Long-Term Prescriptions of Benzodiazepines and Z-drugs - Descriptive Analyses over a 3-Year Period

Objective The majority of medication-dependent persons uses hypnotics or sedatives. The prevalence of long-term prescriptions of benzodiazepines (BZD) and Z-drugs, which play an important role in the development of a dependence, have hardly been studied. Methods Based on the data from the North German Pharmacy Computing Centre (NARZ) prescriptions of benzodiazepines and Z-drugs from 2006 to 2008 were prospectively analysed. Results In the period from 1.1.2006 to 31.12.2008 about 1.2 million patients received benzodiazepines and/or Z-drugs. This corresponds to 13.1% of all statutory health insured people in the four German Federal States that are examined in this study. 64% of the patients are women. According to a risk classification based on the prescription period and medication doses, three quarters of patients, who are in their first prescription year, are in the 'green' classification, meaning they received their prescription for less than 2 months in accordance with the guidelines. Patients with problematic or risky prescription patterns, which hint towards abuse or dependence (risk classifications 'red' or 'black' respectively), make up about 16.7% of all individuals with BZD/Z-drug prescriptions. Of the patients in the green' classification, 84.9% no longer receive BZD/Z-drug prescriptions in the second year. In the third year, this proportion increases slightly to 86.7%. By contrast, a large proportion of patients in the 'red' (36.2%) and 'black' (41.2%) classifications remain in their risky groups during the third prescription year, which indicates the development of a low or even high dose dependency. Conclusion For the majority of patients who use BZD or Z-drugs in accordance with the national guidelines these medications were not prescribed in the following 2 years. Patients with risky patterns of prescriptions are likely to use sedatives or hypnotics anomalously (not in accordance with the prescription guidelines) for longer periods in their life.