Long-term use of benzodiazepine medication results in dependence, tolerance, withdrawal
symptomatology, and reduced pharmacological efficacy. In addition, long-term use of
benzodiazepines can have adverse effects on cognitive, psychomotor and psychological
functioning. In response to these problems prescribing guidelines clearly discourage the
long-term use of benzodiazepines.
The aim of the study was to examine the long-term use of benzodiazepine medication in a
primary care population. The study included patients who were prescribed benzodiazepines
by their general practitioners for sleep problems. Detailed information was collected
regarding psychopathology, sleep difficulties and benzodiazepine dependence in this patient
group with the aim of establishing whether a common psychological profile prevailed
amongst those individuals who had been taking prescribed benzodiazepine medication for
longer than the recommended period of time
This research study could therefore offer support to general practitioners by providing a
greater psychological understanding of this client group, and this knowledge could inform
alternative treatment options.
The research design employed was a cross-sectional survey of an identified population using
standardised questionnaires. The design therefore utilised between subject measures to
examine the relationships between subjects on a number of variables.
Eighty-four participants, recruited from two rural primary care practices, took part in the
study. Data were collected using a semi-structured interview and administration of four selfreport questionnaire measures (The Pittsburgh Sleep Quality Index; The Brief Symptom
Inventory; The Severity of Dependence Scale; The Psychological Mindedness Scale).
Results found significant psychopathology (somatisation and phobic anxiety) in long-term
benzodiazepine users. Anxiety was found to significantly predict benzodiazepine
dependence and sleep difficulties. The use of long-term benzodiazepine medication did not
relieve sleep difficulties. Older benzodiazepine users and daily benzodiazepine users were
significantly less psychologically minded than younger users and non-daily users.
The study concluded that long-term benzodiazepine use is ineffective in treating sleep
difficulties and it would appear that anxiety is a significant feature in this cohort. Therefore,
the study proposes that to address the problem of long-term benzodiazepine use in the
primary care setting, psychological approaches should be employed to treat anxiety and sleep