Association between benzodiazepine use and substance use among older adults in a primary care setting in Nan province, Thailand
DOI:
https://doi.org/10.64838/jmht.2026.282953Keywords:
benzodiazepine, older adult, primary care, substance useAbstract
Objective: To investigate the prevalence of benzodiazepine use and its association with a history of substance use among older adults in a primary care setting.
Methods: A cross-sectional study was conducted among older adults aged 60 years and older at a community hospital in Northern Thailand. Data were collected using structured questionnaires, including the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), the Alcohol Use Disorders Identification Test (AUDIT), and the Fagerström Test for Nicotine Dependence (FTND). Multivariable logistic regression was performed to examine the association between benzodiazepine use and substance use, with sex-specific subgroup analyses.
Results: Among 218 participants, 21.1% reported benzodiazepine use and 45.9% reported any other substance use. Compared with non-users, benzodiazepine users were older, had lower educational attainment, and had a higher prevalence of type 2 diabetes mellitus and chronic kidney disease. After adjusting for covariates, benzodiazepine use was significantly associated with an increased likelihood of substance use (AOR = 11.25, 95% CI = 3.55 - 35.67). In subgroup analyses, a significant association was observed only among females (AOR = 15.05, 95% CI = 4.06 - 55.73), whereas the association among males did not reach statistical significance.
Conclusion: Concurrent benzodiazepine use and substance use are common among older adults and are significantly associated with each other, particularly among females. Routine screening for substance use should be considered for older adults prescribed benzodiazepines. Cautious prescribing practices are warranted to mitigate potential adverse outcomes in this population.
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