Peacock, A and Bruno, R and Larance, B and Lintzeris, N and Nielsen, S and Ali, R and Dobbins, T and Degenhardt, L, Same-day use of opioids and other central nervous system depressants amongst people who tamper with pharmaceutical opioids: A retrospective 7-day diary study, Drug and alcohol dependence, 166 pp. 125-133. ISSN 0376-8716 (2016) [Refereed Article]
Copyright 2016 Elsevier Ireland Ltd.
OBJECTIVE: The aims were to determine: (i) quantity and frequency of same-day use of opioids with benzodiazepines and/or alcohol amongst people who regularly tamper with pharmaceutical opioids; and (ii) socio-demographic, mental health, harms and treatment profile associated with same-day use of high doses.
METHOD: The cohort (n=437) completed a retrospective 7-day diary detailing opioid, benzodiazepine, and alcohol intake. Oral morphine equivalent (OME) units and diazepam equivalent units (DEU) were calculated, with >200mg OME, >40mg DEU and >4 standard alcoholic drinks (each 10g alcohol) considered a "high dose".
RESULTS: One-half (47%) exclusively consumed opioids without benzodiazepines/alcohol; 26% had days of opioid use with and without benzodiazepines/alcohol; and 26% always used opioids and benzodiazepines/alcohol. Same-day use of opioids with benzodiazepines/alcohol typically occurred on 1-3days in the past week. Six in ten (61%) participants reported high dose opioid use on at least one day; one in five (20%) reported high dose opioid and high dose benzodiazepine/alcohol use on at least one day. The latter group were more likely to use prescribed opioid substitution therapy, often alongside diverted pharmaceutical opioids. Socio-demographic and clinical profiles did not vary according to high dose opioid, alcohol and benzodiazepine use, and there was no association with harms.
CONCLUSIONS: Same-day use of opioids with benzodiazepines/alcohol, and high dose combinations, are common amongst people who tamper with pharmaceutical opioids. Assessment of concomitant benzodiazepine/alcohol use during opioid therapy, implementation of real-time prescription monitoring systems, and research to clarify upper safe limits for polydrug depressant use, are potential implications.
|Item Type:||Refereed Article|
|Keywords:||Alcohol; Benzodiazepine; Concurrent use; Opioid; Overdose; Polydrug abuse|
|Research Division:||Psychology and Cognitive Sciences|
|Research Group:||Other Psychology and Cognitive Sciences|
|Research Field:||Psychology and Cognitive Sciences not elsewhere classified|
|Objective Group:||Public Health (excl. Specific Population Health)|
|Objective Field:||Substance Abuse|
|Author:||Peacock, A (Miss Amy Peacock)|
|Author:||Bruno, R (Associate Professor Raimondo Bruno)|
|Funding Support:||National Health and Medical Research Council (APP1022522)|
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