{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:23:18Z","timestamp":1790392998781,"version":"4.1.0"},"reference-count":62,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,5,4]],"date-time":"2018-05-04T00:00:00Z","timestamp":1525392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Social Insurance Institution of Finland","award":["30\/522\/2013"],"award-info":[{"award-number":["30\/522\/2013"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Long\u2010term benzodiazepine (BZD) treatment continues to be a debated topic. Because individual BZDs have different clinical profiles, we assessed the nationwide trends of long\u2010term BZD use at active substance level during years 2006 to 2014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study covered all reimbursed BZD purchases (n\u00a0=\u00a0408\u00a0572\u2010521\u00a0823 annually) for adults recorded in the Finnish Prescription Register. We assessed long\u2010term use (annual cumulative purchase of \u2265180 defined daily doses) in general, and at active substance level with the most commonly used BZD anxiolytics (oxazepam, diazepam, alprazolam, and clonazepam for nonepilepsy indications) and hypnotics (zopiclone, zolpidem, and temazepam) included. The persistence rates for each substance were assessed separately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of long\u2010term BZD use among Finnish adults declined significantly from 5.3% to 3.6%, during years 2006 to 2014. Despite this decline, there was a significant increase in the long\u2010term use of clonazepam for nonepilepsy indications and zolpidem (28.0% and 17.5%, respectively). Long\u2010term use was common in the aged population, as well as among the users of hypnotics or clonazepam. Persistent use of 9 consecutive calendar years varied between 7.5% for incident alprazolam users and 21.0% for incident clonazepam users.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found a declining trend in long\u2010term BZD use, but the decline was not uniform between the substances\u2014the long\u2010term use of clonazepam and zolpidem even increased. Follow\u2010up research is needed to assess whether the decline in BZD use is accompanied by an increased use of other types of anxiolytic or hypnotic drugs or other forms of treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4551","type":"journal-article","created":{"date-parts":[[2018,5,4]],"date-time":"2018-05-04T09:28:29Z","timestamp":1525426109000},"page":"674-682","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Trends in the long\u2010term use of benzodiazepine anxiolytics and hypnotics: A national register study for 2006 to 2014"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9028-8727","authenticated-orcid":false,"given":"Terhi","family":"Kurko","sequence":"first","affiliation":[{"name":"Research Unit The Social Insurance Institution  Helsinki Finland"},{"name":"Department of Psychiatry Turku University Hospital  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena K.","family":"Saastamoinen","sequence":"additional","affiliation":[{"name":"Research Unit The Social Insurance Institution  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamari","family":"Tuulio\u2010Henriksson","sequence":"additional","affiliation":[{"name":"Research Unit The Social Insurance Institution  Helsinki Finland"},{"name":"Department of Psychology and Logopedics University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tero","family":"Taiminen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Turku University Hospital  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jari","family":"Tiihonen","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet Karolinska Universitetssjukhuset Solna  Stockholm Sweden"},{"name":"Department of Forensic Psychiatry, Niuvanniemi Hospital University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marja","family":"Airaksinen","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Group, Faculty of Pharmacy University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarmo","family":"Hietala","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Turku University Hospital  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2015.09.003"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2011.01.002"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2010.03.008"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.04.017"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.5414\/CP202008"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.1763"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/13651500903447810"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.5324\/nje.v21i1.1423"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-011-1124-2"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-017-2253-z"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0714980812000232"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.54.7.1006"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269881113503509"},{"key":"e_1_2_8_15_1","unstructured":"Working group set up by the Finnish Medical Society Duodecim and the Finnish Sleep Research Society.Insomnia (online). Current Care Guidelines. Helsinki: The Finnish Medical Society Duodecim 2012. Available online at:www.kaypahoito.fi[17thAugust2017]."},{"key":"e_1_2_8_16_1","unstructured":"National Supervisory Authority for Welfare and Health. Prescribing Benzodiazepines. Available at:http:\/\/www.valvira.fi\/terveydenhuolto\/hyva\u2010ammatinharjoittaminen\/laakehoito\/bentsodiatsepiinien_maaraaminen_2[17thAugust 2017]."