ANALYSIS OF BENZODIAZEPINE DEPENDENCE AMONG PRIMARY HEALTH CARE USERS AND FACTORS ASSOCIATED WITH USE, PRESCRIPTION, AND WITHDRAWAL: A STUDY IN A FAMILY HEALTH UNIT IN GOIÂNIA-GOIÁS- BRAZIL 2021-2022

Abstract

Introduction: Benzodiazepines (BZDs) act on gamma-aminobutyric acid type A (GABA-A) receptors, and prolonged use can cause cognitive deficits, motor impairment, excessive sedation, and dependence. They are among the best-selling controlled medications in Brazil, and most prescriptions are issued in primary health care (PHC). Objective: To describe the epidemiological profile of BZD users at a Family Health Unit (FHU) and to analyze the association of sociodemographic characteristics and health conditions with the level of dependence. Methodology: This analytical, cross-sectional observational study included 25 BZD users and was conducted between April 2021 and November 2022, using a sociodemographic questionnaire and the Benzodiazepine Dependence Self-Report Questionnaire (BENDEP-SRQ). The variables studied were medication used, sex, marital status, education, age, income, self-perceived health, and degree of benzodiazepine dependence. Results: Participants were mostly women (76%), with a mean age of 59.72 years (SD 11.46) and a mean duration of BZD use of 16.75 years (SD 12.80); clonazepam was the most commonly used drug. Most participants (22; 88%) reported difficulty sleeping. In the multiple linear regression analysis, the models explained 79% of the variability in problematic use (adjusted r² = 0.79), 34% of concern about use (adjusted r² = 0.34), 41% of non-compliance with prescription rules (adjusted r² = 0.41), and 83% of abstinence (adjusted r² = 0.83). Among the associated factors, difficulty sleeping and clonazepam use stand out for problematic use, and the age range of 60 to 80 years, family income of one to three minimum wages, and lack of physical activity for abstinence. Given the convenience sample (n=25), these results are exploratory in nature. Conclusions: The sample was predominantly older and showed a low-dose dependence profile associated with many years of use. BZD dependence has significant implications for individuals' health and well-being. This study highlights the lack of public policies to ensure appropriate prescribing and rational use.