Population trends in the prevalence of benzodiazepine use in the older population of Nova Scotia: A cause for concern?

Because benzodiazepines can cause significant morbidity and data of their use in elderly people in Canada are scarce, the patterns of benzodiazepine use by Nova Scotia's seniors were studied with the use of administrative, population-based data. The prevalence of benzodiazepine use in the fiscal years 1993/94 to 1995/96 was explored, the types of benzodiazepines used and the extent of use for periods exceeding 30 days were examined, and an attempt was made to examine the average daily doses used. Benzodiazepine use decreased from 28.74% in 1993/94 to 24.69% in 1995/96 (P<0.001). Long elimination half-life benzodiazepines accounted for 23% of benzodiazepines in 1995/96. The proportion of benzodiazepines filled for periods exceeding 30 days increased from 65% in 1993/94 to 68% in 1995/96 (P<0.001). Variability in the estimated daily doses of the benzodiazepines was such that comparison with recommended dose maxima could not be made with confidence, even though the averages of these estimated daily doses appeared to exceed recommended maxima, except for users of alprazolam, lorazepam, oxazepam or bromazepam. Although benzodiazepine use decreased, the observed patterns of use may place seniors at unnecessary risk for adverse health outcomes and increased health resource utilization.