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January 20, 1984, Vol 251, No. 3 >
ARTICLE | January 20, 1984

Prevalence and Correlates of the Long-term Regular Use of Anxiolytics FREE

Glen D. Mellinger, PhD; Mitchell B. Balter, PhD; Eberhard H. Uhlenhuth, MD
[+] Author Affiliations

Presented at a conference entitled "The Benzodiazepines Today: Two Decades of Research and Clinical Experience," San Francisco, Oct 9, 1982.

Reprint requests to Institute for Research in Social Behavior, 456 22nd St, Oakland, CA 94612 (Dr Mellinger).


JAMA. 1984;251(3):375-379. doi:10.1001/jama.1984.03340270053027
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References

Long-term use of anxiolytics has been a cause for concern because of the possibility of dependency and other adverse consequences. In a nationally representative probability survey of adults conducted in 1979, we found that long-term use (defined as regular daily use for a year or longer) was relatively rare, occurring among 15% of all anxiolytic users—a rate of 1.6% of all adults between the ages of 18 and 79 years in the general population. The data indicate that long-term regular users tend to be older persons with high levels of emotional distress and chronic somatic health problems. They are preponderantly women, and many are sufficiently distressed to seek out other sources of help (mental health professionals and other psychotherapeutic medications) as well. The sizable majority of long-term users is being monitored by their physicians at reasonably frequent intervals. The data give little support to current stereotypes of long-term users and suggest, instead, that such use is associated with bona fide health problems that are being treated within the broader context of the health system.

(JAMA 1984;251:375-379)

REFERENCES

1 +
Lader M:  Epidemic in the making: Benzodiazepine dependence , in Tognoni G, Bellantuono C, Lader M (eds): Proceedings of the International Seminar on Epidemiological Impact of Psychotropic Drugs . New York, Elsevier North Holland Inc, 1981;, pp 313-324.
2 +
Hollister LE, Conley FK, Britt RH, et al:  Long-term use of diazepam . JAMA 1981;; 246:1568-1570.
3 +
Winokur A, Rickels K, Greenblatt DJ, et al:  Withdrawal reaction from long-term, low-dosage administration of diazepam . Arch Gen Psychiatry 1980;;37:101-105.
4 +
Rickels K, Case WG, Downing RW:  Issues in long-term treatment with diazepam . Psychopharmacol Bull 1982;;37:38-41.
5 +
Berg RH:  The over-medicated woman . McCall's 1971;;67:109-111.
6 +
Manheimer DI, Davidson ST, Balter MB, et al:  Popular attitudes and beliefs about tranquilizers . Am J Psychiatry 1973;;130:1246-1253.
7 +
Mellinger GD, Baiter MB, Parry HJ, et al:  An overview of psychotherapeutic drug use in the United States , in Josephson E, Carroll EE (eds): Drug Use: Epidemiological and Sociological Approaches . Washington, DC, Hemisphere Publishing Corp, 1974;.
8 +
Balter MB, Levine J:  Character and extent of psychotherapeutic drug usage in the United States , in Proceedings of the Fifth World Congress of Psychiatry . Amsterdam, Excerpta Medica, 1973;.
9 +
Mellinger GD, Baiter MB:  Prevalence and patterns of use of psychotherapeutic drugs: Results from a 1979 national survey of American adults , in Tognoni G, Bellantuono C, Lader M (eds): Proceedings of the International Seminar on Epidemiological Impact of Psychotropic Drugs . New York, Elsevier North Holland Inc, 1981,p119.
10 +
Parry HJ, Baiter MB, Cisin IH:  Primary levels of underreporting psychotropic drug use . Public Opin Q 1970-1971;;34:582-592.
11 +
Physicians' Desk Reference , ed 33. Oradell, NJ, Medical Economics Books, 1979;, p 1467.
12 +
Derogatis LR, Lipman RS, Rickels K, et al: The Hopkins Symptom Checklist (HSCL), in Pichot P (ed):  Modern Problems in Pharmacopsychiatry , vol 7, in Psychological Measurements in Psychopharmacology . Basel, Switzerland, S Karger AG, 1974;, pp 79-110.
13 +
Mellinger GD, Baiter MB, Manheimer DI, et al:  Psychic distress, life crisis, and use of psychotherapeutic medications: National drug survey data . Arch Gen Psychiatry 1978;;35:1045-1052.
14 +
Mellinger GD, Baiter MB, Uhlenhuth EH, et al:  Evaluating a household survey measure of psychic distress . Psychol Med 1983;;13:607-621.
15 +
Baiter MB, Manheimer DI, Mellinger GD, et al:  Cross-national comparisons of anti-anxiety/sedative drug use. Read before the international symposium entitled `Rational Prescribing of Benzodiazepines' at the Seventh World Congress of Psychiatry, Vienna, July 10, 1983 . Curr Med Res Opin 1983;;8( (suppl 4) ):5-20.
16 +
Cartwright A:  Prescribing and the relationship between patients and doctors , in Cooperstock R (ed): Social Aspects of the Medical Use of Psychotropic Drugs. Toronto, Alcoholism and Drug Addiction Research Foundation of Ontario , 1974;, pp 63-74.
17 +
Phillips DL, Segal BE:  Sexual status and psychiatric symptoms . Am Sociol Rev 1968;; 34:58-72.
18 +
Uhlenhuth EH, Balter MB, Lipman RS:  Minor tranquilizers: Clinical correlates of use in an urban population . Arch Gen Psychiatry 1978;; 35:650-655.
19 +
Petursson H, Lader MH:  Withdrawal from long-term benzodiazepine treatment . Br Med J 1981;;283:643-645.
20 +
Rickels K, Case WG, Downing RW, et al:  Long-term diazepam therapy and clinical outcome . JAMA 1983;;250:767-771.
21 +
Tyrer P, Owen R, Dawling S:  Gradual withdrawal of diazepam after long-term therapy . Lancet 1983;;1:1402-1406.

