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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

Journal Article


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Abstract


  • 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 >200 mg OME, >40 mg DEU and >4 standard alcoholic drinks (each 10 g 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 1–3 days 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.

Authors


  •   Peacock, Amy (external author)
  •   Bruno, Raimondo (external author)
  •   Larance, Briony
  •   Lintzeris, Nicholas (external author)
  •   Nielsen, Suzanne (external author)
  •   Ali, Robert (external author)
  •   Dobbins, Timothy (external author)
  •   Degenhardt, Louisa (external author)

Publication Date


  • 2016

Citation


  • Peacock, A., Bruno, R., Larance, B., Lintzeris, N., Nielsen, S., Ali, R., Dobbins, T. & Degenhardt, L. (2016). 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, 166 125-133.

Ro Full-text Url


  • https://ro.uow.edu.au/cgi/viewcontent.cgi?article=5200&context=sspapers

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/4175

Number Of Pages


  • 8

Start Page


  • 125

End Page


  • 133

Volume


  • 166

Place Of Publication


  • Ireland

Abstract


  • 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 >200 mg OME, >40 mg DEU and >4 standard alcoholic drinks (each 10 g 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 1–3 days 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.

Authors


  •   Peacock, Amy (external author)
  •   Bruno, Raimondo (external author)
  •   Larance, Briony
  •   Lintzeris, Nicholas (external author)
  •   Nielsen, Suzanne (external author)
  •   Ali, Robert (external author)
  •   Dobbins, Timothy (external author)
  •   Degenhardt, Louisa (external author)

Publication Date


  • 2016

Citation


  • Peacock, A., Bruno, R., Larance, B., Lintzeris, N., Nielsen, S., Ali, R., Dobbins, T. & Degenhardt, L. (2016). 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, 166 125-133.

Ro Full-text Url


  • https://ro.uow.edu.au/cgi/viewcontent.cgi?article=5200&context=sspapers

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/4175

Number Of Pages


  • 8

Start Page


  • 125

End Page


  • 133

Volume


  • 166

Place Of Publication


  • Ireland