Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Despite alternatives, addictive drugs most often prescribed for sleep problems

01.06.2005


Nearly one out of two visits to a doctor’s office for help with a sleep disorder result in the prescription of potentially addictive medications, a new study reports.

Office visits by older patients and those with publicly funded health insurance plans were nearly twice as likely to result in the prescription of these kinds of medications.

The drugs, called benzodiazepines, are often a cheaper alternative to some newer types of medicines that don’t have the same potentially addictive side effects, said Rajesh Balkrishnan, the study’s lead author and the Merrell Dow professor of pharmacy at Ohio State University . “Some of the most vulnerable populations in the United States are at greater risk of receiving prescription sleep medication with a high abuse potential,” he said.



The study, which appears in the current issue of the journal Sleep, includes data from 94.6 million office visits in the United States over a six-year period. Patients included in the data set sought help for sleep-related difficulties in outpatient physician offices. Balkrishnan and his colleagues gathered six years of outpatient office visit data – from 1996 to 2001 – from the National Ambulatory Medical Care Survey (NAMCS). The NAMCS includes information on patient demographics, the reason for a visit, a patient’s diagnosis, the medication prescribed and the therapeutic and preventive services recommended during that visit. The majority of patients went to family practice physicians, internal medicine providers or psychiatrists. Using information from the NAMCS, the researchers analyzed the treatment patterns of patients 18 and older who reported sleep problems.

Nearly two-thirds of those visits resulted in medication prescriptions for a person’s sleep difficulties, and three-quarters of those prescriptions were for a benzodiazepine. (Five of the 13 kinds of benzodiazepines on the market in the United States are indicated for treating insomnia.) The other 25 percent of patient visits for sleep disorders ended with prescriptions for non-benzodiazepine medications.

Benzodiazepines were widely prescribed for anxiety and other stress-related problems in the 1960s and 1970s. These drugs, which have a calming effect on the nervous system, are still prescribed as muscle relaxants and tranquilizers. (Valium is one example of a benzodiazepine, although it is not recommended for treating insomnia in the United States.) “Benzodiazepines are usually effective for just a few weeks when used to treat insomnia. But addiction can develop relatively quickly”, Balkrishnan said. “A person can develop a strong psychological and physical dependence on these drugs in a short time, and experience severe withdrawal-like symptoms once he stops taking the medication,” he said.

Office visits by people 50 and older were about 5 times as likely to result in a drug treatment for sleep problems as were visits by 18- to 34-year-olds. And people 65 and older were twice as likely as the 18- to 34-year-olds to receive prescriptions for benzodiazepines. Visits by patients with Medicare or Medicaid – the federally subsidized health insurance plans – were also twice as likely to result in benzodiazepine prescriptions as visits by patients with private health insurance.

Psychiatrists were four times as likely to prescribe newer non-benzodiazepine drugs during patient visits compared to family practice and internal medicine physicians. “Psychiatrists may be more informed than other kinds of doctors about newer, non-benzodiazepine drugs,” Balkrishnan said. “Or psychiatrists may see patients with more complex problems in whom other therapies such as over-the-counter medications have failed. “Overall, the study suggests that some physicians do consider other options before jumping to prescribe a drug to treat sleep problems,” he said.

But many health care providers don’t take public health insurance, Balkrishnan said. This means that these patients, regardless of their age, are more likely to receive cheaper benzodiazepines as treatments for their sleep problems.

And elderly people, 65 and older, with private health insurance were more likely to receive benzodiazepines. “We need to understand the reasons for these disparities in order to stop this trend,” Balkrishnan said. “There needs to be a move toward a more uniform prescription system – at least for certain types of medications. “One possibility is to create guidelines that say let’s reserve the most addictive benzodiazepines for patients for whom every other kind of treatment has been unsuccessful.”

While the study did not look at the types of non-drug treatments prescribed to treat sleep disorders, such as behavioral therapy, the researchers found that nearly half (48 percent) of patient visits resulted in a drug prescription, while 14 percent of the office visits resulted in a combined prescription of medication and behavioral therapy. Just five percent of patient visits resulted in prescribed behavioral therapy only.

The study was funded by a grant from Takeda Pharmaceuticals of North America, Inc., Lincolnshire, Ill. The study does not discuss any specific products of the sponsor company.

Rajesh Balkrishnan | EurekAlert!
Further information:
http://www.osu.edu

More articles from Studies and Analyses:

nachricht Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University

nachricht New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Developing reliable quantum computers

International research team makes important step on the path to solving certification problems

Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

Im Focus: Hybrid optics bring color imaging using ultrathin metalenses into focus

For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.

But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...

Im Focus: Stem cell divisions in the adult brain seen for the first time

Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.

The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Stiffness matters

22.02.2018 | Life Sciences

Magnetic field traces gas and dust swirling around supermassive black hole

22.02.2018 | Physics and Astronomy

First evidence of surprising ocean warming around Galápagos corals

22.02.2018 | Earth Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>