Home > Sedative, tranquilliser and anti-depressant use in Ireland.

Long, Jean and Lyons, Suzi (2009) Sedative, tranquilliser and anti-depressant use in Ireland. Drugnet Ireland , Issue 30, Summer 2009 , pp. 7-10.

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The sixth bulletin of results from the 2006/7 all-Ireland general population drug prevalence survey focuses on sedative or tranquilliser and anti-depressant use in the adult population (15-64 years).1 The final achieved sample was 4,967 in Ireland. This represented a response rate of 65%.

 This article highlights some of the survey findings and presents unpublished data from the National Drug Treatment Reporting System (NDTRS) and the National Drug-Related Deaths Index (NDRDI).
Use by adult population in 2006/7
 
The proportion of adults who reported using a sedative or tranquilliser2 at some point in their lives was almost 11% (Table 1a). The proportion of young adults was 6%, while the proportion of older adults was higher at just under 15%. More women (13%) than men (8%) reported using a sedative or tranquilliser in their lifetime.
 The proportion of adults who reported using a sedative or tranquilliser in the last year was almost 5%, and of older adults almost 7% (Table 1a).
The proportion of adults who reported using a sedative or tranquilliser in the last month was 3%, and of older adults just over 4% (Table 1a).
 
[Please see PDF document for clear images of figures]
 
The proportion of adults who reported using an anti-depressant3at some point in their lives was just over 9% (Table 1b). The proportion of young adults was 7% while the proportion of older adults was higher at just under 11%. More women (13%) than men (6%) reported using an anti-depressantin their lifetime.
 The proportion of adults who reported using an anti-depressantin the last year was just over 4%, and of older adults just over 5% (Table 1b).
The proportion of adults who reported using an anti-depressantin the last month was just over 3%, and of older adults just under 4% (Table 1b).
 
 
Practices among users - 2006/7 survey
Those who had ever used: The average age at first use of sedatives or tranquillisers was 29 years for males and 31 for females. The average age at first use of anti-depressants was 34 years for males and 30 years for females.
 
 Current users: More than half (57%) of current users of sedatives or tranquillisers, and 91% of current users of anti-depressants, took them daily or almost daily.  Most current users got their sedatives or tranquillisers (89%) or anti-depressants (100%) on prescription. However, 11% of sedative or tranquilliser users reported that they had either got them from a friend or another source or bought them without a prescription in a pharmacy.
 
 Sedative or tranquilliser and anti-depressant use was more likely among those who were dependent on the state long-term, were not in paid employment, had lower levels of educational attainment and had left education before the age of 15 years.
 
 Respondents who were separated, divorced or widowed reported higher prevalence rates of sedative or tranquilliser and anti-depressant use compared to those who were single (never married), co-habiting or married.
 
 Use by 15-16-year-old school children - 2007 ESPAD survey
One in ten of the 2007 ESPAD survey participants reported that they had taken prescribed sedatives or tranquillisers at some point in their lives, and 3% had taken non-prescribed sedatives or tranquillisers.4
 
 NDTRS data - sedatives or tranquillisers
According to NDTRS data for the years 2001 to 2007, the annual number of treated cases reporting sedatives or tranquillisers as a main problem drug ranged between 78 and 171 (Table  2). The total for the period was 778 cases, of whom 87% reported a benzodiazepine as their main problem drug.  Of the 778 cases, 76% used one or more additional drugs.
 
Of the 171 cases treated in 2007 who reported sedatives or tranquillisers as their main problem drug, 98% ate them and 0.5% injected them. Use by these cases in the month prior to treatment was reported as follows: 66% used them daily, 12% used them between two and six days per week, 5% used them once per week or less and 11% had not used them. Half had commenced use before they were 19 years old; 66% were men; and 61% lived in Dublin.
 
  
 
The number of cases reporting sedatives or tranquillisers as an additional problem drug exceeded 1,000 per year between 2001 and 2007 (Table 3). The main drugs associated with sedative or tranquilliser use by new cases entering treatment were cannabis, alcohol, stimulants, cocaine and opiates (Table 4).

