PATIENT TREATMENT INSISTENCE AND MEDICATION CRAVING IN LONG-TERM LOW-DOSAGE BENZODIAZEPINE PRESCRIPTIONS

Background. Long-term low-dosage dependence on benzodiazepines is trad itionally explained by withdrawal symptoms. Previous research has not given much attention to reports that suggest that many patients oppose stopping benzodiazepines long before withdrawal symptoms have develop ed. This study investigates the scope of and factors associated with t his pre-withdrawal treatment insistence.Methods. Patients receiving lo ng-term low-dosage benzodiazepines in primary care were asked to take a drug-holiday of at least 3 weeks. Sociodemographic, medication, morb idity and attitudinal variables were assessed in addition to the GPs' perceptions of their patients. Results. Two-thirds of the patients rej ected the drug-holiday proposal. Patients who refused a drug-holiday w ere less educated and were using a higher percentage of long-acting be nzodiazepines than patients who accepted the drug-holiday proposal. Th ose who refused were seen by their GPs as being more complaining, hard er to satisfy and less co-operative. Conclusions. These results provid e evidence for drug-seeking or craving behaviour of patients who recei ve low-dosage benzodiazepine prescriptions. A major problem in benzodi azepine withdrawal occurs before the withdrawal programme has even beg un. These data show that benzodiazepine low-dosage dependence should b e considered a real form of dependence.