Benzodiazepines in sport, an underestimated problem: Recommendations for sports medicine physicians' practice

Thomas Zandonai; Ana María Peiró; Francesca Fusina; Fabio Lugoboni; Lorenzo Zamboni

doi:10.3389/fpsyt.2022.1066330

Benzodiazepines in sport, an underestimated problem: Recommendations for sports medicine physicians' practice

Front Psychiatry. 2022 Dec 21:13:1066330. doi: 10.3389/fpsyt.2022.1066330. eCollection 2022.

Authors

Thomas Zandonai^{1

2

3}, Ana María Peiró^{1

2

4

5}, Francesca Fusina^{6

7}, Fabio Lugoboni⁸, Lorenzo Zamboni⁸

Affiliations

¹ Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernández University of Elche, Alicante, Spain.
² Neuropharmacology on Pain and Functional Diversity, Institute of Health and Biomedical Research of Alicante (Instituto de Investigación Sanitaria y Biomédica de Alicante), Alicante, Spain.
³ Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy.
⁴ Pain Unit, Department of Health of Alicante, University General Hospital, Alicante, Spain.
⁵ Clinical Pharmacology Unit, Department of Health of Alicante, University General Hospital, Alicante, Spain.
⁶ Padova Neuroscience Center, University of Padova, Padua, Italy.
⁷ Department of General Psychology, University of Padova, Padua, Italy.
⁸ Unit of Addiction Medicine, Department of Internal Medicine, Integrated University Hospital of Verona, Policlinico "G.B. Rossi", Verona, Italy.

Abstract

In the last years, only few studies in literature have focused on the use and abuse of benzodiazepines (BZDs) in sport. Benzodiazepine-related problems include misuse, addiction, driving impairments, and morbidity and mortality related to overdose and withdrawal. Two clinical cases regarding elite endurance athletes evidenced that they had started to use BZDs to counteract insomnia, to recover faster from training sessions and to manage muscle pain. One of the important points that emerged from their stories was that their sports doctors did not recognize the drugs' addictive properties, and did not intervene to gradually reduce the dosage. Experts have previously provided recommendations for BZD therapy management in clinical practice. In this article, we would like to address sports medicine physicians specifically and provide guidelines to help them manage situations involving BZD prescription, the recognition of addiction, and intervention strategies.

Keywords: addiction; anxiety; drugs; guidelines; insomnia; sleep.