![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
ABSTRACT
Background: Benzodiazepine use has been associated with addiction-related risks, but little is known about its association with aberrant drug-related behaviors in patients receiving opioids for chronic pain. The authors examined the association between receipt of a benzodiazepine prescription and 2 aberrant drug-related behaviors, early opioid refills and illicit drug (cocaine) use in patients receiving opioids for noncancer chronic pain. Methods: This was a retrospective cohort study of 847 patients with ≥1 visit to either a hospital-based primary care clinic or one of two community health centers between September 1, 2011, and August 31, 2012. All patients received ≥3 opioid prescriptions written at least 21 days apart within 6 months, and ≥1 urine drug screen during the study period. A Cox proportional hazards model estimated the hazard of a second early opioid refill, defined as an opioid prescription written 7–25 days after the previous prescription for the same drug, as a function of time-varying benzodiazepine prescription. A logistic regression model examined the relationship between benzodiazepine prescription and a positive urine test for cocaine. Models were adjusted for demographics and mental/substance use disorder diagnoses. Results: Twenty-three percent (n = 196) of patients received ≥1 benzodiazepine prescription during the study period. Twenty-two percent (n = 183) of patients had ≥2 early opioid refills, and 11% (n = 93) had ≥1 positive urine drug tests for cocaine. Receipt of benzodiazepine prescription was associated with an increased hazard of having a second early opioid refill, adjusted hazard ratio = 1.54 (95% confidence interval [CI]: 1.09–2.18), but not associated with a positive cocaine test, adjusted odds ratio = 1.07 (95% CI: 0.55–2.23). Conclusions: Among primary care patients receiving chronic opioid therapy, benzodiazepine prescription was associated with early opioid refills but not with cocaine use. Further research should better elucidate the risks and benefits of prescribing benzodiazepines to patients receiving opioids for chronic pain.
Funding
This research was supported by a grant from the National Institute on Drug Abuse (R01DA034252). The funding agencies had no role in data collection, analysis, interpretation, or the decision to submit the results.The authors declare that they have no conflicts of interest
Additional information
Notes on contributors
Tae Woo Park
All coauthors provided substantial contributions to the conception or design of the work, or acquisition, analysis, or interpretation of data for the work, and helped with drafting the work or revising it critically for important intellectual content. All coauthors approve the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. T.P. is the guarantor for the study, had full access to all of the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Richard Saitz
All coauthors provided substantial contributions to the conception or design of the work, or acquisition, analysis, or interpretation of data for the work, and helped with drafting the work or revising it critically for important intellectual content. All coauthors approve the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. T.P. is the guarantor for the study, had full access to all of the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Kerrie P. Nelson
All coauthors provided substantial contributions to the conception or design of the work, or acquisition, analysis, or interpretation of data for the work, and helped with drafting the work or revising it critically for important intellectual content. All coauthors approve the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. T.P. is the guarantor for the study, had full access to all of the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Ziming Xuan
All coauthors provided substantial contributions to the conception or design of the work, or acquisition, analysis, or interpretation of data for the work, and helped with drafting the work or revising it critically for important intellectual content. All coauthors approve the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. T.P. is the guarantor for the study, had full access to all of the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Jane M. Liebschutz
All coauthors provided substantial contributions to the conception or design of the work, or acquisition, analysis, or interpretation of data for the work, and helped with drafting the work or revising it critically for important intellectual content. All coauthors approve the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. T.P. is the guarantor for the study, had full access to all of the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Karen E. Lasser
All coauthors provided substantial contributions to the conception or design of the work, or acquisition, analysis, or interpretation of data for the work, and helped with drafting the work or revising it critically for important intellectual content. All coauthors approve the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. T.P. is the guarantor for the study, had full access to all of the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.