Long-term, high-dose benzodiazepine prescriptions in veteran patients with PTSD: Influence of preexisting alcoholism and drug-abuse diagnoses

Authors

  • John A. Hermos,

    Corresponding author
    1. Pharmacoepidemiology Research Group, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System and Department of Social and Behavioral Sciences, Youth Alcohol Prevention Center, Boston University School of Public Health, Boston, MA
    • Massachusetts Veterans Epidemiology Research and Information Center (151MAV), VA Boston Healthcare System, 150 S. Huntington Ave., Boston, MA 02130
    Search for more papers by this author
  • Melissa M. Young,

    1. Pharmacoepidemiology Research Group, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA
    Search for more papers by this author
  • Elizabeth V. Lawler,

    1. Pharmacoepidemiology Research Group, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System and Department of Epidemiology, Youth Alcohol Prevention Center, Boston University School of Public Health, Boston, MA
    Search for more papers by this author
  • David Rosenbloom,

    1. Department of Social and Behavioral Sciences, Youth Alcohol Prevention Center, Boston University School of Public Health, Boston, MA
    Search for more papers by this author
  • Louis D. Fiore

    1. Pharmacoepidemiology Research Group, Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA and Department of Epidemiology, Youth Alcohol Prevention Center, Boston University School of Public Health, Boston, MA
    Search for more papers by this author

  • This paper was presented at the 29th annual meeting of the Research Society on Alcoholism, June 23–29, 2006, Baltimore, MD. Funding for the study was through the Massachusetts Veterans Epidemiology Research and Information Center from the Veterans Health Administration Cooperative Studies Program

Abstract

Databases from the New England Veterans Integrated Service Network were analyzed to determine factors associated with long-term, high-dose anxiolytic benzodiazepine prescriptions dispensed to patients with posttraumatic stress disorder (PTSD) and existing alcoholism and/or drug abuse diagnoses. Among 2,183 PTSD patients, 234 received the highest 10% average daily doses for alprazolam, clonazepam, diazepam, or lorazepam, doses above those typically recommended. Highest doses were more commonly prescribed to patients with existing drug abuse diagnoses. Among patients with PTSD and alcoholism, younger age, drug abuse, and concurrent prescriptions for another benzodiazepine and oxycodone/acetaminophen independently predicted high doses. Results indicate that for veteran patients with PTSD, alcoholism alone is not associated with high-dose benzodiazepines, but existing drug abuse diagnoses do increase that risk.

Ancillary