# Medication-Seeking Behaviors and Correlated Characteristics of Zolpidem Users in Taiwan—A Shared Patient Network Analysis

## TL;DR

This study explores why zolpidem use is rising in Taiwan, finding that high-dose users are influenced by personal factors and chronic diseases.

## Contribution

The study introduces a novel approach combining logistic regression and social network analysis to examine zolpidem medication-seeking behaviors.

## Key findings

- High-dose zolpidem users are more likely to be male and have chronic diseases.
- High-dose users show a denser social network, visiting multiple healthcare institutions.
- Psychiatrists play a central role in medication-seeking networks, especially for low-dose users.

## Abstract

Increasing insomnia signals a public health problem, alongside rising zolpidem use. This study investigates the factors behind the disproportionate rise in zolpidem prescriptions in Taiwan. It aims to identify the determinants of high-dose zolpidem users in Taiwan’s Yilan County and employ an innovative approach to outline their medication-seeking patterns, using Taiwan’s healthcare database. The associations between sociodemographic and clinical factors and low-dose and high-dose users were analyzed using multiple logistic regression. Social network analysis was employed to explore medication-seeking behavior among these user groups across different healthcare institutions. Of our 5290 participants, 22.82% are high-dose users. This study found that males face a 1.33-fold higher risk and that having chronic diseases is a major risk factor, contributing to a more than four-times higher risk (adjusted OR = 4.27, 95% CI 1.55–11.70) of being a high-dose user of zolpidem. A social network analysis showed a higher density (0.52) for high-dose users, revealing their frequent visits, for zolpidem, to different healthcare institutions. Psychiatrists have a central role in both low-dose and high-dose user networks, with a greater influence on low-dose users (64.4) than high-dose users (32.2). In sum, patients seeking high doses of zolpidem are driven by personal factors. Future efforts should include regulated dispensing, public health education, and specialized training for healthcare professionals on drug addiction.