},{"key":"e_1_2_8_17_1","unstructured":"National Institute for Health and Care Excellence (NICE).Guidance on the use of zaleplon zolpidem and zopiclone for the short\u2010term management of insomnia. Nice Tehcnology appraical Guid. 2004.http:\/\/www.nice.org.uk\/guidance\/ta77\/chapter\/About\u2010this\u2010guidance(17thAugust 2017)."},{"key":"e_1_2_8_18_1","volume-title":"Generalised Anxiety Disorder in Adults: Management in Primary, Secondary and Community Care. National Clinical Guideline Number 113 ed","author":"National Collaborating Centre for Mental Health","year":"2011"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2011.11.003"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2012.04418.x"},{"key":"e_1_2_8_21_1","first-page":"34","article-title":"Benzodiazepines and addiction: Long\u2010term use and withdrawal (part 2)","volume":"27","author":"Cloos J\u2010M","year":"2010","journal-title":"Psychiatr Times"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000437201"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1997.00440350031003"},{"key":"e_1_2_8_24_1","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1111\/j.1532-5415.2012.03923.x","article-title":"American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults","volume":"60","author":"Fick D","year":"2012","journal-title":"J Am Geriatr Soc"},{"key":"e_1_2_8_25_1","first-page":"7","article-title":"Issues in the clinical use of benzodiazepines: potency, withdrawal, and rebound","volume":"65","author":"Chouinard G","year":"2004","journal-title":"J Clin Psychiatry"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000434755"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp16X684385"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-7843.2009.00494.x"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-007-0349-6"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.2165\/11315960-000000000-00000"},{"key":"e_1_2_8_31_1","unstructured":"World Health Organization.ATC\/DDD Index. ATC\/DDD Index 2015. 2015.http:\/\/www.whocc.no\/atc_ddd_index\/[ 24thNovember2015]."},{"key":"e_1_2_8_32_1","first-page":"21","article-title":"Medication dosing in anxiety disorders: what the evidence shows","volume":"16","author":"White MP","year":"2009","journal-title":"Prim Psychiatry"},{"key":"e_1_2_8_33_1","unstructured":"H A. Ashton Manual for Benzodiazepine Withdrawal. Asht. Man.Benzodiazepine withdrawal\/chapter 1 benzodiazepines. 2013.http:\/\/www.benzo.org.uk\/manual\/bzcha01.htm[24th November2015]."},{"key":"e_1_2_8_34_1","volume-title":"Benzodiazepine Conversion Chart","author":"Drug and Alcohol Services South Australia G of SA","year":"2012"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmt010"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1230"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201300066"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.12315"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4338"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4123"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3825"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-199818060-00003"},{"issue":"3","key":"e_1_2_8_43_1","first-page":"247","article-title":"Prescription sedative misuse and abuse","volume":"88","author":"Weaver MF","year":"2015","journal-title":"Yale J Biol Med"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-012-0143-8"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20130076"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-013-1557-x"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00115-007-2280-6"},{"key":"e_1_2_8_48_1","unstructured":"FDA Drug Safety Announcement: Risk of next\u2010morning impairment after use of insomnia drugs; FDA requires lower recommended doses for certain drugs containing zolpidem (Ambien Ambien CR Edluar and Zolpimist).http:\/\/www.fda.gov\/Drugs\/DrugSafety\/ucm334033.htm(17th August2015)"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(96)00296-1"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-002-0548-0"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsx147"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2009.15.9.728"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.12347"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.3109\/13814788.2013.777423"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-008-9224-5"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-013-1613-6"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1611832"},{"key":"e_1_2_8_58_1","unstructured":"World Health Organization.Definition and general considerations.https:\/\/www.whocc.no\/ddd\/definition_and_general_considera\/[25thAugust2017]"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-7-796"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-015-0140-z"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.4081\/jphr.2012.e23"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-012-1424-1"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20219"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpds.4551","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.4551","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T16:17:30Z","timestamp":1695485850000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.4551"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,4]]},"references-count":62,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1002\/pds.4551"],"URL":"https:\/\/doi.org\/10.1002\/pds.4551","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,4]]},"assertion":[{"value":"2017-10-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}