Association of New Perioperative Benzodiazepine Use With Persistent Benzodiazepine Use

Area of Science:

• Pharmacology
• Surgery
• Public Health

Background:

• Benzodiazepine misuse and adverse effects are increasing.
• Understanding initial exposure and sources of persistent benzodiazepine use is limited.

Purpose of the Study:

• To determine the frequency of perioperative and persistent benzodiazepine use in patients undergoing surgery.
• To identify factors associated with persistent benzodiazepine use post-surgery.

Main Methods:

• A large cohort study analyzed 2,509,599 adult patients undergoing common surgical procedures in the US (2009-2017).
• Examined perioperative benzodiazepine prescription and persistent use (90-180 days post-surgery) in benzodiazepine-naive patients.
• Utilized the MarketScan database for data extraction and analysis.

Main Results:

• Perioperative benzodiazepine use occurred in 2.6% of patients (63,931/2,509,599).
• Among naive patients, 19.5% exhibited persistent benzodiazepine use.
• Factors associated with persistent use included Medicaid insurance, age (≥70), female sex, comorbidities, and diagnoses of anxiety, depression, insomnia, or substance use disorder.

Conclusions:

• While perioperative benzodiazepine prescribing is relatively low, a substantial proportion of patients develop persistent use.
• This suggests a need for careful monitoring and alternative pain/anxiety management strategies in surgical patients.
• Identifying at-risk populations is crucial for mitigating long-term benzodiazepine dependence.