Nonmedical prescription sedative/tranquilizer use in alcohol and opioid use disorders

Victoria R Votaw; Katie Witkiewitz; Linda Valeri; Olivera Bogunovic; R Kathryn McHugh

doi:10.1016/j.addbeh.2018.08.010

Nonmedical prescription sedative/tranquilizer use in alcohol and opioid use disorders

Addict Behav. 2019 Jan:88:48-55. doi: 10.1016/j.addbeh.2018.08.010. Epub 2018 Aug 14.

Authors

Victoria R Votaw¹, Katie Witkiewitz², Linda Valeri³, Olivera Bogunovic⁴, R Kathryn McHugh⁴

Affiliations

¹ Department of Psychology, University of New Mexico, MSC 03-2220, Albuquerque, NM 87131, Mexico. Electronic address: vvotaw@unm.edu.
² Department of Psychology, University of New Mexico, MSC 03-2220, Albuquerque, NM 87131, Mexico; Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque, NM 87106, Mexico.
³ Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, USA; Psychiatric Biostatistics Laboratory, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
⁴ Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, USA; Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.

PMID: 30142484
DOI: 10.1016/j.addbeh.2018.08.010

Abstract

Aims: Nonmedical prescription sedative/tranquilizer (e.g., benzodiazepines) use (NMSTU) increases risk of overdose when combined with opioids and/or alcohol. Yet, little is known about NMSTU among those with alcohol and opioid use disorders. We aimed to characterize NMSTU and sedative/tranquilizer use disorder among adults with alcohol use disorder (AUD) and/or opioid use disorder (OUD) in a general population sample.

Methods: We conducted analyses of 2008-2014 National Survey on Drug Use and Health data; adults with past-year AUD-only (n = 27,416), OUD-only (n = 2142), and co-occurring AUD and OUD (n = 1483) were included (total N = 31,041). Multivariable logistic regression models were utilized to examine correlates of past-month NMSTU and past-year sedative/tranquilizer use disorder. Focal independent variables were polysubstance use (i.e., number of substances used in the previous year) and psychiatric distress.

Results: Among those with AUD-only, 27.1% reported lifetime NMSTU, 7.6% reported past-year NMSTU, 2.7% reported past-month NMSTU, and 0.6% met criteria for past-year sedative/tranquilizer use disorder. Corresponding prevalence rates among those with OUD-only were 69.5%, 43.0%, 22.6%, and 11.3%. Those with co-occurring AUD and OUD displayed the highest rates of NMSTU (e.g., 27.5% with past-month NMSTU) and sedative/tranquilizer use disorder (20.2%). Across groups, more severe polysubstance use and psychiatric distress were associated with increased risk of NMSTU and sedative/tranquilizer use disorder.

Conclusions: Results of this analysis indicate that >25% of adults with AUD and approximately 70% of those with OUD report lifetime NMSTU. Among these populations, individuals with more polysubstance use and greater psychiatric distress might benefit from targeted interventions to reduce NMSTU.

Keywords: Alcohol use disorder, sedatives; National Survey on drug use and health; Nonmedical use; Opioid use disorder; Tranquilizers.

MeSH terms

Adolescent
Adult
Alcoholism / epidemiology*
Female
Humans
Hypnotics and Sedatives*
Male
Middle Aged
Opioid-Related Disorders / epidemiology*
Prescription Drug Misuse / statistics & numerical data*
Tranquilizing Agents*
United States / epidemiology
Young Adult

Substances

Hypnotics and Sedatives
Tranquilizing Agents