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Published Online: 10 June 2020

Concurrent Opioid and Benzodiazepine Utilization Patterns and Predictors Among Community-Dwelling Adults in the United States

Abstract

Objective:

Using benzodiazepines and opioids together substantially increases the risk of fatal overdose. Yet, concurrent benzodiazepine and opioid prescribing rates continue to increase amid the opioid overdose epidemic. Therefore, this study sought to identify patterns and predictors associated with self-reported concurrent benzodiazepine and opioid use among community-dwelling adults.

Methods:

This retrospective, cross-sectional study used Medical Expenditure Panel Survey data from 2011, 2013, and 2015. The study population included adults (age ≥18) who did not die during the calendar year. The dependent variable was concurrent benzodiazepine and opioid use, which was identified with Multum Lexicon therapeutic class codes. Multivariable logistic regression analysis was conducted to examine the association of various individual-level factors with concurrent benzodiazepine and opioid use.

Results:

The final study sample consisted of 44,808 individuals (unweighted), of which 680 (1.6%) (weighted frequency=7,806,636) reported concurrent benzodiazepine and opioid use. Several individual-level factors were significantly associated with reporting use of this combination. For example, individuals with anxiety were more likely to report using both benzodiazepines and opioids (odds ratio [OR]=9.61, 95% confidence interval [CI]=7.37–12.5), and those with extreme pain levels were more likely to report concurrent use (OR=5.11, 95% CI=2.98–8.78). Other predictors of reporting concurrent benzodiazepine and opioid use were depression, arthritis, region, race-ethnicity, insurance, activities disability, general and mental health status, and smoking status.

Conclusions:

Several individual-level factors were associated with reporting concurrent benzodiazepine and opioid use. Therefore, enhanced educational interventions targeting both clinicians and community-dwelling adults are warranted to minimize use of this high-risk medication combination.

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Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 1011 - 1019
PubMed: 32517642

History

Received: 6 September 2019
Revision received: 8 January 2020
Revision received: 20 February 2020
Accepted: 26 March 2020
Published online: 10 June 2020
Published in print: October 01, 2020

Keywords

  1. Opioid
  2. Benzodiazepine
  3. Adults
  4. Community
  5. United States
  6. Public health

Authors

Details

Nina Vadiei, Pharm.D., B.C.P.P. [email protected]
Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson.
Sandipan Bhattacharjee, M.S., Ph.D.
Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson.

Notes

Send correspondence to Dr. Vadiei ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

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