Frequent benzodiazepine intake not linked to long-term use, dose escalation

Among adults receiving benzodiazepine receptor agonist (BZRA), a limited number are considered continuous users and a small portion have moved to a higher-than-recommended dose, reports a study.

The authors assessed all adults (aged 20‒80 years) living in Denmark on 1 January 2000 who redeemed prescriptions of BZRAs in the Danish National Prescription Registry from 1 January 2000 to 31 December 2020. They calculated long-term use in each drug class as more than 1 or 7 years, and measured dose escalation as an increase in dose to a level above the recommendations set by guidelines. Finally, logistic regression was used to examine associations.

A total of 950,767 incident BZRA users were identified. Of these, 15 percent were classified as long-term users for >1 year and 3 percent for at least 7 years. Long-term use was highest among individuals using Z-drugs (17.8 percent and 4 percent).

No indication of dose escalation was observed among the 5 percent of BZRA users with 3 or more years of continuous use since the median dose remained relatively stable. On the other hand, 7 percent of BZRA users had dose escalations greater than the recommended level.

Notably, psychiatric comorbidity, specifically substance use disorder, appears to contribute to an increased risk of long-term use and dose escalation.

“Thus, this study does not, under the current regulations, support the belief that BZRA use frequently results in long-term use or dose escalation,” the authors said.