Abstract
BackgroundThere are hardly any studies carried out in Pakistan on the usage of benzodiazepines at the level of community. This research was aimed to determine the frequency of benzodiazepine use, along with its associations with socio-demographic and clinical characteristics among community dwelling adults, residing in two urban settlements of Karachi, Pakistan.MethodsWe performed a cross sectional study from August 2008 to December 2009, in 2 areas of Karachi, namely Garden and Sultanabad. We followed the systematic sampling strategy to randomly select the households, with an adult of either sex and of age 18 years or more. Data collection was carried out through interview, using a pre-tested questionnaire, with items on socio-demographic position, medical history and benzodiazepine use. Student's t-test and χ2 test was employed to determine the associations between socio-demographic and clinical characteristics, and their relationship with benzodiazepine use was determined using applied logistic regression.ResultsThe overall percentage of benzodiazepine consumption was estimated to be 14%. There were significantly more benzodiazepine users in the peri-urban Sultanabad community to the urban community of Garden (p-value = 0.001). The mean age (± SD) for users was 51.3 (± 15.6) years compared to 37.1 (± 14.4) years among non-users. Bromazepam was the most widely used benzodiazepine (29%); followed by diazepam, with a median duration on primary use being 144 weeks (IQR = 48-240). The adjusted logistic regression model revealed that increasing age, location, female sex, unemployment and psychiatric consultation were associated with increased likelihood of benzodiazepine use.ConclusionWe believe the unregulated over-the-counter sales of benzodiazepines and social conditions might be playing a role in this high consumption of benzodiazepines in the community.
Highlights
There are hardly any studies carried out in Pakistan on the usage of benzodiazepines at the level of community
The objective of the present study was to estimate the frequency of benzodiazepine use among 2 populations in Karachi, Pakistan, and to determine its associations with related socio-demographic and clinical characteristics which are unique to these populations
Two sites from the metropolitan city of Karachi, Pakistan were selected for this research, namely Sultanabad and Garden, as community health services were provided to these areas by the Aga Khan University
Summary
There are hardly any studies carried out in Pakistan on the usage of benzodiazepines at the level of community. After the discovery of chlordiazepoxide in 1957, benzodiazepines are among the most widely used drugs in the general population [1,2,3,4,5,6] These were generally prescribed to combat anxiety and insomnia but over time these are being used for a wide array of psychiatric and non-psychiatric illnesses, in view of their sedative, anti-convulsant and muscle relaxing properties [1,7,8,9]. Despite their therapeutic uses, tendency remains for benzodiazepine abuse among the general population. This is not commonly practiced in most developing countries, including Pakistan, where practically these can be purchased over-the-counter, with considerable ease [9,15,16]
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