Abstract
INTRODUCTION: The use of anxiolytics and hypnotics has become a significant public health concern, primarily driven by stress-related conditions. Although psychosocial risk factors are a major source of work-related stress, their association with the use of these drugs has been scarcely investigated. The primary objective of this study was to explore this association within the salaried population in Spain. METHODS: We conducted a cross-sectional study using data from the 2019/2020 EDADES (Encuesta sobre Alcohol y Drogas en España) survey, focusing on salaried workers aged 16-65 (N=9851). Three psychosocial risk indicators were analysed: workload, job insecurity and social support. Prevalence ratios (PR) and 95% CIs were estimated using Poisson regression models with robust variance. Multivariable models were adjusted for age, occupational level, risk awareness and self-perceived health. All analyses were stratified by gender. RESULTS: Women reported higher anxiolytic and hypnotic use (8.8%) compared with men (4.6%). Among female workers, high job insecurity was significantly associated with increased use (adjusted PR (PR(a))=1.45, 95% CI 1.08 to 1.96). No significant associations were observed for workload or social support in either sex. Lack of awareness of the risks of anxiolytics and hypnotics was strongly associated with higher consumption in both genders (PR(a)=1.80, 95% CI 1.47 to 2.20 for women; PR(a)=2.50, 95% CI 1.92 to 3.27 for men). Self-perceived health showed the strongest association, with markedly higher use among those reporting poor or very poor health (PR(a)=6.04, 95% CI 4.03 to 9.07 for women; PR(a)=7.32, 95% CI 4.36 to 12.29 for men). CONCLUSIONS: Anxiolytic and hypnotic use was higher among female workers, with job insecurity emerging as a significant risk factor, with higher use observed among female workers aged over 50 in the stratified analyses. Risk awareness appears to play a key role in psychotropic medication patterns among workers. Future research should employ validated assessment tools for psychosocial risk factors and further investigate the mechanisms through which workplace conditions and risk awareness influence psychotropic drug use.