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1 +
Lader M:  Epidemic in the making: Benzodiazepine dependence , in Tognoni G, Bellantuono C, Lader M (eds): Proceedings of the International Seminar on Epidemiological Impact of Psychotropic Drugs . New York, Elsevier North Holland Inc, 1981;, pp 313-324.
2 +
Hollister LE, Conley FK, Britt RH, et al:  Long-term use of diazepam . JAMA 1981;; 246:1568-1570.
3 +
Winokur A, Rickels K, Greenblatt DJ, et al:  Withdrawal reaction from long-term, low-dosage administration of diazepam . Arch Gen Psychiatry 1980;;37:101-105.
4 +
Rickels K, Case WG, Downing RW:  Issues in long-term treatment with diazepam . Psychopharmacol Bull 1982;;37:38-41.
5 +
Berg RH:  The over-medicated woman . McCall's 1971;;67:109-111.
6 +
Manheimer DI, Davidson ST, Balter MB, et al:  Popular attitudes and beliefs about tranquilizers . Am J Psychiatry 1973;;130:1246-1253.
7 +
Mellinger GD, Baiter MB, Parry HJ, et al:  An overview of psychotherapeutic drug use in the United States , in Josephson E, Carroll EE (eds): Drug Use: Epidemiological and Sociological Approaches . Washington, DC, Hemisphere Publishing Corp, 1974;.
8 +
Balter MB, Levine J:  Character and extent of psychotherapeutic drug usage in the United States , in Proceedings of the Fifth World Congress of Psychiatry . Amsterdam, Excerpta Medica, 1973;.
9 +
Mellinger GD, Baiter MB:  Prevalence and patterns of use of psychotherapeutic drugs: Results from a 1979 national survey of American adults , in Tognoni G, Bellantuono C, Lader M (eds): Proceedings of the International Seminar on Epidemiological Impact of Psychotropic Drugs . New York, Elsevier North Holland Inc, 1981,p119.
10 +
Parry HJ, Baiter MB, Cisin IH:  Primary levels of underreporting psychotropic drug use . Public Opin Q 1970-1971;;34:582-592.
11 +
Physicians' Desk Reference , ed 33. Oradell, NJ, Medical Economics Books, 1979;, p 1467.
12 +
Derogatis LR, Lipman RS, Rickels K, et al: The Hopkins Symptom Checklist (HSCL), in Pichot P (ed):  Modern Problems in Pharmacopsychiatry , vol 7, in Psychological Measurements in Psychopharmacology . Basel, Switzerland, S Karger AG, 1974;, pp 79-110.
13 +
Mellinger GD, Baiter MB, Manheimer DI, et al:  Psychic distress, life crisis, and use of psychotherapeutic medications: National drug survey data . Arch Gen Psychiatry 1978;;35:1045-1052.
14 +
Mellinger GD, Baiter MB, Uhlenhuth EH, et al:  Evaluating a household survey measure of psychic distress . Psychol Med 1983;;13:607-621.
15 +
Baiter MB, Manheimer DI, Mellinger GD, et al:  Cross-national comparisons of anti-anxiety/sedative drug use. Read before the international symposium entitled `Rational Prescribing of Benzodiazepines' at the Seventh World Congress of Psychiatry, Vienna, July 10, 1983 . Curr Med Res Opin 1983;;8( (suppl 4) ):5-20.
16 +
Cartwright A:  Prescribing and the relationship between patients and doctors , in Cooperstock R (ed): Social Aspects of the Medical Use of Psychotropic Drugs. Toronto, Alcoholism and Drug Addiction Research Foundation of Ontario , 1974;, pp 63-74.
17 +
Phillips DL, Segal BE:  Sexual status and psychiatric symptoms . Am Sociol Rev 1968;; 34:58-72.
18 +
Uhlenhuth EH, Balter MB, Lipman RS:  Minor tranquilizers: Clinical correlates of use in an urban population . Arch Gen Psychiatry 1978;; 35:650-655.
19 +
Petursson H, Lader MH:  Withdrawal from long-term benzodiazepine treatment . Br Med J 1981;;283:643-645.
20 +
Rickels K, Case WG, Downing RW, et al:  Long-term diazepam therapy and clinical outcome . JAMA 1983;;250:767-771.
21 +
Tyrer P, Owen R, Dawling S:  Gradual withdrawal of diazepam after long-term therapy . Lancet 1983;;1:1402-1406.

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