Comparison of patients with benzodiazepine receptor agonist‐related psychiatric disorders and over‐the‐counter drug‐related psychiatric disorders before and after the COVID‐19 pandemic: Changes in psychosocial characteristics and types of abused drugs

• Published in: Neuropsychopharmacology reports 2024-06, Vol.44 (2), p.437-446
• Main Authors: Usami, Takashi, Okita, Kyoji, Shimane, Takuya, Matsumoto, Toshihiko
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Alcohol; Analgesics; benzodiazepine receptor agonist; Benzodiazepines; Cocaine; codeine; Comorbidity; COVID-19; COVID-19 - epidemiology; COVID-19 - psychology; dextromethorphan; Drug abuse; Drug addiction; drug dependence; Drug use; Female; GABA-A Receptor Agonists - adverse effects; Heroin; Humans; Male; Mental disorders; Mental Disorders - epidemiology; Mental institutions; Middle Aged; Narcotics; Nonprescription drugs; Nonprescription Drugs - adverse effects; Original; over‐the‐counter drug; Pandemics; Patients; Pharmaceutical industry; Prescription drugs; Psychotropic drugs; Statistical analysis; Substance-Related Disorders - epidemiology; Young Adult
• ISSN: 2574-173X; 2574-173X
• DOI: 10.1002/npr2.12440

Aim To investigate changes in the clinical characteristics of patients who abused benzodiazepine receptor agonists (BZRA) or over‐the‐counter (OTC) drugs before and after COVID‐19 based on the 2018 and 2022 data of the “Nationwide Psychiatric Hospital (NPH) Survey on Drug‐related Psychiatric Disorders.” Method A total of 446 and 155 cases, and 435 and 273 cases, who mainly abused BZRAs or OTC drugs, respectively, were extracted from the database of the two NPH Surveys. Demographic variables, education, employment, criminal record, drug use during the previous year, psychiatric diagnosis, and types of abused drugs were compared between 2018 and 2022. Result A comparison of BZRA abusers revealed a decreased number of users during the previous year and an increase in the comorbidity rate of other disorders (F3 and F4 in ICD‐10) in 2022. Etizolam, flunitrazepam, triazolam, and zolpidem were used most in both years, with an increase in zolpidem and a decrease in triazolam in 2022. A comparison of OTC drug abusers revealed a higher proportion of women and young patients in 2022. An increase in the comorbidity rate of F3 and F9 and a significant increase in the use of dextromethorphan products were observed in 2022, although codeine products were in the majority in both years. Conclusion By comparing NPH Surveys before and after the COVID‐19 pandemic, both BZRA abusers and OTC drug abusers present complex pathologies, requiring tailor‐made treatment. The younger OTC drug abusers were particularly evident among women, and the abuse of dextromethorphan‐containing OTC drugs has increased alarmingly. This study examined changes in clinical characteristics of patients who abused benzodiazepine receptor agonists (BZRA) or over‐the‐counter (OTC) drugs before and after COVID‐19, using data from the 2018 and 2022 Nationwide Psychiatric Hospital Surveys in Japan. Both BZRA abusers and OTC drug abusers present complex pathologies and experienced an increase in comorbidity rates in 2022. Zolpidem use increased while triazolam decreased. OTC drug abusers in 2022 were more often women and younger, with increased dextromethorphan product abuse. Tailored treatments are needed for both groups.