BENZODIAZEPINE USE AMONG RESIDENT DOCTORS IN TERTIARY CARE HOSPITAL

Authors

  • Aftab Alam Khan Department of Psychiatry, Ayub Medical College, Abbottabad
  • Imtiaz ud Din Department of Pharmacology, Bacha Khan Medical College, Mardan
  • Adil Naseer Khan Department of Gastroenterology, Ayub Teaching Hospital, Abbottabad
  • Humera Hanif Department of Psychiatry, Ayub Teaching Hospital, Abbottabad
  • Imran Ullah Department of Psychiatry, Ayub Teaching Hospital, Abbottabad
  • Haq Nawaz Department of Pharmacology, Ayub Medical College, Abbottabad

Abstract

Background: Benzodiazepines (BZD) are some of the most common medications in the world. Benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal. Benzodiazepines are generally considered safe and well tolerated but are commonly misused and taken in combination with other drugs of abuse. The usage and prescription of BDZ in most developed countries are tightly regulated. This is however, not true in developing countries where these medicines are available over-the-counter (OTC). This study was carried out to assess the benzodiazepine use in Ayub Teaching Hospital Trainee doctors. Methods: This was a cross sectional study carried out in Ayub Teaching Hospital between January and December 2018. Sample size was calculated to be 276 using WHO sample size calculator. These 276 residents and house officers were selected using stratified random sampling to ensure the representation from every year of residency. Results: Hundred and nine (48.7%) participants responded positively to the use of BZD. Male doctors were more likely 57 (52.3%) to use BZD as compared to their female colleges. Most of the doctors 71 (65.1%) purchased BZD over the counter without prescription. Alprazolam was the most preferred benzodiazepine by doctors regardless of their specialty and year of residency except in specialty of Anaesthesia in which prevalence of Midazolam was the highest. This preference of Alprazolam by doctors of all specialty was statistically significant (p=0.007). Conclusion: Because of the knowledge about medicines and tendency to self-treat, doctors are prone to BZD abuse. Doctors working in psychiatry are more likely to use BZD with Alprazolam the BZD of choice.

Keywords: Benzodiazepines; Alprazolam; Drug Abuse; Resident Doctors

Author Biographies

Aftab Alam Khan, Department of Psychiatry, Ayub Medical College, Abbottabad

Department of Psychiatry, Ayub Medical College, Abbottabad

Imtiaz ud Din, Department of Pharmacology, Bacha Khan Medical College, Mardan

Department of Pharmacology, Bacha Khan Medical College, Mardan

Adil Naseer Khan, Department of Gastroenterology, Ayub Teaching Hospital, Abbottabad

Department of Gastroenterology, Ayub Teaching Hospital, Abbottabad

Humera Hanif, Department of Psychiatry, Ayub Teaching Hospital, Abbottabad

Department of Psychiatry, Ayub Teaching Hospital, Abbottabad

Imran Ullah, Department of Psychiatry, Ayub Teaching Hospital, Abbottabad

Department of Psychiatry, Ayub Teaching Hospital, Abbottabad

Haq Nawaz, Department of Pharmacology, Ayub Medical College, Abbottabad

Department of Pharmacology, Ayub Medical College, Abbottabad

References

Baenninger A. Good chemistry: The life and legacy of valium inventor Leo Sternbach. New York: McGraw-Hill Professional; 2004.

Washton AM, Zweben JE. Treating Alcohol and Drug Problems in Psychotherapy Practice: Doing What Works. New York: Guilford Publications; 2011.

Olkkola KT, Ahonen J. Midazolam and other benzodiazepines. In: Schüttler J, Schwilden H. Modern Anesthetics. Handbook of Experimental Pharmacology. Springer, 2008; p.335-60.

Charlson F, Degenhardt L, McLaren J, Hall W, Lynskey M. A systematic review of research examining benzodiazepine-related mortality. Pharmacoepidemiol Drug Saf 2009;18(2):93-103.

White JM, Irvine RJ. Mechanisms of fatal opioid overdose. Addiction 1999;94(7):961-72.

Lader MH. Limitations on the use of benzodiazepines in anxiety and insomnia: are they justified? Eur Neuropsychopharmacol 1999;9(Suppl 6):S399-405.

