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October 17, 1986

Substance Abuse

JAMA. 1986;256(15):2114-2116. doi:10.1001/jama.1986.03380150124041

Recent advances in the understanding of anxiety and drug abuse have cast new light on the controversy about dependence on antianxiety medications in clinical practice.

Epidemiologic data gathered over the last 15 years show that US benzodiazepine use is not higher than that of other developed nations and that most patients who use these drugs do so with both symptomatic relief and restraint in terms of amount, dose, and duration of treatment.1 On the other hand, these same data show that almost 2% of the adult population use these agents more or less chronically.

The last decade has seen remarkable changes in our understanding of anxiety disorders. It was once thought that anyone who was "nervous" or "tense" was more or less like everyone else, except perhaps that they were more sensitive to unpleasant feelings. It is now clear that pathological anxiety affects a minority of the population, strongly