A qualitative study of benzodiazepine/z-drug and opioid co-use patterns and overdose risk
Harm Reduction Journal,
Journal Year:
2025,
Volume and Issue:
22(1)
Published: Feb. 27, 2025
Abstract
Background
Co-use
of
benzodiazepines
and/or
‘z-drugs’
along
with
opioids
is
linked
to
the
rise
in
drug
related
deaths
(DRD)
UK.
Understanding
patterns
co-use
could
inform
harm
reduction
strategies
for
reducing
DRDs.
This
study
explored
how
people
co-use,
including
dosages,
timings,
methods
administration,
use
other
substances
and
desired
effects
sought.
Methods
Forty-eight
semi-structured
interviews
across
Glasgow
Scotland
(n
=
28),
Bristol
10)
Teesside
England
individuals
who
illicit
prescribed
benzodiazepines/z-drugs
were
conducted.
Eighteen
co-facilitated
qualitatively
trained
local
peer
researchers.
Interviews
analysed
using
Framework
method.
Results
Six
generated:
(1)
aid
sleep
or
come
down,
(2)
curated
opioid
agonist
therapy
(OAT)
only
(3)
morning
evening
benzodiazepine
doses
throughout
day
(4)
binges
(5)
day,
(6)
plus
OAT.
Patterns
one
three
reflected
more
controlled
a
focus
on
self-medicating
give
confidence,
manage
anxiety,
promote
come-down
from
cocaine/ketamine.
four
six
involved
greater
poly-drug
use,
less
seeking
euphoria
(“warm
glow”,
“gouching
out”)
oblivion
(to
escape
untreated
mental
health
conditions
trauma).
two,
three,
five
daily
co-use.
People
switched
between
depending
available
resources
(e.g.
finances)
changes
prescriptions
(opioids
benzodiazepines).
Near-fatal
overdoses
reported
by
participants
all
patterns.
conceptualised
as
presenting
overdose
risk
due
extensive
polydrug
use.
Conclusions
The
identified
provide
opportunities
future
strategies,
tailoring
advice
updated
prescribing
guidance
policies,
need
better
access
care,
reduce
Language: Английский
The implementation of safer drug consumption facilities in Scotland: a mixed methods needs assessment and feasibility study for the city of Edinburgh
Harm Reduction Journal,
Journal Year:
2025,
Volume and Issue:
22(1)
Published: Jan. 13, 2025
Scotland
currently
has
amongst
the
highest
rates
of
drug-related
deaths
in
Europe,
leading
to
increased
advocacy
for
safer
drug
consumption
facilities
(SDCFs)
be
piloted
country.
In
response
concerns
about
harms
Edinburgh,
elected
officials
have
considered
introducing
SDCFs
city.
This
paper
presents
key
findings
from
a
feasibility
study
commissioned
by
City
Edinburgh
Council
support
these
deliberations.
Using
multi-method
needs
assessment
approach,
we
carried
out
spatial
and
temporal
analysis
data
including
health,
mortality,
consumption,
crime
service
provision
indicators;
48
interviews
22
people
with
lived/living
experience
(PWLE)
use
city,
five
family
members
affected
harms,
21
professional
stakeholders
likely
involved
commissioning
or
delivering
SDCFs.
Data
were
collected
using
convergent
parallel
design.
We
descriptive
quantitative
date
thematic
qualitative
data.
Quantitative
provides
an
overview
local
context
terms
recorded
patterns
as
reported
prior
surveys.
Qualitative
PWLE
families
captures
lived
experiences
who
drugs,
loved
ones,
within
that
context,
perceived
trends,
views
on
practicality
SDCF
provision,
hopes
anxieties
regarding
potential
provision.
Professional
insights
into
how
responsible
strategic
planning
delivery
view
role
described
are
dispersed
across
multiple
locations,
some
areas
higher
concentration.
Reported
levels
opioid
use,
illicit
benzodiazepine
cocaine
injecting
high.
revealed
strong
SDCFs,
preference
services
include
peer
delivery.
However,
also
expressed
safety
security,
remained
uncertain
prioritisation
possible
opportunity
costs
face
restricted
budgets.
There
is
case
Edinburgh.
design
reflect
distributions
harm,
type,
preferences
both
informality
security
among
users.
Models
used
elsewhere
would
therefore
need
adapted
such
considerations.
These
may
apply
more
broadly
UK
internationally,
given
changing
harm.
Language: Английский
Factors associated with SARS-CoV-2 testing, diagnosis and COVID-19 disease among individuals prescribed opioid-agonist treatment: a nationwide retrospective cohort study
Clinical Microbiology and Infection,
Journal Year:
2024,
Volume and Issue:
30(10), P. 1312 - 1318
Published: June 25, 2024
ObjectivesAmong
people
receiving
opioid-agonist
treatment
(OAT),
the
risk
of
COVID-19
infection
and
disease
may
be
higher
owing
to
underlying
health
problems
vulnerable
social
circumstances.
We
aimed
determine
whether
recent
OAT,
when
compared
with
past
exposure,
affected
(i)
testing
for
SARS-CoV-2,
(ii)
positive
(iii)
being
hospitalized
or
dying
disease.MethodsWe
included
individuals
prescribed
OAT
in
Scotland
from
2015
2020.
performed
record
linkage
SARS-CoV-2
PCR
testing,
vaccination,
hospitalization,
mortality
data,
followed
up
March
2020
December
2021.
used
proportional
hazards
analysis
multivariate
logistic
regression
estimate
associations
between
prescription
(in
previous
2
months),
exposure
(off
over
a
year),
outcomes.
