{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:07:30Z","timestamp":1792159650427,"version":"4.4.0"},"reference-count":67,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T00:00:00Z","timestamp":1682294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objectives<\/jats:title>\n                    <jats:p>To investigate the trends in the consumption of benzodiazepines (BZDs) and Z-drugs at global, regional, and national levels from 2008 to 2018, across 67 countries and regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional descriptive study investigated the consumption of BZDs and Z-drugs analyzed by global pharmaceutical sales data from the IQVIA-Multinational Integrated Data Analysis System database between 2008 and 2018. Consumption was measured in defined daily dose (DDD) per 1000 inhabitants per day (DDD\/TID). The global, regional, and national trends were estimated using linear mixed models. Additional analyses were conducted by grouping countries by income level. The association between consumption and Gross Domestic Product (GDP) and the prevalence of different medical conditions was explored in univariable linear models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>BZD consumption decreased annually by \u22121.88% (95% CI: \u22122.27%, \u22121.48%), and Z-drugs increased by\u2005+\u20053.28% (+2.55%, +4.01%). In 2008, the top ten countries for BZD and Z-drug consumption were all European, ranging from 63.69 to 128.24 DDD\/TID. Very low levels were found in Russia, Kuwait, United Arab Emirates, Saudi Arabia, French West Africa, and the Philippines, with DDD\/TID\u2005&amp;lt;\u20051. The consumption in high-income countries was much higher than in middle-income countries. The results showed that increased consumption of BZDs and Z-drugs was statistically associated (p\u2005&amp;lt;\u20050.05) with higher GDP and increased prevalence of anxiety, self-harm, neurological disorders, chronic respiratory diseases, cardiovascular diseases, and cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Distinct differences in consumption and trends of BZDs and Z-drugs were found across different countries and regions. Further exploration is needed to understand the association and safety of the use of BZDs and Z-drugs in patients with comorbidities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleep\/zsad124","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T14:24:55Z","timestamp":1682346295000},"source":"Crossref","is-referenced-by-count":74,"title":["Global trends in the consumption of benzodiazepines and Z-drugs in 67 countries and regions from 2008 to 2018: a sales data analysis"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1361-4055","authenticated-orcid":false,"given":"Tian-Tian","family":"Ma","sequence":"first","affiliation":[{"name":"Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park , Hong Kong , China"},{"name":"Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong , Hong Kong , 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and Technology Park , Hong Kong , China"},{"name":"Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong , Hong Kong , China"},{"name":"Research Department of Practice and Policy, School of Pharmacy, University College London , London , UK"},{"name":"Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Castle","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Toronto , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing","family":"Chung Chang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong , Hong Kong , China"},{"name":"State Key Laboratory in Brain and Cognitive Sciences, University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne Y L","family":"Chan","sequence":"additional","affiliation":[{"name":"Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park , Hong Kong , China"},{"name":"Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong , Hong Kong , China"},{"name":"Unit of Pharmacotherapy Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund C L","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celine Sze Ling","family":"Chui","sequence":"additional","affiliation":[{"name":"Laboratory of Data Discovery for Health (D24H), 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