Prevalence of and pathways to benzodiazepine use in Brazil: the role of depression, sleep, and sedentary lifestyle

Objective: This study aimed to determine the prevalence of benzodiazepine (BZD) use in Brazil and to investigate the direct and indirect effects of alcohol consumption, sedentary lifestyle (SL), depressive symptoms (DS), and sleep dissatisfaction (SD) on BZD use. Methods: The Second Brazilian Alcohol and Drugs Survey (II BNADS) used stratified cluster probabilistic sampling to select 4,607 individuals aged 14 years and older from the Brazilian household population. Results: The lifetime and 12-month prevalence of BZD use was 9.8 and 6.1%, respectively. Older participants (age 40 and older) and women had higher rates. Alcohol use disorder, DS, and SD were significantly more prevalent in BZD users. The parallel multiple mediator model showed a positive direct effect of alcohol consumption on BZD use, with significant positive indirect effects of SL, SD, and DS as simultaneous mediators leading to higher BZD intake. Other statistically significant indirect pathways were DS alone, SD alone, and all of the above except SL. Conclusion: The prevalence of BZD use in Brazil is high compared to that of other countries. Knowledge of the main risk factors and pathways to consumption can guide prevention initiatives and underlie the development of better tailored and effective treatment strategies.

Substance Dependence in a Tribal District.

Introduction: Retrospective study was carried out with an aim to understand the status of substance dependence in Adilabad which is a tribal district of Telangana region and to know the possible reasons behind it. Material and Methods: Records from September 2009 to August 2010 was collected and analysed from patients of RIMS Adilabad. Cases of single substance dependence or polysubstance dependence and associated disorders were included in the study. Parameters were incidence, socio-demographics, age, sex, polysubstance dependence, alcohol dependence, comorbidity, management of substance dependence and hospital stay. Results: A total of 157 patients included in the study. Significant (p<0.05) seasonal variations were observed. Villagers 57.32%, Hindus 92.36%, Muslims 6.37% with mean age of 37 years was observed. Female to male ratio was 0.05:1. 86% females were from tribal villages, chronic beedi smokers and all had family history. Polysubstance dependence (3.18%) included alcohol 100% and cannabis 2.55%. Chronic alcoholics 44.59%, moderate quantity in 76%, consciousness in 53%, handmade liquor in 18% and alcohol without food in 7.64% observed. Associated comorbidity seen in 70.70% cases. Death occurred in 3.18% cases. Ranitidine and ampicillin were mainly given. Mean hospital stay was 2.26 days. Conclusion: Productive age group and handmade liquor is common but polysubstance dependence is negligible. Comprehensive strategy involving education, counselling, treatment and rehabilitation programs are needed to fight against substance dependence in the region.

Efecto de la inhibición de la síntesis de angiotensina II en el consumo de alcohol / Effect of angiotensin II synthesis inhibition on alcohol consumption

Background: Central reninangiotensin system modulates alcohol intake and inhibition of angiotensin converting enzyme reduces ethanol consumption in rats, and may be potentially useful in the treatment of alcoholism. Aim: To study the effect of captopríl on alcohol intake, both in humans and animals . Material and methods: In a double-blind, placebo-controlled clinical study, 15 alcoholics who met DSM-IV criíteria were randomized to receive captopril 100 mg/day or placebo for 12 weeks. In the experimental study, daily consumption of ethanol (10 percent v/v), water and solid food was assessed in 12 male Wistar rats before and after the intraperítoneal administration of captopríl 50 mg/kg/day. Results: In alcoholics, mean weekly standard alcoholic drínk consumption was not different during captopríl treatment or placebo. However, both groups had a signiñcantly lower intake than duríng baseline. Days of abstinence increased and days of drunkeness decreased in the group receiving captopril, when compared with baseline but not with placebo. Craving was significantly reduced by captopríl when compared with placebo. In rats, captopríl reduced not only alcohol consumption but also water and food intake. Conclusions: Captopríl decreases alcohol intake in rats and this effect is not speciñc for ethanol. Captopril did not alter alcohol consumption in alcoholics when compared with placebo but reduced craving.