How prevalent and severe is addiction on GABAmimetic drugs in an elderly German general hospital population? Focus on gabapentinoids, benzodiazepines, and z‐hypnotic drugs

Abstract Objective Gabapentinoids (GPT) are reported to be increasingly misused by opioid‐ and polydrug‐users, but the addictive potential of GPT outside of these populations remains understudied. Investigations comparing GPT abuse and dependence liability to that of other commonly prescribed Central Nervous System‐acting medications are therefore warranted. We provide a comparison of GPT‐abuse/dependence to that of other GABAmimetics within an elderly population. Design DSM‐IV‐TR‐based data (previously prospectively collected by SKID‐I‐interview) from a random sample of elderly patients admitted to a metropolitan German general hospital were reviewed. The prevalence and severity of GPT, benzodiazepine (BDZ), and z‐hypnotic drug (ZD)‐abuse and ‐dependence were compared, stratified also by mono‐substance (no concurrent current or previous substance use) and de novo‐substance (first)‐abuse and ‐dependence states. Results Among 400 patients (75 ± 6.4 years old; 63% females), neither current nor past abuse of BDZ, ZD or GPT, nor other illicit substances was observed. Dependence upon BDZ, ZD or GPT was observed among 55 (13.75%) individuals. The related lifetime/12‐month prevalence‐rates were: dependence condition (BDZ: 7%/2.45%; ZD: 4.25%/4.25%; GPT: 2.75/2.5%); mono‐dependence condition (BDZ: 2.25%/0.75%; ZD: 1%/1%, GPT: 0%/0%); de novo‐dependence condition (BDZ: 2.75%/1.75%; ZD: 1%/1%, GPT: 0.5%/0.5%). Opioid analgesic‐dependence ( N = 43/400) was significantly more frequently linked with BDZ than with GPT ( p < 0.01) [Correction added on 29 December 2021, after first online publication: In the sentence ‘Opioid analgesic‐dependence…’, the term ‘and ZD’ has been deleted]. For all three GABAmimetic classes, most mono‐ and de novo‐dependence states were mild‐to‐moderate and lasted 2–6 years (median). Conclusion GABAmimetic‐dependence was usually mixed with other substance‐dependences. Every third to fourth instance of BDZ‐ or ZD‐dependence was a mono‐dependence condition, while a pure GPT‐dependence was absent in this elderly (and illicit substance‐naïve) population.