A Norwegian hospital study linked greater illness burden with prolonged use of potentially addictive medications. Its combined exposure category prevents treating the association as a benzodiazepine-only effect.
Population and exposure definition
Cheng and colleagues studied 246 patients aged 65–90 admitted to a Norwegian university hospital. They assessed illness burden with the Cumulative Illness Rating Scale for Geriatrics and classified use of benzodiazepines, opioids, or Z-hypnotics for at least four weeks as prolonged use.
Patients with prolonged use had a mean illness-burden score of 7.7 compared with 4.6 in those without prolonged use. The adjusted association between burden and prolonged medication use had an odds ratio of 1.72, with a 95% confidence interval of 1.42–2.08.
Direction of causation remains unresolved
The cross-sectional design measures illness and medication patterns within the same study period. Greater illness could encourage continued prescribing, medication effects could contribute to problems, or both processes could operate. The design cannot establish which came first.
The authors also identify hospital-based selection and possible differences among people who declined participation. Results from this sample should not be treated as population prevalence estimates for every older adult.
Interpreting an older patient’s medication history
The findings support a careful review of multiple illnesses and overlapping medications. They do not establish that a benzodiazepine caused a particular disorder, nor that every prolonged user has an addiction diagnosis. Duration of use and a clinical substance-use diagnosis are different variables.
A forensic report should identify the specific drug classes involved, indications, chronology, and clinical observations. Quoting the combined-group odds ratio as the effect of benzodiazepines alone would overstate what this study separated and measured.
Source
Based on the supplied paper: The patterns and burden of multimorbidity in geriatric patients with prolonged use of addictive medi. PMC8531043.
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