Benzodiazepine misuse in adults with alcohol use disorder: Prevalence, motives and patterns of use

Abstract

Objective.-Benzodiazepines are among the most commonly misused drugs. Despite the known risks of combining benzodiazepines and alcohol, little is known about misuse among people with alcohol use disorder (AUD). Our aim was to characterize the prevalence, correlates, and patterns of misuse of benzodiazepines in adults with AUD.Method.-Adults receiving treatment for AUD (N=258) completed a battery of questionnaires. We used descriptive statistics to characterize the prevalence and patterns of misuse and we used logistic regression models to identify correlates of misuse.Results.-Almost half of the sample reported a history of benzodiazepine prescription and 30% reported a history of misuse. Younger age, female sex, anxiety, and other substance use were associated with misuse. Coping was the most commonly reported reason for misuse. All participants who had misused a benzodiazepine in the past year used concurrently with another substance.Conclusions.-Benzodiazepine misuse was common in this study, and risky patterns of use, such a co-use with other substances, were prevalent. Coping was the most common reason for misusing benzodiazepines, suggesting that un-or under-treated psychiatric symptoms may contribute to misuse.

Characterization of benzodiazepine misuse and comorbidities in patients with alcohol use disorder

“…Moreover, AUD severity was higher in patients with BZD consumption. In multivariate analysis, we found that age, psychiatric comorbidities and lifetime use of cocaine were significantly associated with BZD misuse, as reported in other studies [5,15]. BZD misuse in patients with AUD has major impacts on public health because these SUD are directly and indirectly linked to higher mortality [1,16].…”

“…In our population, AUD was severe in 91% of BZD users and this may explain the high rate of BZD misuse. In addition, in our population, the concomitant consumption of illicit psychoactive substances was high (25% of patients consumed cocaine in the last month before hospitalization), but in line with previous studies [5,15]. Nevertheless, due to the AUD severity that required hospitalization for alcohol withdrawal, our population is not comparable with the general population of patients with AUD.…”

“…Moreover, 36% of BZD users misused these drugs. In other studies, the rate of BZD misuse in AUD varies from 7 to 40%, in function of AUD severity [5,15]. In our population, AUD was severe in 91% of BZD users and this may explain the high rate of BZD misuse.…”

“…In our sample, 43% of patients consumed BZD in combination with alcohol. In a recent study on the same topic, 60% of BZD misusers took BZD with alcohol [15]. In our study, BZD are associated with alcohol to reduce the adverse effects of drinking (withdrawal symptoms), to alleviate anxiety, or improve sleep.…”

COVID-19 and the health of people who use drugs: What is and what could be?

“…Here, emergent theories of causation suggest use as a ‘coping strategy’ to manage anxiety, or as an alternative given lack of access to preferred drugs of choice. Shifts to increased benzodiazepine use is an obvious concern given the potential for harm, including through dependence, polysubstance use ( McHugh et al, 2020 , Votaw et al, 2020 ), and increased risk of drug-related morbidity and mortality (particularly among people who are opioid dependent) ( Dasgupta et al, 2016 , Macleod et al, 2019 , McCowan et al, 2009 , Park et al, 2015 ).…”