Prevalence and Correlates of Benzodiazepine Use, Misuse, and Use Disorders Among Adults in the United States

Objective: Although benzodiazepine misuse and use disorders are associated with adverse health effects, it is unknown what proportion of benzodiazepine users misuse them or meet criteria for benzodiazepine use disorders. The goal of this study was to examine the prevalence and correlates of benzodiazepine use, misuse, and use disorders among US adults. Methods: Data from 102,000 adults 18 years and older who participated in the 2015-2016 National Surveys on Drug Use and Health were used. IMS Health Total Patient Tracker data were also examined. Descriptive analyses and multinomial logistic regressions were applied. Results: Among US adults in 2015-2016, 12.5% (annual average, 95% CI, 12.19%-12.81%) used benzodiazepines, 2.1% (95% CI, 2.03%-2.25%) misused benzodiazepines at least once, and 0.2% (95% CI, 0.15%-0.22%) had benzodiazepine use disorders. Among benzodiazepine users, 17.1% (95% CI, 16.30%-17.93%) misused benzodiazepines, and 1.5% (95% CI, 1.26%-1.72%) had benzodiazepine use disorders. Benzodiazepine use was associated with emergency room visits, suicidal ideation, use of most substances, and mental disorders. Benzodiazepine misuse without use disorders was associated with younger age, male sex, being black, poor educational attainment, being uninsured and unemployed, being single, having family income below $50,000, and having suicidal ideation and other specific substance use problems. Correlates of benzodiazepine use disorders were similar, but most correlates were associated with benzodiazepine use disorders more strongly than with misuse without use disorders. Conclusions: While benzodiazepine use is highly prevalent among US adults, benzodiazepine use disorders are relatively rare among benzodiazepine users. Our results help characterize benzodiazepine users and identify adults at risk for misuse and use disorders