Psychotropics in medical students: A latent danger

Dear Editor,

The use of psychotropics has increased exponentially in recent years among young people and adolescents. The main reasons that would explain this fact are medical prescription for mental health issues and self-medication. The latter is the reason behind our letter. According to the World Health Organization, the use of psychoactive substances has the potential to produce dependence.¹ One of the pharmacological groups that has seen the biggest growth in its use is benzodiazepines. Universities, and health sciences students in particular (especially medicine students) are more predisposed to use drugs of this type; knowledge of the “benefits” of these medications and ease of acquiring them may explain this phenomenon²; moreover, the more intense pace of their intellectual work, while living alone in a new city and a lack of academic motivation may contribute to the problem. Evidently, there is a knowledge gap in this area.

Associated with the use of benzodiazepines, it is common to hear statements from students such as “they improve my academic performance”, “they reduce stress before exams” or “they boost my concentration”. The use and prescription of these drugs therefore needs to be monitored, as they have been associated with a high risk of abuse and dependence (even when administered by physicians at therapeutic doses).

Martínez, at the Universidad Nacional de Colombia, found high levels of use of psychotropics among health sciences (medicine and nursing) students; regarding the means of obtaining these medications, 49% purchased them directly, 35% obtained them through a healthcare provider, 11% received them from a relative and 5% from a friend. None reported having obtained drugs from medical samples.²

In Croatia, Trkulja reported that the lifetime prevalence of contact with psychoactive medications among medicine students had increased from 15% in 1989 to 33% in 2000. The medications used most often were benzodiazepines, and reasons for doing so were anxiety, insomnia, stress, overwork and depression; only 3.5% indicated that they took them for reasons such as entertainment, curiosity or experimentation.³

At a private Colombian university, Calderón found that 13.4% of students had taken benzodiazepines at least once in their life, and that 43.5% of them did so without a medical prescription. He also found that the mean age at first use was 19.4 years.⁴

In Peru, under Supreme Decree No. 023-2001-SA on the sale and marketing of psychotropics, the sale of benzodiazepines requires a medical prescription (prescribed by an accredited physician) and they can only be dispensed at authorised establishments (under the responsibility of a pharmaceutical chemist); the prescription must also be retained, with the details of the professional responsible, the number of units dispensed and the purchaser's details written on the reverse.⁵

However, in Colombia, benzodiazepines are not obtained in a controlled manner, as they are easy to access through small pharmacies, which contributes to non-compliance with standards and fosters addiction in the student population. In daily contact with students, it is common to hear of the same prescription for benzodiazepines being used for purchases from multiple pharmacies, thereby building up “reserves” and continuing dependence.

To conclude, this letter seeks to report the problem of benzodiazepine use in young people studying health sciences at university and to bring it to the attention of the authorities. Local data are minimal and protocols need to be established in this area. With these results, strategies can be informed and proposed to improve the dispensing, control and auditing of their use to avoid issues of abuse, dependence and other associated risks.

Funding

This work was funded by the authors.

Conflicts of interest

None.