@article{ref1,
title="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="Drug and alcohol dependence",
year="2016",
author="Peacock, Amy and Bruno, Raimondo and Larance, Briony and Lintzeris, Nick and Nielsen, Suzanne and Ali, Robert and Dobbins, Timothy and Degenhardt, Louisa",
volume="166",
number="",
pages="125-133",
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. <br><br>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 &quot;high dose&quot;. <br><br>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. <br><br>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.<br><br>Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0376-8716",
doi="10.1016/j.drugalcdep.2016.07.003",
url="http://dx.doi.org/10.1016/j.drugalcdep.2016.07.003"
}