Division of Respirology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.
Keenan Research Centre in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
Sleep. 2019 Apr 1;42(4). doi: 10.1093/sleep/zsy264.
The study objectives were to explore trends in prevalence of couse of benzodiazepine receptor modulators and opioids, and nonselective and selective (i.e. Z-drugs) benzodiazepine receptor modulators, in the United States, as well as risk factors for these drug utilization patterns.
This was a multiyear, cross-sectional, population-level study, using US health survey data. Data from eight National Health and Nutrition Examination Survey (NHANES) cycles were analyzed, from 1999-2000 until 2013-2014, with each survey cycle containing information on ~10 000 individuals. The main measure was prevalent prescription drug use within 30 days preceding survey administration. Drug usage was objectively confirmed for a large majority of participants though direct inspection of prescription bottles.
The estimated prevalence of concurrent benzodiazepine receptor modulator and opioid use in the United States was 0.39% in 1999-2000 and 1.36% in 2013-2014, reflecting absolute and relative changes of +0.97% and +249%. The estimated prevalence of nonselective and selective benzodiazepine receptor modulator couse steadily rose in the United States from 0.05% in 1999-2000 to 0.47% in 2013-2014, reflecting absolute and relative increases of +0.42% and +840%. Independent risk factors for these two forms of psychoactive medication polypharmacy were identified.
In this exploratory analysis, concurrent use of benzodiazepine receptor modulators and opioids, and nonselective and selective benzodiazepine receptor modulators, was found to have progressively risen in the United States. The progressive increases in these two forms of psychoactive medication polypharmacy are concerning, given that these drug use patterns are associated with increased risk for serious adverse outcomes.
本研究旨在探讨美国苯二氮䓬受体调节剂和阿片类药物、非选择性和选择性（即 Z 类药物）苯二氮䓬受体调节剂的使用趋势，以及这些药物使用模式的风险因素。
这是一项多年的、横断面的、基于人群的研究，使用了美国健康调查数据。对 1999-2000 年至 2013-2014 年的 8 个国家健康和营养检查调查（NHANES）周期的数据进行了分析，每个调查周期包含约 10000 个人的信息。主要衡量标准是在调查前 30 天内普遍使用处方药物。通过直接检查处方瓶，对绝大多数参与者的药物使用情况进行了客观确认。
1999-2000 年，美国同时使用苯二氮䓬受体调节剂和阿片类药物的估计患病率为 0.39%，2013-2014 年为 1.36%，反映出绝对和相对变化分别为+0.97%和+249%。1999-2000 年，美国非选择性和选择性苯二氮䓬受体调节剂的使用估计患病率稳定上升，从 0.05%上升至 0.47%，反映出绝对和相对增幅分别为+0.42%和+840%。确定了这两种形式的精神药物联合使用的独立风险因素。
在这项探索性分析中，在美国发现同时使用苯二氮䓬受体调节剂和阿片类药物，以及非选择性和选择性苯二氮䓬受体调节剂的情况呈逐渐上升趋势。这两种形式的精神药物联合使用的逐渐增加令人担忧，因为这些药物使用模式与严重不良后果的风险增加有关。