* By cases reporting use of one, two or three additional drugs
† Additional problem drug(s) used may be a form of drug in the same family as the main problem drug.
Source: Unpublished data from the NDTRS
 NDTRS data -anti-depressants
According to NDTRS data for the years 2001 to 2007, only 10 treated cases reported anti-depressants as a main problem drug, of whom half used one or more additional drugs. In the seven-year period, 56 cases reported anti-depressants as an additional problem drug. The drugs associated with anti-depressant use were opiates and sedatives. Of the 66 cases treated who reported anti-depressants as a problem drug, 53% were men, and 58% lived in Dublin.
NDRDI data
The NDRDI reported that there were 1,553 deaths as a result of poisoning between 1998 and 2005. The coroners reported that in 703 (45%) of these deaths sedatives, tranquillisers, and/or anti-depressants were implicated (either alone or in conjunction with other substances) (Table 5). Of those who died, 61% were male, 63% were aged between 20 and 44 years, and 44% were unemployed. Benzodiazepines were the most common form of sedative or tranquilliser implicated in these deaths. Only 113 (16.1%) of the 703 poisoning deaths were attributable to a sedative, tranquilliser or antidepressant alone.  Of the 590 polysubstance deaths, over half (57.6%) also involved an opiate (often heroin or methadone) and 206 (34.9%) also involved alcohol. The number of deaths in which anti-depressants played a part increased during the reporting period.
 
Conclusions
The use of sedatives or tranquillisers by teenagers and adults is common in Ireland, and such use leads to dependence and fatalities. Benzodiazepines are the main type of sedative or tranquilliser used. In order to reduce the negative consequences of benzodiazepine misuse, the Department of Health and Children recommendations need to be revisited.5 These included: improvement of the legislation, tighter monitoring and control of prescribing, improved clinical guidelines with an emphasis on short-term treatment and the use of alternatives. (Jean Long and Suzi Lyons)
 
1. National Advisory Committee on Drugs and Drug and Alcohol Information and Research Unit (2009) Drug use in Ireland and Northern Ireland. 2006/2007 drug prevalence survey: sedatives or tranquillisers, and anti-depressants use results. Bulletin 6. Dublin: National Advisory Committee on Drugs.
2. 'Sedatives' and 'tranquillisers' are commonly used terms for the same group of medicines which depress, slow down or calm the brain and central nervous system. They are mainly benzodiazepines, but other drugs with the same effects, such as Zolpidem and Zopiclone, are included in this group. Medically they are often referred to as hypnotics, which induce sleep, and anxiolytics, which reduce anxiety. The same drug can be used as a hypnotic or as an anti-anxiety agent depending on the dose used and on the time of day that they are taken.
3. Anti-depressants are medicines used to treat conditions such as the low or sad mood, loss of interest or pleasure in daily activities, fatigue and energy loss usually known as depression. Different drug classes are available on prescription to treat depression.
4. Hibell B et al. (2009) The 2007 ESPAD report: substance use among students in 35 European countries. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs (CAN) and the Pompidou Group of the Council of Europe.
5. The Benzodiazepine Committee (2002) Report of the Benzodiazepine Committee. Dublin: Department of Health and Children.
Item Type:Article
Issue Title:Issue 30, Summer 2009
Date:2009
Page Range:pp. 7-10
Publisher:Health Research Board
Volume:Issue 30, Summer 2009
EndNote:View
Accession Number:HRB (Available)
Subjects:J Health care, prevention and rehabilitation > Care by type of problem > Mental health care
VA Geographic area > Europe > Ireland
P Demography, epidemiology, and history > Population dynamics > Substance related mortality / death
B Substances > Sedatives or tranquillisers (CNS depressants)
J Health care, prevention and rehabilitation > Treatment and maintenance > Treatment factors
E Concepts in biomedical areas > Substance by legal status > Prescription drug (medicine / medication)

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