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Monitoring of benzodiazepine diversion using a multi-indicator approach

Pauly, Vanessaa; Frauger, Elisabethb; Pradel, Vincentb; Nordmann, Sandrab; Pourcel, Laurec; Natali, Francoisd; Sciortino, Vincentd; Lapeyre-Mestre, Marysec; Micallef, Joelleb; Thirion, Xaviera

International Clinical Psychopharmacology: September 2011 - Volume 26 - Issue 5 - p 268–277
doi: 10.1097/YIC.0b013e32834967e5
Original Articles

Fourteen benzodiazepine (BZD) or BZD-like medications were analyzed with three data sources aiming to assess prescription drug abuse for the year 2008. After a descriptive analysis, a principal component analysis was carried out to explore correlations between seven indicators obtained by different methods using these three different data sources and to compute a composite score of diversion for these drugs. For all the indicators, flunitrazepam appears first with much higher values than the other drugs, whereas clonazepam appears in the second or third place. These methods produce globally correlated indicators and the composite score obtained from principal component analysis ranks the drugs with the highest diversion as follows: flunitrazepam, clonazepam, oxazepam, diazepam, and bromazepam. This study shows that these methods yield consistent results. Their integration into a single multi-indicator approach gives health authorities a global view of different behaviors regarding diversion of a given drug.

aLaboratoire de Santé Publique, Centre d'Evaluation et d'Information sur la Pharmacodépendance (CEIP), Centre Associé, Faculté de médecine EA 3279

bCentre d'Evaluation de la Pharmacodépendance-Addictovigilance (CEIP-A) de Marseille (PACA-Corse), Fédération de Pharmacologie et de Toxicologie, CHU Timone, Marseille, France et UMR 6193 CNRS-Université de la Méditerranée, Marseille

cCentre d'Evaluation et d'information sur la Pharmacodépendance-Addictovigilance CEIP-Addictovigilance, Service de Pharmacologie Clinique, CHU, Toulouse

dDirection Régionale du Service Médical de la Région Provence-Alpes-Côte d'Azur et Corse (CNAMTS), Marseille, Cedex, France

Correspondence to Xavier Thirion, PhD, Laboratoire de Santé Publique, Centre d'Evaluation et d'Information sur la Pharmacodépendance (CEIP), Centre Associé, Faculté de médecine EA 3279, 37 Bd Jean Moulin, Marseille 13005, France Tel: +4 91 74 47 44; fax: +491 74 47 04; email:

Received November 29, 2010

Accepted June 1, 2011

© 2011 Lippincott Williams & Wilkins, Inc.