Benzodiazepine kinetics contribute to their differential abuse

benzodiazepine dependence

Drug abuse behaviour is the consequence of an interaction between the drug and the individual. More specifically, abuse potential ofa prescription drug is mainly determined by five factors: the intrinsic pharmacological action of the drug, the availability or market exposure, the recommended and prescribed drug dose, patient-related factors and the pharma cokinetic properties of the particular drug. Price and fashion also play a role in the abuse of street drugs but these will not be discussed here.

The intrinsic pharmacological action(s) of a drug is the major determinant of whether a drug is likely to be abused. Evidence for this includes correspondence within and among drug classes with respect to intensity of self-administration by animals and humans, extent of substitution in physically dependent animals and generalized preference for the drug. Appearance ofwithdrawalmay contribute to the maintenance of abuse; however withdrawal is neither sufficient nor necessary to maintain drug administration. With respect to the intrinsic pharmacological activity, benzodiazepines are weak reinforcers and maintain low levels of selfadministration compared with other drugs of abuse such as narcotics or barbiturates. Therefore, in this respect they have relatively low abuse potential. Dreaming of a reliable pharmacy that could give you an opportunity to buy any amounts of generic viagra professional online with no prescription required and spend less money?

Market exposure is a factor that includes extent ofuse (market penetration) and duration ofuse. Provided that drugs have the intrinsic pharmacological activity that permits abuse, availability of drugs plays a major role in determining which compounds will be abused. Benzodiazepines are widely used drugs and different compounds have been available in the market for varying numbers of years. Therefore, the relative frequency of abuse problems should be interpreted taking these factors into consideration.

Dose size alone is not an abuse risk factor. Instead, it is the relationship between dose (concentration) and the drug’s phar ma cological prop er ties that deter mine the likelihood of the acquisition and maintenance of drug taking behaviour. Evidence for this comes from animal studtes that show selfadministration is maintained more robustly if the animal is accustomed to higher doses ; physical dependence is greater at higher doses. In the case ofbenzodiazepines, recommended doses vary greatly in relation to receptor affinity (or drug potency), intrinsic efficacy and their indication for use (eg, anxiety, in som nia, alco hol with drawal, panic at tacks). Thus, it is the relative position of the recommended dose for a particular drug on its dose-response curve that may influence risk abuse of that drug.

Patient factors also play a role in determintng persistent drug self-administration. Humans show marked individual differences in their potential to abuse drugs or to use them persistently . Genetic differences and psychiatric comorbidity seem to play a role but patterns of use (ie, intermittent versus regular), prior use of the same and/ or similar drugs as well as other drug experi ences are among the factors that will determine which drugs may be preferred .

This entry was posted in Benzodiazepine and tagged Benzodiazepines, Pharm acoepidem iology, Pharmacokinetics, Substance abuse.