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Same-day use of opioids and other central nervous system depressants amongst people who tamper with pharmaceutical opioids: A retrospective 7-day diary study


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 Statement

Copyright 2016 Elsevier Ireland Ltd.

DOI: doi:10.1016/j.drugalcdep.2016.07.003


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 Details

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 Division:Health
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)
ID Code:112897
Year Published:2016
Funding Support:National Health and Medical Research Council (APP1022522)
Deposited By:Psychology
Deposited On:2016-12-02
Last Modified:2017-11-08

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