Prevalence and correlates of benzodiazepine use and misuse among young adults who use prescription opioids non-medically

Bouvier, Benjamin; Waye, Katherine M.; Elston, Beth; Hadland, Scott E.; Green, Traci C.; Marshall, Brandon D. L.

doi:10.1016/j.drugalcdep.2017.10.023

Cited by 27 publications

(21 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…BZD misuse was very common in our sample, in that it was reported by 20.0 and 8.6% of patients for intravenous and intranasal route, respectively, with some patients misusing both OMT and BZD. These figures are in accordance with previous reports [1,21,24,47], and suggest particular care when prescribing BZD and the importance of investigating BZD misuse in patients under OMT. The large number of patients under OMT and BZD in our sample is surprising because there is little or no evidence of the benefit of BZD in this population.…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Association between Adult Attention Deficit/Hyperactivity Disorder and Intravenous Misuse of Opioid and Benzodiazepine in Patients under Opioid Maintenance Treatment: A Cross-Sectional Multicentre Study

et al. 2020

View full text Add to dashboard Cite

Background: Intravenous misuse and attention-deficit/hyperactivity disorder (ADHD) are common in patients under opioid maintenance treatment (OMT), who often misuse benzodiazepine (BZD). Objectives: To explore the rate of adult ADHD among patients under OMT in Italy and whether screening positive for adult ADHD is associated with OMT and BZD misuse and emergency room (ER) admission because of misuse. Methods: We recruited 1,649 patients from 27 addiction units (AUs) in Italy and collected data on the self-reported rate of OMT intravenous misuse (prevalence, repeated misuse, main reason, temporal pattern in relation to AU access, experience), concurrent intravenous and intra-nasal BZD misuse (prevalence, type of misused BZD), ADHD and ER admissions because of misuse complications. Results: Screening positive for adult ADHD was found in 11.2% patients (ADHD+), with a significant gender difference (women: 15.3%, men: 10.3%). OMT misuse was reported by 24.4 and 18.5% patients during lifetime and in the previous 6 months respectively. BZD misuse was reported by 20.0 and 8.6% patients for intravenous and intranasal route respectively. Misuse was significantly more common in ADHD+ (OMT 27.4-33.1%, BZD 14.5-31.5%) than ADHD-group (OMT 17.4-23.3%, BZD 7.9-18.3%). The multivariate logistic regression model showed positive screening for ADHD to be significantly associated with intravenous OMT misuse in the previous 6 months, and intravenous/intranasal BZD misuse, independently of age, gender and route of previous heroin administration. Conclusions: Screening positive for adult ADHD was associated with OMT and BZD misuse. AU physicians and medical personnel should focus on OMT patient's features that are associated with a higher likelihood of misuse, in particular ADHD.

show abstract

Section: Discussionsupporting

confidence: 92%

“…BZD is commonly co-prescribed [21] but also frequently misused in patients under OMT [1,[21][22][23][24], yielding worse outcome, lower OMT adherence, higher risk of overdose and admission to the emergency room (ER) [25,26].…”

Section: Introductionmentioning

confidence: 99%

Association between Adult Attention Deficit/Hyperactivity Disorder and Intravenous Misuse of Opioid and Benzodiazepine in Patients under Opioid Maintenance Treatment: A Cross-Sectional Multicentre Study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Benzodiazepine misuse and its frequency were associated with OMT misuse, repeated misuse and ER admission, suggesting that it represents the variable more significantly correlated to OMT misuse outcomes in our study. This finding is in keeping with previous studies and suggest considering overall drug misuse instead of focusing on OMT misuse only [31], and paying attention to concurrent anxiety disorders or sleep disorders that may require benzodiazepine prescription [24,41].…”

Section: Discussionsupporting

confidence: 91%

Intravenous Misuse of Methadone, Buprenorphine and Buprenorphine-Naloxone in Patients Under Opioid Maintenance Treatment: A Cross-Sectional Multicentre Study

