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Worrying trends continue in long-term sedative use

A new study renews concerns about long-term sedative use in Canada. Researchers found that despite efforts to lower the chronic use of benzodiazepines and benzodiazepine-like sedatives, long-term use remained stable in older adults, and increased in younger adults.

Benzodiazepines include the medications diazepam (known by the trade name Valium), lorazepam (known as Ativan) and clonazepam (known as Xanax). Benzodiazepine-like sedatives include zopiclone, zolpidem (Ambien) and zaleplon, and are often called “z-drugs.” All of these medications are used to treat conditions such as anxiety and insomnia, but they are not recommended for long-term use. Risks of long-term use include becoming dependent on the drug, misusing the drug, and declining cognitive and psychomotor function.  

Despite these risks, chronic use of these medications remains a concern in Canada, especially in older adults. To look at recent trends, researchers at the University of British Columbia looked at sedative use in adults in different age groups from 2004 to 2013 in British Columbia.

Even though chronic sedative use is often associated with older adults, the researchers found that more than half of long-term users (53.4 per cent) were under age 65. Over the study period, prevalence of sedative use grew from 11.6 per cent to 12.2 per cent in women under age 65, and from 6.6 per cent to 7.2 per cent in men in this age group.

For people 65 and over, the rate of chronic use did not appear to change between 2004 and 2013, until the researchers looked at drug class. Prevalence of sedative use remained at about 23 per cent for women and 15 per cent for men in this group. However, as benzodiazepine use decreased in older adults, use of z-drugs increased. This suggests that previous efforts to reduce use of benzodiazepines in older adults may have resulted in a trend towards prescribing z-drugs instead, which have similar risks.

The increasing use of sedatives in people under age 65 is also a concern. The study authors suggest that efforts to reduce long-term sedative use might be best targeted at all adults, rather than focusing on people over 65.

The retrospective study, which was led by Steven G. Morgan, PhD, used health data from Population Data BC representing about 3 million adults, or about three-quarters of the province’s population. It was published in CMAJ Open on Jan. 24, 2017. 

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  • A publication of:
  • Women's College Hospital