Background: The use of benzodiazepines and z-drugs remains controversial given their potential for misuse and harm. Investigation of their use in Manitoba remains important for monitoring and improving prescribing patterns.

Methods: Administrative data was used to conduct i) drug utilization study from 2001-2016, and ii) incident-user cohort study of patients with anxiety/insomnia.

Results: i) Z-drug use increased on all measures while only dose intensity increased for benzodiazepines. Higher utilization occurred among females and those ≥65 years. ii) The proportion of patients who became long-term users (>6months) in their first episode of use ranged from 4.5-9.6%. Males, older age, socioeconomically deprived, use of opioids or psychotropic agents, and poor physical health, were associated with long-term use.

Conclusion: While less than one in 10 were considered a long-term user of these agents, further investigation into whether specific factors associated with long-term use requires consideration during the prescribing of these agents is warranted.