Max Rady College of Medicine

Concept: Benzodiazepine Use / Benzodiazepine Dispensations

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Concept Description

Last Updated: 2020-05-20


    The benzodiazepine family of depressants is used therapeutically to produce sedation, induce sleep, relieve anxiety and muscle spasms, and to prevent seizures. In general, benzodiazepines act as hypnotics in high doses, anxiolytics in moderate doses, and sedatives in low doses. Short-acting benzodiazepines are generally used for patients with sleep-onset insomnia (difficulty falling asleep) without daytime anxiety. Benzodiazepines with a longer duration of action are utilized to treat insomnia in patients with daytime anxiety. Repeated use of large doses or in some cases, daily use of therapeutic doses of benzodiazepines is associated with amnesia, hostility, irritability, and vivid or disturbing dreams, tolerance, and physical dependence. The withdrawal syndrome is similar to that of alcohol and may require hospitalization. Abrupt cessation of benzodiazepines is not recommended and tapering-down the dose eliminates many of the unpleasant symptoms (Fransoo et al., 2009).

    Long-term use of benzodiazepines is not recommended for older adults because they are more sensitive to the depressant effects benzodiazepines cause on the central nervous system, and because prolonged use can cause confusion, night wandering, amnesia and loss of balance. The use of high daily doses by older adults has been associated with an increased risk of hip fractures and accidental falls (Egan MY, Wolfson C, Moride Y, Monette J. High daily doses of benzodiazepines among Quebec seniors: Prevalence and correlates. BMC Geriatr. 2001;1:1-7). In addition, tolerance and physical and psychological dependence may occur with prolonged use. Lower rates of benzodiazepine prescription are therefore desirable (Katz et al., 2014).

Methods of Identifying Benzodiazepines - ATC Codes and Generic Drug Names

    Methods for identifying the use of benzodiazepines include identifying ATC codes and generic drug names.

1. Fransoo et al. (2009) and Martens (2010)

    In Fransoo et al. (2009) and in Martens et al. (2010), benzodiazepines were identified by specific ATC codes N05BA01, N05BA02, N05BA04 - N05BA06, N05BA08, N05BA10, N05BA12, N05CD01, N05CD02, N05CD04, N05CD05 and N05CD07, as well as the generic drug names diazepam, chlordiazepoxide, oxazepam, clorazepate potassium, lorazepam, bromazepam, alprazolam, flurazepam, nitrazepam, triazolam, and temazepam. In this scenario, medications with ATC code N05CD01 were included, as these are classified as "benzodiazepine-related drugs" and appropriate in this context.

2. Fransoo et al. (2013), Katz et al. (2014), Katz et al. (2019), and Fransoo et al. (2019)

Indicators for Measuring Benzodiazepine Use

    Two indicators for measuring benzodiazepine use have been developed at MCHP. They include rates for community-dwellling adults and rates for residents of personal care homes (PCHs).

1. Benzodiazepine Prescribing/Dispensations for Community-Dwelling Seniors (Adults 75 Years and Older)

2. Benzodiazepine Prescribing/Dispensations for Residents of Personal Care Homes (PCH)


    NOTE: Lists of drugs to treat diseases and conditions change all the time: new drugs are added, drugs are taken off the market, etc. Also it is very research specific. The list of ATC codes presented in this concept represent a starting point and it is advisable to verify with a clinician or pharmacist the list of current medications being used.

Related terms 


  • Chartier M, Finlayson G, Prior H, McGowan K, Chen H, de Rocquigny J, Walld R, Gousseau M. Health and Healthcare Utilization of Francophones in Manitoba. Winnipeg, MB: Manitoba Centre for Health Policy, 2012. [Report] [Summary] (View)
  • Fransoo R, Martens P, Burland E, The Need to Know Team, Prior H, Burchill C. Manitoba RHA Indicators Atlas 2009. Winnipeg, MB: Manitoba Centre for Health Policy, 2009. [Report] [Summary] [Additional Materials] (View)
  • Fransoo R, Martens P, The Need to Know Team, Prior H, Burchill C, Koseva I, Bailly A, Allegro E. The 2013 RHA Indicators Atlas. Winnipeg, MB: Manitoba Centre for Health Policy, 2013. [Report] [Summary] [Additional Materials] (View)
  • Fransoo R, Mahar A, The Need to Know Team, Anderson A, Prior H, Koseva I, McCulloch S, Jarmasz J, Burchill S. The 2019 RHA Indicators Atlas. Winnipeg, MB: Manitoba Centre for Health Policy, 2019. [Report] [Summary] [Updates and Errata] [Additional Materials] (View)
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  • Katz A, Avery Kinew K, Star L, Taylor C, Koseva I, Lavoie J, Burchill C, Urquia M, Basham A, Rajotte L, Ramayanam V, Jarmasz J, Burchill S. The Health Status of and Access to Healthcare by Registered First Nation Peoples in Manitoba. Winnipeg, MB: Manitoba Centre for Health Policy, 2019. [Report] [Summary] [Updates and Errata] [Additional Materials] (View)
  • Martens PJ, Bartlett J, Burland E, Prior H, Burchill C, Huq S, Romphf L, Sanguins J, Carter S, Bailly A. Profile of Metis Health Status and Healthcare Utilization in Manitoba: A Population-Based Study. Winnipeg, MB: Manitoba Centre for Health Policy, 2010. [Report] [Summary] [Updates and Errata] [Additional Materials] (View)

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University of Manitoba
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