France is the second-largest consumer of benzodiazepines in Europe. More than 9 million people consumed these molecules (alprazolam, bromazepan, lorazepam, but also zopiclone, zolpidem under the name Imovane, Stilnox) in 2023, three-quarters of them prescribed by general practitioners, according to the French National Agency for the Safety of Medicines and Health Products (ANSM), whose campaign is aimed at the general public and healthcare professionals.
"With around 34 units – tablets or capsules – consumed per inhabitant per year, we are behind Spain, which is at 54 units, but far ahead of the United Kingdom or Germany, with 5 to 7 units per inhabitant per year," Dr. Philippe Vella, the agency's medical director, told the press.
Drugs responsible for"the majority of road accidents are linked to medication"
Xanax, Imovane, Lexomil – the top three – "are useful drugs, important to prescribe wisely, but which expose elderly people to risks of drowsiness, dependence, memory problems and potentially serious falls. However, these side effects, which are increased when the treatment duration is long, are often unrecognized," he added.
By impairing the ability to drive – particularly in combination, "strongly discouraged", alcohol – these drugs are responsible for "the majority of road accidents are linked to medication", stressed Mehdi Benkebil, director of surveillance at ANSM.
However, 3.6 million French people, or 40% of patients treated with benzodiazepines, have prescription durations that are too long. Marketed since the 1960s in France, these molecules which act on the central nervous system nevertheless constitute only a "temporary help to alleviate symptoms" and no "treat the cause" anxiety and severe sleep disorders, recalls the drug agency.
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“Recreational” and criminal use
Their prescription, which "should, as far as possible, be avoided in the elderly", born "should not exceed 12 weeks in anxiety (anxiolytic benzodiazepines) and three weeks in insomnia (hypnotic benzodiazepines)", recalled Dr. Vella. While nearly one in two patients treated with these drugs is over 65, the ANSM also wants to alert young people. Because less than a quarter (23%) of those under 30 who take or have taken them are aware of the risks of addiction or driving, according to a Viavoice survey for the ANSM.
Overall stable between 2017 and 2023, prescriptions for anxiolytics – mainly Xanax – jumped by 25% among young people under 19 (170,000 took them) and even by 40% among girls in this age group.
And, among 18-25 year olds, the diversion of benzodiazepines to "recreational use" – in "cocktail" associated with opioids or in "party lollipops", combining ketamine and MDMA, according to the European Monitoring Centre for Drugs and Drug Addiction – is "very pronounced", alerted Mr. Benkebil.
Chemical Submissions
These molecules are also the most used in the context of chemical submissions, such as lorazepam (Temesta) with which Gisèle Pelicot's husband drugged her for years to abuse her and have her raped by strangers.
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To target young people, the ANSM has formed a partnership with the social networks TikTok and Instagram and collaborated with influencers: posters and videos promote non-drug alternatives (yoga, meditation, sport, etc.).
The agency's campaign also targets general practitioners, who are encouraged to address the causes of patients' insomnia and anxiety and to prescribe these medications for the shortest possible duration. For insomnia, small packs of five to seven tablets are available: laboratories have been encouraged to produce them since 2022. Of the €100 million in benzodiazepine reimbursements per year, the French National Health Insurance estimates it can save €30 million due to their misuse.
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