Lugoboni

Zamboni

Cibin³

et al. 2019

Eur Addict Res

View full text Add to dashboard Cite

Background: The act of intravenous misuse is common in patients under opioid maintenance treatment (OMT), but information on associated factors is still limited. Objectives: To explore factors associated with (a) intravenous OMT misuse, (b) repeated misuse, (c) emergency room (ER) admission, (d) misuse of different OMT types and (e) concurrent benzodiazepine misuse. Methods: We recruited 3,620 patients in 27 addiction units in Italy and collected data on the self-reported rate of intravenous injection of methadone (MET), buprenorphine (BUP), BUP-naloxone (NLX), OMT dosage and type, experience of and reason for misuse, concurrent intravenous benzodiazepine misuse, pattern of misuse in relation to admission to the addiction unit and ER admissions because of misuse. According to inclusion/exclusion criteria, 2,585 patients were included. Results: Intravenous misuse of OMT substances was found in 28% of patients with no difference between OMT types and was associated with gender, age, type of previous opioid abuse and intravenous benzodiazepine misuse. Repeated OMT misuse was reported by 20% (i.e., 71% of misusers) of patients and was associated with positive OMT misuse experience and intravenous benzodiazepine misuse. Admission to the ER because of misuse complications was reported by 34% of patients, this outcome being associated with gender, employment, type of previous opioid abuse and intravenous benzodiazepine misuse. OMT dosage was lower than the recommended maintenance dosage. Conclusions: We offered new information on factors associated with intravenous OMT misuse, repeated misuse and ER admission in Italian patients under OMT. Our data indicate that BUP-NLX misuse is not different from that of BUP or MET. Choosing the more expensive BUP-NLX over MET will likely not lead to the expected reduction of the risk of injection misuse of the OMT. Instead of prescribing new and expensive OMT formulations, addiction unit physicians and medical personnel should better focus on patient’s features that are associated with a higher likelihood of misuse. Care should be paid to concurrent benzodiazepine and OMT misuse.

show abstract

“…Combining prescription opioids with recreational drugs, such as alcohol, can interact to produce a harmful and potentially lethal chemical effects for the user, 10,11 and increase the risk for overdose-though previous research shows concurrent prescription opioid and illicit drug users perceive risk as low. 12 The combination of prescription opioids and benzodiazepines has been a primary area of concern given their potential for harm, 13,14 but less attention has focused on prescription opioid and comorbid use of recreational substances despite the prevalence of recreational drug use of substances-such as alcohol, tobacco, and marijuana-is higher than prescription drug misuse. 15 Misuse of prescription opioids and recreational substance use behaviors is consistent with research indicating that prescription drug misuse is associated with an increased risk of mental health problems, including substance use disorders.…”

mentioning

confidence: 99%

Prescription opioid misuse and comorbid substance use: Past 30‐day prevalence, correlates and co‐occurring behavioral indicators in the 2016 National Survey on Drug Use and Health

Grigsby

Howard

2019

American J Addict

View full text Add to dashboard Cite

Background and objectives: Prescription opioid misuse has not been well examined in the context of comorbid substance use in representative samples of substance users. Past 30-day comorbid prescription opioid misuse and recreational substance use (e.g., alcohol, marijuana, cocaine, etc.) was studied in a representative sample of substance users in the United States using the 2016 National Survey on Drug Use and Health (NSDUH). Methods: Prevalence of prescription opioid misuse with and without comorbid substance use was estimated with the 2016 NSDUH. Generalized linear modeling was used to describe demographic correlates of opioid and comorbid substance use and explore the relation of opioid and comorbid substance use with social and behavioral health indicators. Results: The majority of past month prescription opioid misusers reported use of other substances including cigarettes, alcohol, marijuana, or hard drugs (cocaine, methamphetamine, etc.). Males and younger respondents had a significantly higher risk of reporting past month prescription opioid misuse with illicit drug or polydrug use (p's <0.01). Prescription opioid and polydrug users had the greatest odds of stealing property, selling drugs, having suicidal ideations, major depressive episode, and perceived treatment need in the past year compared to all other categories of prescription opioid misuse categories. Conclusions and scientific significance: Prescription opioid misuse is likely a part of a larger set of psychological, behavioral, and mental health problems. More attention should be given to the profiles of recreational (non-medical) substance use involving prescription opioids to curtail the current opioid crisis and prevent other similar epidemics in the future.

show abstract

Prevalence and correlates of benzodiazepine use and misuse among young adults who use prescription opioids non-medically

Abstract: Benzodiazepine use and misuse are highly prevalent among young adult NMPO users. Harm reduction and prevention programs for this population are urgently needed.

Cited by 27 publications

References 38 publications

Association between Adult Attention Deficit/Hyperactivity Disorder and Intravenous Misuse of Opioid and Benzodiazepine in Patients under Opioid Maintenance Treatment: A Cross-Sectional Multicentre Study

Association between Adult Attention Deficit/Hyperactivity Disorder and Intravenous Misuse of Opioid and Benzodiazepine in Patients under Opioid Maintenance Treatment: A Cross-Sectional Multicentre Study

Intravenous Misuse of Methadone, Buprenorphine and Buprenorphine-Naloxone in Patients Under Opioid Maintenance Treatment: A Cross-Sectional Multicentre Study

Prescription opioid misuse and comorbid substance use: Past 30‐day prevalence, correlates and co‐occurring behavioral indicators in the 2016 National Survey on Drug Use and Health

Contact Info

Product

Resources

About