Benzodiazepine pathways in the chronically ill

The association between patterns of use of benzodiazepines and chronic somatic morbidity was examined by applying the Chronic Disease Score (CDS). In the only pharmacy in a Dutch community, 6921 patients with data available covering a 10-year period (1983-1992) were included. In 1992, two-thirds of the patients had a CDS of 0, indicating no chronic morbidity. Patients with chronic morbidity showed a twofold risk of a history of benzodiazepine use. Within the group of benzodiazepine users, longer exposure to benzodiazepines as well as a history of different benzodiazepines were associated with a higher risk of chronic morbidity. Duration of episodes of use and daily dose were not found to be significantly associated with chronic disease. A pattern of increased benzodiazepine use showed a higher risk of chronic morbidity compared with benzodiazepine users with a stable use. Moreover, a history of benzodiazepine use was found to predict a sharp increase in chronic morbidity. We found a clear association between previous and actual use of benzodiazepines and chronic somatic disease. Benzodiazepine use may be induced by sleeping difficulties and anxiety problems caused by the chronic disease.