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Reasons for Benzodiazepine Use Among Persons Seeking Opioid Detoxification.
J Subst Abuse Treat. 2016 09; 68:57-61.JS

Abstract

BACKGROUND

Over the past decade, patients admitted to addiction treatment programs have reported increasing rates of concurrent opioid and benzodiazepine (BZD) use. This drug combination places individuals at high risk for accidental overdose. Little is known about reasons for BZD use among individuals seeking treatment for opioid use disorders.

METHODS

We surveyed consecutive persons initiating inpatient opioid detoxification and identified 176 out of 438 who reported BZD use in the past 30 days and/or had a positive toxicology.

RESULTS

Forty percent of persons surveyed used a BZD in the month prior to admission, and 25% of these met criteria for BZD dependence (DSM IV). BZD users averaged 32.0 years of age, 63.6% were male, 85.2% used heroin, and reported, on average, 13.3 (±11.2) days of BZD use during the past month. Alprazolam (Xanax) was the most commonly used BZD (52%), and buying it on the street the most common source (48%). The most commonly reported reason for BZD use was 'to manage anxiety' (42.6%), followed by 'to get or enhance a high' (27.7%), 'to help with sleep' (11.4%), and 'to decrease opioid withdrawal' (10.2%). The most common reason for BZD use was significantly associated (p<.001) with most likely source of BZDs, with persons who got their BZDs from a prescriber (23%) more likely to report BZD anxiety as their primary reason for use, while persons who bought BZDs on "the street" (48%) had the highest likelihood of reporting using BZD to get or enhance a high. Participants using BZDs most commonly for anxiety did not endorse lower anxiety than those using BZDs for other reasons.

CONCLUSIONS

Two in five persons seeking detoxification for an opioid use disorder used a BZD in the prior month. Anxiety was the most common reason patients reported using a benzodiazepine, but they also reported using BZDs to enhance a 'high' and manage opioid withdrawal. Evidence-based discussions about the risks of combining BZDs and opioids, and alternatives to BZDs should be a high priority in detoxification settings.

Authors+Show Affiliations

Behavioral Medicine Division, Butler Hospital, Providence, RI, 02906, USA; Warren Alpert Medical School of Brown University, Providence, RI, 02912, USA. Electronic address: Michael_Stein@brown.edu.Stanford University School of Medicine, Stanford, CA, 94305, USA.Behavioral Medicine Division, Butler Hospital, Providence, RI, 02906, USA.Stanford University School of Medicine, Stanford, CA, 94305, USA.Warren Alpert Medical School of Brown University, Providence, RI, 02912, USA; Stanley Street Treatment and Resources, Inc., Fall River, MA 02720, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27431047

Citation

Stein, Michael D., et al. "Reasons for Benzodiazepine Use Among Persons Seeking Opioid Detoxification." Journal of Substance Abuse Treatment, vol. 68, 2016, pp. 57-61.
Stein MD, Kanabar M, Anderson BJ, et al. Reasons for Benzodiazepine Use Among Persons Seeking Opioid Detoxification. J Subst Abuse Treat. 2016;68:57-61.
Stein, M. D., Kanabar, M., Anderson, B. J., Lembke, A., & Bailey, G. L. (2016). Reasons for Benzodiazepine Use Among Persons Seeking Opioid Detoxification. Journal of Substance Abuse Treatment, 68, 57-61. https://doi.org/10.1016/j.jsat.2016.06.008
Stein MD, et al. Reasons for Benzodiazepine Use Among Persons Seeking Opioid Detoxification. J Subst Abuse Treat. 2016;68:57-61. PubMed PMID: 27431047.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reasons for Benzodiazepine Use Among Persons Seeking Opioid Detoxification. AU - Stein,Michael D, AU - Kanabar,Mitika, AU - Anderson,Bradley J, AU - Lembke,Anna, AU - Bailey,Genie L, Y1 - 2016/06/16/ PY - 2016/02/29/received PY - 2016/05/06/revised PY - 2016/06/06/accepted PY - 2016/7/20/entrez PY - 2016/7/20/pubmed PY - 2017/12/8/medline KW - Anxiety KW - Benzodiazepine KW - Detoxification KW - Opioids KW - Reasons for use SP - 57 EP - 61 JF - Journal of substance abuse treatment JO - J Subst Abuse Treat VL - 68 N2 - BACKGROUND: Over the past decade, patients admitted to addiction treatment programs have reported increasing rates of concurrent opioid and benzodiazepine (BZD) use. This drug combination places individuals at high risk for accidental overdose. Little is known about reasons for BZD use among individuals seeking treatment for opioid use disorders. METHODS: We surveyed consecutive persons initiating inpatient opioid detoxification and identified 176 out of 438 who reported BZD use in the past 30 days and/or had a positive toxicology. RESULTS: Forty percent of persons surveyed used a BZD in the month prior to admission, and 25% of these met criteria for BZD dependence (DSM IV). BZD users averaged 32.0 years of age, 63.6% were male, 85.2% used heroin, and reported, on average, 13.3 (±11.2) days of BZD use during the past month. Alprazolam (Xanax) was the most commonly used BZD (52%), and buying it on the street the most common source (48%). The most commonly reported reason for BZD use was 'to manage anxiety' (42.6%), followed by 'to get or enhance a high' (27.7%), 'to help with sleep' (11.4%), and 'to decrease opioid withdrawal' (10.2%). The most common reason for BZD use was significantly associated (p<.001) with most likely source of BZDs, with persons who got their BZDs from a prescriber (23%) more likely to report BZD anxiety as their primary reason for use, while persons who bought BZDs on "the street" (48%) had the highest likelihood of reporting using BZD to get or enhance a high. Participants using BZDs most commonly for anxiety did not endorse lower anxiety than those using BZDs for other reasons. CONCLUSIONS: Two in five persons seeking detoxification for an opioid use disorder used a BZD in the prior month. Anxiety was the most common reason patients reported using a benzodiazepine, but they also reported using BZDs to enhance a 'high' and manage opioid withdrawal. Evidence-based discussions about the risks of combining BZDs and opioids, and alternatives to BZDs should be a high priority in detoxification settings. SN - 1873-6483 UR - https://www.unboundmedicine.com/medline/citation/27431047/Reasons_for_Benzodiazepine_Use_Among_Persons_Seeking_Opioid_Detoxification_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0740-5472(16)30071-X DB - PRIME DP - Unbound Medicine ER -