Background:
The COVID-19 pandemic led to many psychosocial problems in the general population. Sleeping problems have been one of them. This study examined if these developments led to an increased intake of psychoactive medications which have an addictive potential – e.g. benzodiazepines.
Methods:
Data on change of intake of sleep medication resp. tranquilizers (by prescription only) collected from a general population survey (n=6996) and time series of waste-water analysis were compared. To understand differences between trends, an in-depth investigation among 624 participants of the general population survey who had stated use of these medications was carried out, asking them the concrete names of their medications.
Results:
Retrospective data from the general population survey show a slight increased intake of sleep medication and tranquilizers. 9 percent of the general population reported having used sleep medication or tranquilizers more than once per week before the pandemic, this increased to 11 percent during phases of lockdowns of the COVID-19 pandemic followed by a decrease to 10 percent after the pandemic. Considering the marker for benzodiazepines in waste-water analysis, there was hardly any change during the pandemic. The 624 participants considered in the in-depth analysis named a broad variety of medications. One quarter named home remedies like valerian drops. Three quarters named psychoactive medications but only 13 % of the medications were benzodiazepines. Interestingly, antidepressants were mentioned by a large proportion. This gives some insight into prescription practices of doctors prescribing antidepressants under the label of sleeping aids.

Conclusions:
We observed no significant increase of intake of sleeping medication and tranquilizers with addictive potential in the general population of Austria during the pandemic. The results show the restrictions of using data from general population surveys to measure the intake of potentially addictive psychoactive medication, given the broad variety of what people view as sleeping aids and tranquil-izers. This highlights the value of multi-indicator analysis, whereby multiple indicators (e. g. from general population surveys, waste-water analysis, treatment data, prescription data, sales data…) are combined to monitor the use (and misuse) of psychoactive medication. Efforts should be undertaken to reach a multi-indicator harmonised monitoring of psychoactive medications which allows comparisons between countries.