Use of benzodiazepines in the community

Background: Although benzodiazepines are the most commonly prescribed psychotropic medications in the United States, considerable controversy surrounds their proper role in medical practice. Methods: Data from the household section of the 1987 National Medical Expenditure Survey were analyzed to estimate the prevalence and general characteristics of adults who purchased benzodiazepines in 1987. Results: An estimated 6.2% (10.9 million) of the adult population purchased benzodiazepines in 1987. In nearly half (47.0%) of the purchases, the use of benzodiazepines perceived by the patient did not correspond to a labeled or literature-supported unlabeled use. Multivariate analysis disclosed that benzodiazepine use was predicted by sociodemographic factors (white race, female gender, age older than 64 years, and unemployed work status), pharmacologic factors (use of an antidepressant), mental health factors (high levels of anxiety), and general health factors (poor general health, cardiac disease, arteriosclerosis, health-related work impairment, and trouble walking one block). Conclusions: These data indicate that benzodiazepine use is less prevalent than previously reported and suggest that there has been a recent decline in use. A marked discrepancy exists between why people perceive they purchase benzodiazepines and the recognized uses of these medications. (Arch Intern Med. 1994-154;1235-1240)