TY - JOUR T1 - Combatting the misuse of benzodiazepines and related Z drugs in French general practice: a clinical review JF - BJGP Open JO - BJGP Open DO - 10.3399/bjgpopen20X101014 VL - 4 IS - 1 SP - bjgpopen20X101014 AU - Gaetan Gentile AU - Maryse Lapeyre-Mestre AU - Joelle Micallef Y1 - 2020/04/01 UR - http://bjgpopen.org/content/4/1/bjgpopen20X101014.abstract N2 - Benzodiazepines (BZDs) are widely used as anxiolytic, hypnotic, and antiepileptic drugs. They have a fast pharmacodynamic tolerance to hypnotic and anxiolytic effects and long-term prescribing of them is ineffective and potentially dangerous because of the induced dependence. Numerous studies have outlined the high level of their use in Europe, with a particular high level of use in France. The risk of death is not negligible in any patient population,1 and can be a result of long-term exposure, acute exposure, or sudden dosage increase.This article reviews the determinants of BZD prescription by GPs and existing measures to reduce it. A synthesis narrative review of recent published or unpublished international literature on BZD prescription in general practice has been used.France’s position in BZD consumptionFrance is second to Spain in the use of anxiolytic BZDs and Sweden and Norway have the highest level of use of hypnotic BZDs, with France in third place. A moderate decrease in BZD use has been observed in France over the past 3 years, but the number of French people consuming BZDs is still too high and many campaigns in France to reduce BZD use have been unsuccessful. In most European countries included in the Agence National de Sécurité du Médicament et des Produits de Santé (ANSM) report,2 long-term BZD use is stable over time even though short-term use decreases.3 BZDs consumption and the public health problemIn France, BZDs and related Z drugs (such as zolpidem and zopiclone) are actively monitored by the ANSM ‘addictovigilance’ network, through national survey databases, spontaneous reports by health professionals, and health insurance reimbursement databases.4 BZDs are legitimately obtained in pharmacies by GP prescriptions, but are also obtained through ‘doctor shopping’ and through illegal means.5,6 The benefit–risk ratio of a long-term treatment is unfavourable. After a few weeks, there is an increased risk of … ER -