“The use of benzodiazepines in Spain is abusive and unjustified”. Antonio Torres, head of the Mental Health Working Group of the Spanish Society of General and Family Physicians (SEMG) is forceful in the face of “a problem that needs a solution.”
“We are facing an endemic disease throughout the Spanish health system,” underlines the specialist, with data in hand.
In the last 10 years, the sale of anxiolytics and antidepressants in pharmacies has increased by 30%, with increases in consumption year after year. In 2022, 111,182 million drugs of this class were dispensed, half, approximately benzodiazepines, “figures that make Spain the first country in the world in its consumption.”
“In Spain, 110 doses per day are consumed per 1,000 inhabitants”, a volume much higher than Belgium and Portugal, the next in the ranking, with 80 doses per day per 1,000 inhabitants and far from 0.4 doses/day /1,000 inhabitants taken in Germany.
After alcohol and tobacco, benzodiazepines are the substance with the highest addictive use in Spain, above cannabis.
“These drugs have a low risk social profile. They are considered to be almost innocuous, when they are not,” Torres stressed at the XXIX National Congress of General and Family Medicine, which is being held in Granada from June 14 to 17 and which, among other issues, will address the importance of deprescription of benzodiazepines.
Risks of abusing benzodiazepines
The risks of taking these drugs unjustifiably and for a longer time than recommended are abundant, Rafael Castro, also a member of the Mental Health Working Group of the aforementioned society, told the press.
Among other problems, this consumption can lead to slowing down, memory and sleep disturbances, muscle weakness or sedation, in addition to contributing to increasing the risk of accidents.
According to the guidelines, the consumption of benzodiazepines should not exceed three months in cases of anxiety disorders and one month in cases of insomnia, Torres and Castro explained.. However, the consumption time is much higher, they regretted.
“In many cases the drug is not prescribed and the patient is not told to gradually reduce the dose,” they noted.
“A global initiative is needed at the State level,” claimed the specialists, who pointed out that despite the fact that regions such as Andalusia, Castilla-La Mancha, Castilla y León, the Canary Islands or Navarra have launched programs aimed at reducing the consumption of these drugs, a state and coordinated approach is needed.
“In 2015, France ranked second in the European consumption ranking. The Ministry then carried out an awareness campaign and a direct intervention with doctors focused on deprescription and it worked. That is necessary”, claimed Torres, who raised the difficulty that is often for the family doctor “to convince the patient, who is often already in a condition of addiction, that he must stop a drug for which he does not have a risk prescription because no one talks about it,” he added.
As Rafael Castro explained, this type of medication is useful in addressing some Mental Health problems, such as depression.. “But at the time of the indication, the patient must be aware, from the outset, of the risks of the drug and that they should only take it for a certain time,” he clarified.
Among the reasons that explain this high consumption of benzodiazepines, Castro pointed out “the population's low tolerance for frustration,” which leads to wanting to “medicalize life.”
“We want to correct any discomfort with drugs,” he added, stressing that many life situations that cause restlessness cannot be confused with real anxiety disorders or insomnia.
To this we must add that “we live in a competitive and stressful society in which we must maintain routines that require staying at the limit of performance without anguish and without giving up,” the specialists pointed out.
On the other hand, they also pointed out that the lack of time of Primary Care doctors -barely five minutes per patient, they regretted- may also influence the observed abuse of psychotropic drugs.
“The resource that is denied us the most is the most precious, which is time,” they concluded.