Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults Title.

benzodiazepine older persons substance use disorder

Journal

Canadian geriatrics journal : CGJ
ISSN: 1925-8348
Titre abrégé: Can Geriatr J
Pays: Canada
ID NLM: 101579189

Informations de publication

Date de publication:
Mar 2020
Historique:
entrez: 1 4 2020
pubmed: 1 4 2020
medline: 1 4 2020
Statut: epublish

Résumé

Benzodiazepine receptor agonist (BZRA) use disorder among older adults is a relatively common and challenging clinical condition. The Canadian Coalition for Seniors' Mental Health, with financial support from Health Canada, has produced evidence-based guidelines on the prevention, identification, assessment, and management of this form of substance use disorder. Inappropriate use of BZRAs should be avoided by considering non-pharmacological approaches to the management of late life insomnia, anxiety, and other common indications for the use of BZRA. Older persons should only be prescribed BZRAs after they are fully informed of alternatives, benefits, and risks associated with their use. Clinicians should have a high index of suspicion for the presence of BZRA use disorders. The full version of these guidelines can be accessed at www.ccsmh.ca. A person-centred, stepped care approach utilizing gradual dose reductions should be used in the management of BZRA use disorder.

Sections du résumé

BACKGROUND BACKGROUND
Benzodiazepine receptor agonist (BZRA) use disorder among older adults is a relatively common and challenging clinical condition.
METHOD METHODS
The Canadian Coalition for Seniors' Mental Health, with financial support from Health Canada, has produced evidence-based guidelines on the prevention, identification, assessment, and management of this form of substance use disorder.
RESULTS RESULTS
Inappropriate use of BZRAs should be avoided by considering non-pharmacological approaches to the management of late life insomnia, anxiety, and other common indications for the use of BZRA. Older persons should only be prescribed BZRAs after they are fully informed of alternatives, benefits, and risks associated with their use. Clinicians should have a high index of suspicion for the presence of BZRA use disorders. The full version of these guidelines can be accessed at www.ccsmh.ca.
CONCLUSIONS CONCLUSIONS
A person-centred, stepped care approach utilizing gradual dose reductions should be used in the management of BZRA use disorder.

Identifiants

pubmed: 32226570
doi: 10.5770/cgj.23.419
pii: cgj-8-116
pmc: PMC7067147
doi:

Types de publication

Journal Article

Langues

eng

Pagination

116-122

Informations de copyright

© 2020 Author(s). Published by the Canadian Geriatrics Society.

Déclaration de conflit d'intérêts

CONFLICT OF INTEREST DISCLOSURES The project was funded by Health Canada (Substance Use and Addictions Program). The funder had no role in the creation or approval of the recommendations. Authors received an honorarium for their work. A rigorous process was undertaken to ensure that members of the working group did not have any significant conflict of interest.

Références

Can J Aging. 2010 Jun;29(2):205-13
pubmed: 20420748
BMC Geriatr. 2017 Jan 31;17(1):37
pubmed: 28143413
BMJ. 2008 Apr 26;336(7650):924-6
pubmed: 18436948
Ther Adv Psychopharmacol. 2018 Mar;8(3):99-114
pubmed: 29492258
J Addict Med. 2018 Jan/Feb;12(1):4-10
pubmed: 28777203
JAMA. 2018 Nov 13;320(18):1889-1898
pubmed: 30422193
J Am Geriatr Soc. 2019 Apr;67(4):674-694
pubmed: 30693946
Age Ageing. 2010 May;39(3):313-9
pubmed: 20089547
Am J Public Health. 2010 Jan;100(1):108-14
pubmed: 19443821
Arch Intern Med. 2010 Jul 12;170(13):1155-60
pubmed: 20625025
Acta Psychiatr Scand. 2008 Jun;117(6):403-11
pubmed: 18479316
J Psychopharmacol. 2012 Jul;26(7):899-952
pubmed: 22628390
Drugs Aging. 2014 Feb;31(2):131-40
pubmed: 24353033
Ann Intern Med. 2016 Jul 19;165(2):125-33
pubmed: 27136449
JAMA Intern Med. 2014 Jun;174(6):890-8
pubmed: 24733354
Br J Clin Pharmacol. 2015 Dec;80(6):1254-68
pubmed: 27006985
J Sleep Res. 2017 Dec;26(6):675-700
pubmed: 28875581
Can J Psychiatry. 2010 Nov;55(11):709-14
pubmed: 21070698
Am J Alzheimers Dis Other Demen. 2014 Nov;29(7):565-74
pubmed: 25551131
Can Fam Physician. 2018 May;64(5):339-351
pubmed: 29760253

Auteurs

David K Conn (DK)

Baycrest Health Sciences, North York, ON.
Department of Psychiatry, University of Toronto, Toronto, ON.

David B Hogan (DB)

Brenda Strafford Centre on Aging, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB.
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB.

Lori Amdam (L)

Canadian Coalition for Seniors Mental Health, Markham, ON.

Keri-Leigh Cassidy (KL)

Department of Psychiatry, Dalhousie University, Halifax, NS.

Peter Cordell (P)

Department of Psychiatry, McMaster University, Hamilton, ON.

Christopher Frank (C)

Department of Family Medicine, Queen's University, Kingston, ON.

David Gardner (D)

Department of Psychiatry, Dalhousie University, Halifax, NS.

Morris Goldhar (M)

Baycrest Health Sciences, North York, ON.
Department of Psychiatry, University of Toronto, Toronto, ON.
Brenda Strafford Centre on Aging, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB.
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB.
Canadian Coalition for Seniors Mental Health, Markham, ON.
Department of Psychiatry, Dalhousie University, Halifax, NS.
Department of Psychiatry, McMaster University, Hamilton, ON.
Department of Family Medicine, Queen's University, Kingston, ON.
Department of Medicine, McMaster University, Hamilton, ON.
Department of Psychiatry, University of Montreal, Montreal, QC.

Joanne M-W Ho (JM)

Department of Medicine, McMaster University, Hamilton, ON.

Christopher Kitamura (C)

Baycrest Health Sciences, North York, ON.

Nancy Vasil (N)

Department of Psychiatry, University of Montreal, Montreal, QC.

Classifications MeSH