Highlights

Use of Z-drugs rising in Manitoba

Concerns have been raised about the long-term use of benzodiazepines, especially in older people. Although it has been suggested that Z-drugs, a newer class of hypnotic medication, have lower potential for abuse and dependence, concerns remain about their effects on human performance and driving.

In this population-based study, researchers looked at the incidence and prevalence of benzodiazepine and Z-drug (zoplicone and zaleplone) use in Manitoba over a 16-year period, 1996–2012. (Zolpidem was not available on the Canadian market until end of 2011.) Over the study period, the authors found that benzodiazepines were prescribed less frequently to patients ≥ 65 yr (55.5 to 30.3 users per 1000). Use remained stable among the rest of the adult population (18–64 yr). Zopiclone prescribing, however, continued to rise in all age groups studied (7.3 to 20.3 users per 1000) (Figure). Highest rates of use were seen among older women and the low-income population.

• Download figure
• Open in new tab
• Download powerpoint

Figure:

Incidence of benzodiazepine and Z-drug (zopiclone and zaleplon) use in Manitoba, 1996–2012.

It is unclear whether the observed drop in benzodiazepine use in older people is limited to the diagnosis of insomnia or whether other medications have replaced benzodiazepines for conditions such as anxiety. Despite recommendations to restrict the use of benzodiazepines and Z-drugs for insomnia to a maximum of four weeks, patients of all ages seem to stay on these drugs for extended periods, say the authors. CMAJ Open 2014;2:E208–E216

Use of alternative medicine by children with cardiac conditions is common

Use of complementary and alternative medicine is increasing among children, especially among those with chronic illnesses. This survey looked at the use of these products and practices in patients attending pediatric cardiology clinics in two Canadian children’s hospitals.

Of the 176 respondents, almost 60% reported use of complementary and alternative medicine at any time in the child’s life. The most common products in use were multi-vitamins, vitamin C, calcium, unspecified cold remedies and fish oil or omega-3 fatty acids. Use of alternative practices was also common (Table). Although almost 45% used these products and practices concurrently with conventional medicine, about one-third of these respondents did not disclose this concurrent use to their physician; two-thirds did not inform their pharmacist. CMAJ Open 2014; 2:E217–E224