Epidemiology

Prevalence studies of BZD use vary according to the population sampled, but about 10% of the US older population use BZDs regularly, mostly for sedative and anxiolytic purposes.[3] This figure is as high as 36% for adults receiving treatment for depression in mental healthcare settings.[4] BZDs are prescribed for 30% to 74% of patients with post-traumatic stress disorder (PTSD), despite research showing that BZDs are ineffective for the prevention and management of PTSD.[5]

BZD use is higher in white people than in other ethnic groups. Twice as many females as males use BZDs. Sedatives, anxiolytics, and hypnotics are commonly prescribed for people in the sixth and seventh decades of life. Prevalence of BZD use has been reported as ranging from 3.9% in middle-aged and older adults in Brazil, to 35.9% in people ages 65 years and older in Canada.[6][7] There is evidence to suggest that among older people, with or without Alzheimer disease, BZD use may increase risk of stroke and hip fracture.[8][9][10]

Nonmedical use of BZDs is highest in people ages 18 to 25 years, with rates of 0.7% to 1.9%.[11] Use is especially common in those who abuse alcohol, with up to 40% reporting inter-current or concurrent self-medication with BZDs.

With regard to illicit drug use, BZDs have largely replaced barbiturates, methaqualone, and glutethimide for sedation, anxiolysis, and inducing sleep. BZDs are preferred over older agents both medically and as recreational drugs because of the much greater safety profile and decreased risk of serious toxicity with overdose.[11]

Despite their safety, BZD overdose is now common, particularly with suicidal behavior and in conjunction with opioid abuse.[12] BZDs account for approximately 31% of fatal overdoses involving prescription drugs in the US, while 75% of these fatal overdoses also involve opioids.[13] Drug-related overdose deaths are increasing, with more than 106,000 individuals in the US dying from drug-induced overdose in 2021, compared with 52,000 in 2016.[14] Of these 106,000, approximately 12,500 deaths were associated with BZD use.[14]​

Use of this content is subject to our disclaimer