From molecular mechanisms to digital surveillance: the 2010-2025 evolution of benzodiazepine and Z-drug misuse research
Naunyn-Schmiedeberg's archives of pharmacology · 2026 Jun 30
Abstract
The misuse of benzodiazepines (BZDs) and Z-drugs poses significant global public health challenges. This study maps the scientific evolution and paradigm shifts in this field from 2010 to 2025. A bibliometric analysis of 6,311 publications from the Web of Science Core Collection was performed using VOSviewer and CiteSpace to identify collaboration networks, research hotspots, and emerging frontiers. The USA and Harvard Medical School dominated global contributions. Research hotspots evolved through three distinct phases: (1) 2010-2014 focused on GABA A receptor subtype-specific pharmacology, specifically the role of the alpha1 subunit in midbrain disinhibition and the biological basis of addiction; (2) 2015-2019 shifted toward the pharmacodynamic synergy of BZD-opioid interactions and the implementation of mass spectrometry-based toxicological surveillance; and (3) 2020-2025 centered on integrated computational pharmacology (QSAR and docking) for designer BZDs, alongside digital governance using electronic health records (EHR) and machine learning for precision deprescribing. Burst detection reveals a trajectory shifting from retrospective mechanistic deconstruction to prospective, data-driven risk prediction. BZD research has undergone a paradigm shift from molecular pharmacology to multidimensional digital and computational surveillance. Future directions prioritize utilizing big data and in silico modeling for individualized risk forecasting and precision clinical intervention to address the complex landscape of designer analogs and improve public mental health governance.
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