

“…Finally, these authors also report data on the abuse of benzodiazepines and GABA analogues in various European countries using the NMURx survey from France, Germany, Italy, Spain, and the United Kingdom. 11 wileyonlinelibrary.com/journal/bcp © 2021 British Pharmacological Society resources and expertise currently stretched by a viral pandemic will need to be refocused on other global health challenges of which prescription medicine misuse should be a high priority. Hopefully data can then also be thoroughly analysed using various mathematical modelling techniques as previously reported for deaths from accidental drug overdoses, which may further aid in the development of effective prevention and control strategies.…”