Models
were
adjusted
confounders.ResultsAmong
36
093
19
071
(52.9%)
tested
SARS-CoV-2;
2896
(8.3%)
positive;
552
(1.5%)
died
COVID-19.
Recent
was
associated
lower
odds
among
those
(aOR,
0.63;
95%
CI,
0.57–0.69).
However,
positive,
two-fold
hospitalization
death
2.04;
1.60–2.59).DiscussionWe
found
that
infection,
but
once
diagnosed.
Clinical
studies
are
needed
unravel
role
these
associations.
An
enhanced
effort
is
warranted
increase
vaccine
coverage
patients
mitigate
severe
consequences
Language: Английский
Suicide in people prescribed opioid‐agonist therapy in Scotland, United Kingdom, 2011–2020: A national retrospective cohort study
Addiction,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Oct. 22, 2024
Abstract
Background
and
aims
Opioid
dependence
is
associated
with
an
increased
risk
of
suicide.
Drug‐related
mortality
among
people
opioid
in
Scotland
has
more
than
tripled
since
2010;
less
known
about
changes
suicide
risk.
We
aimed
to
determine
if
agonist
therapy
(OAT)
protective
against
measure
trends
rates
those
over
time.
Design
Retrospective
cohort
study.
Setting
Scotland,
UK.
Participants
46
453
individuals
who
received
at
least
one
prescription
for
OAT
between
2011
2020
304
000
person‐years
(pys)
follow‐up.
Measurements
calculated
standardised
ratios
(SMR)
using
the
age‐
sex‐specific
years
2011–2020.
fitted
multivariable
competing‐risk
regression
models
estimate
by
exposure
time,
adjusting
potential
confounders.
Findings
There
were
575
deaths
classed
as
overall
rate
was
1.89
(95%
confidence
interval
[CI]
=
1.74–2.05)
per
1000
pys.
Age
sex
SMR
7.05
times
CI
6.50–7.65)
higher
general
population.
After
adjustment,
shown
be
highly
suicide,
three
greater
(adjusted
hazard
ratio:
3.07;
95%
2.60–3.62)
off
compared
on
OAT.
Suicide
decreased
falling
from
2.57
2.19–3.02)
pys
2011–12
1.48
1.21–1.82)
2019–20.
Conclusion
People
appear
have
a
Treatment
protective,
lower
therapy.
during
period
which
drug‐related
death
risen
globally
high
levels.
Language: Английский
Estimating prevalence of opiate and crack cocaine use and injecting in England using mixed-effects capture–recapture models
Journal of the Royal Statistical Society Series A (Statistics in Society),
Journal Year:
2024,
Volume and Issue:
188(1), P. 68 - 83
Published: Dec. 16, 2024
Abstract
Multiple
social
and
health
problems
are
associated
with
opiate
crack
cocaine
use
injecting,
but
the
prevalence
of
these
behaviours
is
unknown.
We
linked
three
sources
administrative
data
on
individuals
engaging
in
and/or
(OCU)
community
treatment;
arrests,
prison,
or
probation;
drug-related
deaths.
used
probabilistic
linkage
to
increase
number
matching
records
capture-recapture
analysis
estimate
unknown
not
observed
any
source.
fitted
random
effects
models
stratified
by
source,
local
authority
(LA)
area,
age,
sex,
drug
type,
injecting.
Two-way
interactions
between
explanatory
variables
were
included
as
fixed
effects.
at
LA
level,
intercepts
coefficients.
The
total
count
and/
financial
year
2018/19
was
estimated
336,531
[95%
confidence
interval
(CI):
311,932-360,845],
corresponding
9.44
(95%
CI:
8.75-10.12)
per
1,000
population
England.
Three-quarters
men,
people
currently
injecting
drugs
67,715
64,769-70,526).
Our
study
borrow
strength
across
authorities
produce
robust
estimates
OCU
for
England
Language: Английский
Bolstering the HIV Surveillance System Through Innovative Methods, Technologic Advances, and Community-Driven Solutions to Inform Intervention Efforts and End the Epidemic
Current HIV/AIDS Reports,
Journal Year:
2024,
Volume and Issue:
22(1)
Published: Dec. 17, 2024
An
accurate
and
comprehensive
HIV
surveillance
system
is
critical
to
understanding
the
burden
of
infection.
Reliable
estimates
into
serve
as
cornerstone
for
prevention
treatment
programs.
In
this
article,
we
review
current
structure
function
in
US,
identify
gaps
reporting,
propose
multiple
potential
interventions
augment
system.
Recent
literature
demonstrate
that
substantial
reporting
health
departments
from
clinical
providers
exist.
These
include
stigma,
knowledge
requirements,
inaccurate
direct
testing
estimates,
errors,
lack
community
engagement.
All
these
place
a
on
departments,
hinder
responses,
effect
funding.
Leveraging
partnerships,
technologic
advances,
emerging
methodologies
may
fill
some
gaps.
Advancements
self-testing,
broad
testing,
indirect
statistical
methods,
machine
learning
bolstered
by
engagement
oversight
could
modernize
achieve
Ending
Epidemic
goals.
Language: Английский