Benzodiazepine self-administration in humans and laboratory animals – implications for problems of long-term use and abuse

  title={Benzodiazepine self-administration in humans and laboratory animals – implications for problems of long-term use and abuse},
  author={Roland R. Griffiths and Elise M. Weerts},
Abstract Drug reinforcement may represent the primary behavioral-pharmacological mechanism underlying two types of problematic use of benzodiazepines – recreational abuse by polydrug abusers and inappropriate chronic use by patients. High dose polydrug abuse for the purpose of getting high is readily recognized as a significant social problem. Inappropriate chronic benzodiazepine use is more subtle but relatively common: for anxiolytics, 36% of past-year users (3% of the adult population in the… 

The diagnosis and management of benzodiazepine dependence

  • H. Ashton
  • Medicine, Psychology
    Current opinion in psychiatry
  • 2005
Benzodiazepine dependence could be prevented by adherence to recommendations for short-term prescribing (2–4 weeks only when possible), and withdrawal from dependent patients is feasible and need not be traumatic if judiciously, and often individually, managed.

Relative abuse liability of hypnotic drugs: a conceptual framework and algorithm for differentiating among compounds.

Concern about recreational abuse, inappropriate long-term use, or adverse effects should not deter physicians from prescribing hypnotics when clinically indicated, according to the primary clinical implication.

Abuse and Dependence Liability of GABAA-Receptor Modulators

Perhaps the most firm conclusion that can be made is that stimulation of GABAA receptors containing α1 subunits (α1GAB AA receptors) is not necessary for self-administration of benzodiazepine-type compounds, and systematic studies with selective compounds having relatively high intrinsic efficacy at particular subtypes should shed light on theses important mechanistic issues.

A pilot study of benzodiazepine cue-induced craving.

Predictors of Benzodiazepine Discontinuation in Subjects Manifesting Complicated Dependence

Patients manifesting cluster B personality/borderline personality disorder and benzodiazepine dependence may need concomitant treatment for their personality disorders to benefit from benzodiazine discontinuation treatment.

Long-term benzodiazepine use in patients with major depressive disorder in China.

Univariate analyses revealed that long-term BZD users were older, poorer, and had more impaired occupational functioning than patients not taking BZDs, while multivariate analyses showed that long -term BzD users had fewer psychotic symptoms and took less antipsychotic drugs.

Use and misuse of sedative drugs and related substances - Findings in the general population and in individuals with opioid dependence

Investigation of prescription sedative use and misuse in the general population and in the subpopulation of individuals with opioid dependence found sedative misuse was found to be associated with poor self-assessed mental health and poor quality of life, and prescriptions of ‘z-drug’ hypnotics and pregabalin were associated with mortality.

Abuse and dependence liability of benzodiazepine-type drugs: GABAA receptor modulation and beyond

Defining Patterns of Benzodiazepine Use in Older Adults

A set of definitions for classification of use can be used to develop clinical guidelines based on empirically derived clinical research models and help improve identification of which patients will benefit from intermittent versus continuous treatment while minimizing risk for adverse side effects.



Rational Use of Benzodiazepines in the Elderly

It is essential that the practitioner develop a treatment plan when utilising these agents to treat older patients, as the acute administration of benzodiazepines is associated with impairments in cognition, memory, coordination and balance, and long term use has been associated with symptoms of withdrawal upon abrupt discontinuation.

Abuse of benzodiazepines: the problems and the solutions. A report of a Committee of the Institute for Behavior and Health, Inc.

  • R. Dupont
  • Medicine, Psychology
    The American journal of drug and alcohol abuse
  • 1988
This report focuses specifically on the nonmedical use, or abuse, of benzodiazepines for purposes, durations, or at dosage levels not intended by the prescribing physician or in ways outside medical guidelines.

Benzodiazepine use and anxiolytic abuse and dependence in treated alcoholics.

  • H. Ross
  • Psychology, Medicine
  • 1993
Patients with antisocial personality disorder (ASPD) were at higher risk for an anxiolytic disorder as were women and the unemployed as well as recent users of benzodiazepines, who were more likely to have a lifetime DSM-III anxiety disorder.

Benzodiazepine use in anxiety disordered patients with and without a history of alcoholism.

The presence or absence of a history of alcohol use disorders is not a strong predictor of the use of benzodiazepines in subjects with anxiety disorders over 12 months of prospective follow-up.

Abuse and Dependency:An International Perspective

Although benzodiazepine abuse by recreational drug abusers occurs, the problem is not of primary public health importance anywhere in the world.

Prevalence and correlates of the long‐term regular use of anxiolytics

The data suggest that long-term regular users tend to be older persons with high levels of emotional distress and chronic somatic health problems, and many are sufficiently distressed to seek out other sources of help (mental health professionals and other psychotherapeutic medications).

Benzodiazepines and other psychotropic drugs abused by patients in a methadone maintenance program: familiarity and preference.

Overall, the attractiveness of benzodiazepines as drugs of abuse for poly-drug abusers is lower than that of other sedative/hypnotics.

The use of benzodiazepines among regular amphetamine users.

Results are consistent with studies of other groups of illicit drug users, such as heroin users, in indicating that benzodiazepine use is associated with greater levels of risk and psycho-social dysfunction.

Relative Abuse Liability of Different Benzodiazepines in: Drug Abusers

There is a convergence of data from various sources suggesting that there are meaningful differences among the benzodiazepines with respect to their attractiveness as drugs of abuse for drug abusers, and diazepam, in particular, has a greater abuse liability than many of the other benzodiazines.