Benzodiazepines are commonly used in France. A recent study performed by the health authorities has reported that 17% of the French population had a benzodiazepine dispensation at least once in 2012. Numerous studies have shown that benzodiazepine use and especially their misuse is associated with risks such as falls, bone fractures, dementia, road traffic accidents and work injuries. In the context of the DRUGS-2M program, the study objective was to estimate the frequency of benzodiazepine misuse in France between 2007 and 2012 using a French insurance claims database (Échantillon Généraliste de Bénéficiaires [EGB]).

Between 2007 and 2012, every subject contributing to the EGB with a first benzodiazepine dispensation (hypnotics including derivatives, i.e. zopiclone, zolpidem, and anxiolytics), and with at least one-year history and follow-up in the database was included in the study. The date of first dispensation was the index date. Three misuse criteria were defined:

– frequency of concomitant dispensations of two benzodiazepines of the same type within 30 days following the index dispensation;

– frequency of index dispensations covering more than 4 weeks of treatment for hypnotics and more than 12 weeks for anxiolytics;

– frequency of at least one new dispensation of a hypnotic or anxiolytic over the 2 months following the end of the treatment coverage period.

About 28,000 subjects were identified each year between 2007 and 2012 as new users of benzodiazepines (about 10,000 hypnotics and 18,000 anxiolytics each year). According to the year of benzodiazepine initiation, 27% to 30% of hypnotic users and 17% to 20% of anxiolytic users had at least one misuse criterion. The most frequent misuse criterion was renewal of the first dispensation over the 2 months following the end of the treatment coverage period, which varied between 2007 and 2012 from 19 to 22% for hypnotics and from 10 to 12% for anxiolytics. Misuse by a treatment covering more than 4 weeks for hypnotics varied from 14 to 16%, and covering more than 12 weeks for anxiolytics varied from 11 and 19%. Misuse by concomitance varied from 4 to 6% for both hypnotics and anxiolytics.

According to the considered criteria, one third of hypnotic users and one fifth of anxiolytic users in France presented with misuse of benzodiazepines. These results confirm that actions to improve good prescription and use of benzodiazepines are still needed in France.