TY  - JOUR
PY  - 2016//
TI  - Same-day use of opioids and other central nervous system depressants amongst people who tamper with pharmaceutical opioids: a retrospective 7-day diary study
JO  - Drug and alcohol dependence
A1  - Peacock, Amy
A1  - Bruno, Raimondo
A1  - Larance, Briony
A1  - Lintzeris, Nick
A1  - Nielsen, Suzanne
A1  - Ali, Robert
A1  - Dobbins, Timothy
A1  - Degenhardt, Louisa
SP  - 125
EP  - 133
VL  - 166
IS  - 
N2  - 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 "high dose". <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>
LA  - en
SN  - 0376-8716
UR  - http://dx.doi.org/10.1016/j.drugalcdep.2016.07.003
ID  - ref1
ER  -