Psychoactive drug consumption: performance-enhancing behaviour and pharmacodependence in workers

Purpose The aim of this study was to investigate factors associated to psychoactive medication use and dependence in working environment during a 1-year period. Methods We performed a 1-year-follow-up cohort study including workers from Toulouse metropolitan area. During their annual compulsory examination to assess their aptitude to work, subjects were asked to fill in an anonymous questionnaire at I year interval, in May 2000 and May-June 2001. Results Among a study sample of 1273 subjects (47.4% of men, mean age 39.2 +/- 9.2 years), the prevalence of psychoactive medication use at baseline was 9.1% (4.3% anxiolytic, 1.9% hypnotic, 1.7% antidepressant, 2.1% opiate analgesic and 0.5% antipsychotic drugs, according to ATC classification). Dependence on these drugs was found in 3.5% of workers. This consumption was associated with professional categories (higher in employees versus senior executive, Odds Ratio: 1.80; 95% Confidence Interval [1.04 - 3.11]), low job satisfaction and outside workplace (1.92; [1.30 - 2.84] and 3.40; [2.27 - 5.09] respectively), and patterns of medication use at workplace: for sleeping disorders related to job (18.27; [ 11.81 - 28.26]), for enhancing performance at work (28.13; [12.00 - 65.92]), for relieving unpleasant symptoms at work (22.98; [9.59 - 55.01]). The risk of psychoactive medication chronic use (psychoactive drug users in 2000 and 2001), and dependence at I year were both strongly associated with nicotine dependence (5.99 and 6.23, respectively) and performance-enhancing behaviour with drugs and/or alcohol (8.35 and 3.32 respectively), whereas current use (psychoactive drug users only in 2001) was strongly associated with performance-enhancing behaviour. Conclusions Among workers using psychoactive drugs, one out of three are dependent on psychoactive medications. Performance-enhancing behaviour and coping strategies might be a determinant of psychoactive drug use and could lead to dependence in the workplace. Copyright (C) 2004 John Wiley Sons, Ltd.