Lader M. Short-term versus long-term benzodiazepine therapy. Curr Med Res Opin 1984;8(Suppl 4):120-6.

Lader M. Benzodiazepine dependence. Prog Neuropsychopharmacol Biol Psychiatry 1984;8(1):85-95.

Kapczinski F, Amaral OB, Madruga M, Quevedo J, Busnello JV, de Lima MS. Use and misuse of benzodiazepines in Brazil: a review. Subst Use Misuse 2001;36(8):1053-69.

Khawaja MR, Majeed A, Malik F, Merchant KA, Maqsood M, Malik R, et al. Prescription pattern of benzodiazepines for inpatients at a tertiary care university hospital in Pakistan. J Pak Med Assoc 2005;55(6):259-63.

National Institutes of Health. Despite risks, benzodiazepine use highest in older people [Internet]. 2014 [cited 2019 Jul 26]. Available from: https://www.nih.gov/news-events/news-releases/despite-risks-benzodiazepine-use-highest-older-people

Olfson M, King M, Schoenbaum M. Benzodiazepine use in the United States. JAMA Psychiatry 2015;72(2):136-42.

Osswald W, Guimarães S. Drug therapy and its pharmacological bases [Terapêutica medicamentosa e suas bases farmacológicas]. 4th Ed. Porto Editora, 2004; p. 90-107.

Ashton H. Benzodiazepines: How they work & how to withdraw [internet]. 2002 [cited 2015 Oct 8]. Available from: http://www.benzo.org.uk/manual/index.htm

Ford C, Law F. Guidance for the use and reduction of misuse of benzodiazepines and other hypnotics and anxiolytics in general practice [Internet]. Shropshire: SMMGP/FDAP; 2014.[cited 2015 Oct 8]. Available from: https://www.smmgp-fdap.org.uk/guidance-for-the-use-and-reduction-of-misuse-of-benzodiazepines

Kollen BJ, van der Veen WJ, Groenhof F, Donker GA, van der Meer K. Discontinuation of reimbursement of benzodiazepines in the Netherlands: does it make a difference? BMC Fam Pract 2012;13(1):111.

Maria VA, Pimpão MV, Carvalho ML. Characterization of Benzodiazepine Consumption in Primary Health Care [Caracterização do Consumo de Benzodiazepinas em Cuidados de Saúde Primários]. Rev Port Clínica Geral 1994;11:99-114.

Akvardar Y, Demiral Y, Ergor G, Ergor A. Substance use among medical students and physicians in a medical school in Turkey. Soc Psychiatry Psychiatric Epidemiol 2004;39(6):502-6.

Conrad S, Storr CL. Resident physician substance use, by specialty. Am J Psychiatry 1992;149:1348-54.

Raoof M, Nawaz H, Nusrat R, Pabaney AH, Randhawa AR, Rehman R, et al. Awareness and use of benzodiazepines in healthy volunteers and ambulatory patients visiting a tertiary care hospital: a cross sectional survey. PloS One 2008;3(3):e1804.

Kumar P, Basu D. Substance abuse by medical students and doctors. J Indian Med Assoc 2000;98(8):447-52.

Stein MD, Kanabar M, Anderson BJ, Lembke A, Bailey GL. Reasons for benzodiazepine use among persons seeking opioid detoxification. J Subst Abuse Treat 2016;68:57-61.

Lader M. Benzodiazepines revisited-will we ever learn? Addiction 2011;106(12):2086-109.

McAuliffe WE, Rohman M, Santangelo S, Feldman B, Magnuson E, Sobol A, et al. Psychoactive drug use among practicing physicians and medical students. N Eng J Med 1986;315(13):805-10.

Maddux JF, Timmerman IM, Costello RM. Use of psychoactive substances by residents. Acad Med 1987;62(10):852-4.

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Published

2019-11-01

How to Cite

Khan, A. A., Din, I. ud, Khan, A. N., Hanif, H., Ullah, I., & Nawaz, H. (2019). BENZODIAZEPINE USE AMONG RESIDENT DOCTORS IN TERTIARY CARE HOSPITAL. Journal of Ayub Medical College Abbottabad, 31(4), 553–557. Retrieved from https://demo.ayubmed.edu.pk/jamc/index.php/jamc/article/view/7006

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