Diazepam on demand. Drug-seeking behavior in psychiatric inpatients.

For six months patients admitted to a psychiatric ward were allowed to seek diazepam (Valium) on demand. Details of 689 requests by 83 patients were recorded. Drug-seeking behavior was expressed as a drug-seeking index (DSI) based on the ratio of requests to duration of stay. For the whole ward there was an increasing trend in drug use and nurses' attitudes became more favorable. Over a quarter of the patients never sought drugs and requests were made on an average of only once every three days. The features correlated with DSI were anxiety, being female, white, and having an elevated psychasthenia scale on the MMPI. The DSI was not related to either diagnosis or use of major psychiatric drugs. Extensive use of antianxiety drugs might be reduced by prescribing them "when necessary" rather than on fixed schedules.